The First 100 Days: Obama and the Welfare State
The First 100 Days: Obama and the Welfare State
The First 100 Days: Ted Marmor
President-elect Obama has used the first weeks following his electoral victory for two main ends: to prudently select his cabinet and White House staff and to boldly call for an economic stimulus package that would have satisfied John Maynard Keynes.
But what are three things President Obama should do on taking office?
My first suggestion is obvious in one respect and not in another. It is for President Obama to limit the appeal to FDR’s first hundred days of reform to his economic stimulus plan. The need here is immediate; the ideas for action are reasonably clear, and the president’s team is experienced and ready.
But the context for the economic stimulus plan is not the same for many of our social welfare problems. There is much to be worked out–and intense conflicts to be resolved–concerning what to do about health care costs, Medicare reform, the fiscal strains on Medicaid, and what, if anything, needs to be done about Social Security pensions, disability insurance, and long-term unemployment policy.
My second suggestion is thus that the new Administration begin a broad review of the social welfare legacy of the Bush Administration and the Republican-dominated Congresses since 1994. The legacy of this period requires fundamental adjustments and calls not for immediate action but rethinking. The President-elect should address in a set of major speeches what kind of welfare state he thinks America should embody, particularly with regard to the problems caused by the growing longevity of Americans.
My third suggestion is that the president take on the problem of how the United States can extend health insurance to all its citizens. There are many ideas about how to do that, but considerable institutional barriers to bringing the doable and the desirable together. The good news is that former Senator Tom Daschle, the new secretary of health and human services, will be leading the health care reform effort. His 2008 book, Critical: What we Can Do About the Health Care Crisis, is historically informed, alert to the pitfalls of prior reform efforts, and calls for what is crucial to future health care reform. Daschle, unusually for D.C. insiders, emphasizes realistic cost controls, recognizes that it is possible to get to universal health insurance by aggregating many different programs, and realizes that such a plan requires common rules enforced by what he calls the national health board.
Ted Marmor, the author of The Politics of Medicare, now teaches part-time at Harvard’s Kennedy School of Government.
