Diary

Obama's "scalpel"

I have been trying hard to give the President the benefit of the doubt.  Obviously, he was not my guy, but I don’t want the country to suffer in order for Republicans or conservatives to score political points.  At the same time, inevitably, I was likely going to be wary of him.

During the Presidential debates, the topic of spending cuts and budget priorities came up several times.

McCain, to his credit, offered a fairly specific answer.  He said,  “How about a spending freeze on everything but defense, veteran affairs and entitlement programs.”  We’ll never know whether he would have actually held to that, but at least he put that stake in the ground.

When put to it, Obama was predictably evasive.  He said, “I want to go line by line through every item in the federal budget and eliminate programs that don’t work and make sure that those that do work, work better and cheaper.”  No word yet from the White House on how his “line by line” review is coming.  My guess is that they’ve scrapped such plans as it would surely be anti-stimulus.

The response that was most telling to me, particularly now in hindsight, from Obama was his reaction to McCain’s proposed spending freeze.  He said, “The problem with a spending freeze is you’re using a hatchet where you need a scalpel.”

(In the interest of full disclosure, the above quotes are taken across the first two debates).

Let that comment sink in for just a second.  Scalpel, not a hatchet.

This coming from the man that has just pushed the mother of all bludgeons on all of us. This stimulus is not a surgical strike on the economy. It is an example of government at its worst. At best, it is a crude, blunt object that may have a limited positive impact. At its heart, however, this is Washington being Washington.

If they had wanted a surgical strike. They could have passed tax relief quickly. Cut the payroll taxes. That was low hanging fruit. It would have gotten additional money into paychecks within weeks, and that is money people would have continued to see paycheck after paycheck.

With that relief in hand, they could have then started talking about targeted spending programs, and those programs that might have benefit vs those that were pure pork would have received a much more public treatment.  But no, Washington has to do everything “comprehensively”. They stuffed this thing and now the government has grown. And once the government grows, it never contracts.  Why do major initiatives all have to be comprehensive? Change (and I’m sick of that word, by the way), rarely comes all at once.

Immigration reform? All attempts have been comprehensive. Here’s an idea, deal with the border first. Slow the flood of illegal immigrants to a trickle. Then you can deal with those that are already here.

Health care reform? Again, you don’t have to overhaul everything at once. Most can agree for those that have access to medical care, the services provided in the US are the best in the world. That has to be the starting point. We don’t want to tinker with that quality of care, we want to find way to make it more widely available and less expensive. Granted, the opinions on just how to do that are all over the map. Personally, I would first focus on medical liability reform, which I believe is a large part of the reason for runaway medical expenses. It’s not just the lawsuits and awards against doctors. The threat of such lawsuits has driven malpractice insurance through the roof. That has forced a lot of doctors in small towns to close up shop. Furthermore, the threat of medical liability causes doctors to often order batteries of tests that are irrelevant to a patient’s condition, but in case the worst happens, these physicians are not going to leave themselves open to a trial lawyer saying, “If only this doctor had ordered this test, he / she would still be with us today.” That picture is rarely painted for people as part of the medical debate. Usually, any talk of liability reform degenerates into a battle between rich doctors / insurance companies vs evil trial lawyers (and neither combatant is viewed highly in the public’s eye).

I’m not suggesting fully insulating doctors, but I am suggesting imposing liability limits. Doctors are not infallible. They may make a mis-diagnosis while having a split second to assess a life and death situation. It is unfair to hold them to such a severe standard. If I make a mistake at work, it’s rarely something that can’t be undone by fixing an Excel formula the next day (and also, in many cases, there is no mis-diagnosis on the part of the physician. The patient’s condition or other complications come into play and may result in a bad outcome) . Also, there’s a world of difference between a mis-diagnosis, and gross / criminal negligence. If a surgeon is drunk or under the influence, you should take him / her for all she’s worth, make sure he / she never practices again, and prosecute him / her to the full extent of the law.

Apologies for the medical rant. Medical reform is my own “pet project”. Unfortunately, I’m not in Congress.

But back to the stimulus. Obama has defended the stimulus saying that he can’t take critics of the spending seriously when he inherited a huge deficit. That may be true, but that doesn’t mean you have to make plans to almost double it within your first weeks in office. He also said we don’t have time to make this bill perfect. Few people expect perfect, Mr. President. What we do expect is caution and restraint, and we’re seeing little of that from you thus far.

Scalpel indeed.