Many years ago I worked in a public sector health department. As part of my responsibilities I had to help create a budget every 2 years. This budget had to be presented and approved by a board of directors. My boss at the time taught me a very powerful lesson: always include paint mixers in your budget.
A paint mixer you say? Why would a health department put in a request for a paint mixer?
As it was explained to me, the board would look at the budget, and they too would immediately say "A paint mixer? We don't need a paint mixer! No! Take it out!!" And then proceed to approve everything else in the budget almost without question. It worked almost every cycle. Maybe it wasn't ACTUAL paint mixers every time, but there was always some frivolous, large, recognizable thing that they could feel good about cutting from to show that they were being fiscally responsible, before they stamped off on the remainder of the essential things in the budget.
I am reminded of these paint mixers when I read about the plans for Healthcare Reform, and the myriad of options and line items that go into all the different plans. I ask myself, where are the paint mixers?
I wonder if the Public Option is just a paint mixer, because Obama knows if they take THAT out, it will cost them serious political capital that they will have to "buy back" with a host of things like abolishing pre-existing conditions, capping rates, Rx negotiation, etc...
I know it sounds cynical and even a little defeatist that we are already getting set up to accept less than what we want, but my (limited!) experience in public sector budgeting has taught me that it is all a show when it comes time to get something funded. There are always people dealing cards and trading bones on the things that you think are inviolable items in your budget.
So of all the things in the HCR budgets, are any of them worth admitting that they are there for the horse trading? Things that we can keep saying we MUST have, but that we would gladly trade away for the unmixed paint of a public option?