How Obama can make health care better without Congress
By Bruce Walker
We are, President Obama informs us, in need of health care reform. Congress may be deadlocked on the issue. Obama seems to speak as if congressional inaction on improving health care means no federal action on improving health care. He needs to read the Constitution and, even more, he needs to review all the powers which Congress and federal courts have given to the Presidency. President Obama could take action to improve our nation's health care system right now.
Consider the savings which President Obama intends to get from reducing fraud, waste, and abuse in Medicare and Medicaid. Three months ago, on June 13, he identified $313 Billion that could be saved this way. The Executive Branch, not Congress, executes the laws and regulations of the nation. If there are such massive savings by better and more honest execution of the laws, programs, and regulations of Executive Branch agencies, then Barack Obama should make that a priority right now, without waiting for Congress to act. In fact, fighting this fraud and waste is purely an Executive Branch function.
It is almost as if Obama is telling Congress "If you pass my giant, almost incomprehensible health care reform, I will start to do my job by reducing waste, fraud, and abuse in Medicare and Medicaid, and that will produce savings which will help pay for the reforms you pass." This is the same sort of silliness that President Bush suggested when he was pushing immigration reform "If Congress passes my immigration reform bill, I will start enforcing existing laws regarding immigration." In both these examples, the duty of the president is to execute the laws and run the executive departments faithfully. That includes stopping fraud, criminality, and waste – regardless of what Congress does.
America had a health care crisis almost fifty years ago. JFK, soon after he became president, took note of the inactivity and obesity of American children. He built upon a program that Eisenhower had started to encourage exercise, particularly in public schools. John Kennedy did not ask Congress to pass massive reforms. Instead, Kennedy acted. Bud Wilkinson, the very successful and well respected coach of the Oklahoma Sooner's football team (and also a Republican), was selected by JFK to improve physical fitness in schools and other places.
Why doesn't Obama do that? JFK did not even have a United States Department of Education to help implement a major improvement in physical education in public schools. Obama could pick someone – ideally, a Republican like Joe Paterno or Lance Armstrong – who is very well respected and who can communicate the value of physical education in schools. Doubtless the Department of Education could find ways to strongly encourage public schools which did not have mandatory physical education to re-introduce it into the curriculum.
Obama does not need anything – money, authority, laws – to do just what JFK did. The overwhelming majority of Americans would find this a long overdue and valuable program to combat the growing health problem caused by obesity among our young. This Executive Branch action would be simple, direct, and uncontroversial. There is no reason why Obama, who has found time to expound on a college football playoff system or speculate about which team will win the NCAA Basketball Tournament, could not dedicate as much energy and attention to a JFK style plan for physical fitness for our schoolchildren.
The Food and Drug Administration has for decades delayed approving drugs in America which have been used successfully for many years by other modern industrial nations. If there is one aspect of the health care system of Britain, Sweden, Holland, and Canada which Americans should look at closely, it is the approval process for new drugs. Fortunately, all the FDA really has to do is piggy-back on the precautionary tests and the history of other advanced nations.
President Obama, through his cabinet officers, runs agencies like the FDA. He or HHS Secretary Sebelius can issue orders, directives, and regulations. They can allocate and reallocate staff and other resources to speed up the process of FDA certification. Significant numbers of Americans die each year because the FDA has not yet approved for use in America drugs that have been used for years in other nations. Even more Americans unnecessarily suffer because drugs which can be prescribed in other nations cannot be prescribed here to relieve pain, reduce symptoms and improve the quality of life.
Without waiting for congressional approval, which he does not need to end fraud in Medicaid, push our schools to bring back physical education, or streamline the process of FDA approval of drugs, President Obama could begin to make health care in America better and less costly right now. In fact, if Obama as president did all that he could to make these changes, he would have a much better case in asking Congress for new legislation: "I have done, as president, what I can."
But that assumes that President Obama actually wants to improve health care in America. In fact, all the countless speeches, all the vastly complex congressional bills, all the relentless insistence that America is in crisis, are all intended to accomplish just one thing: Obama was to gain giant chunks of power and authority for the federal government at the expenses of individual Americans. It is not a reform of our health care he seeks; it is a reform of the balance between personal liberty and government control.
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