For those who missed President Bush's State of the Union address last Tuesday, you have only to read the analysis of Paul Krugman ("State of Delusion") and E.J. Dionne ("Another Bush Deficit: Ideas") to get the gist of it.
Krugman writes in the New York Times:
The State of the Union is normally an occasion for boasting about an administration's achievements. But what's a speechwriter to do when there are no achievements?E.J. Dionne draws attention to Bush's deficiencies regarding healthcare in the Washington Post:
One answer is to pretend that the bad stuff never happened. The Medicare drug benefit is Mr. Bush's largest domestic initiative to date. It's also a disaster: at enormous cost, the administration has managed to make millions of elderly Americans worse off. So drugs went unmentioned in the State of the Union.
Another answer is to rely on evasive language. In Iraq, said Mr. Bush, we've "changed our approach to reconstruction."
In fact, reconstruction has failed. Almost three years after the war began, oil production is well below prewar levels, Baghdad is getting only an average of 3.2 hours of electricity a day, and more than 60 percent of water and sanitation projects have been canceled.
So now, having squandered billions in Iraqi oil revenue as well as U.S. taxpayer dollars, we've told the Iraqis that from now on it's their problem. America's would-be Marshall Plan in Iraq, reports The Los Angeles Times, "is drawing to a close this year with much of its promise unmet and no plans to extend its funding." I guess you can call that a change in approach.
There's a common theme underlying the botched reconstruction of Iraq, the botched response to Katrina (which Mr. Bush never mentioned), the botched drug program, and the nonexistent energy program. John DiIulio, the former White House head of faith-based policy, explained it more than three years ago. He told the reporter Ron Suskind how this administration operates: "There is no precedent in any modern White House for what is going on in this one: a complete lack of a policy apparatus. ... I heard many, many staff discussions but not three meaningful, substantive policy discussions. There were no actual policy white papers on domestic issues."
In other words, this administration is all politics and no policy. It knows how to attain power, but has no idea how to govern. That's why the administration was caught unaware when Katrina hit, and why it was totally unprepared for the predictable problems with its drug plan. It's why Mr. Bush announced an energy plan with no substance behind it. And it's why the state of the union — the thing itself, not the speech — is so grim.
Bush endorsed "wider use of electronic records and other health information technology," promised to "strengthen health savings accounts," pledged to make insurance more portable, and issued yet another of his standard attacks on medical malpractice lawsuits.
Hurray for electronic records and portability. But this list does little to help either the uninsured or those who fear losing their coverage. And health savings accounts aren't really health plans. They're tax-avoidance investment vehicles -- Wall Street can't wait -- that will mostly help the healthy and the wealthy while raising costs for the sick. That's not wise.
Here is Opportunity No. 1 for a smart opposition. It's time for aggressive approaches to expanding the number of Americans with insurance. The government should commit itself to making sure that all children under 18 are covered, and workers between the ages of 55 and 65 should be able to buy into Medicare, with subsidies if they need them, because many approaching retirement have a hard time buying private policies.
And it's time to open what might be thought of as both a dialogue and a negotiation with the business community on what the split between public and private spending on health care should be. Businesses that provide broad health coverage are indirectly subsidizing businesses that don't. Businesses that fail to provide coverage, especially for low-paid workers, often count on public programs, i.e., the taxpayers, to pay their employees' health bills.
The system is bad for capitalism, for social justice and for taxpayers. Employers who now pay nothing for health care should kick in to help pay the bills. Businesses being strangled by health costs deserve some relief. And, yes, the government will need to fill in the gaps.
When Bush got around to calling for a bipartisan commission "to examine the full impact of baby boom retirements on Social Security, Medicare and Medicaid," Democrats chuckled. This from a president who tried to ram through the partial privatization of Social Security last year on the basis of the political "capital" he said he had earned. That capital is gone. The commission is his bailout.