FYI on Federal Budgets.

[Nicholas D Wolfwood]

Just so we're all on the same page here: In a legal sense, the President's budget is pretty much meaningless. It has no force of law whatsoever (remember, power of the purse resides with Congress.) It exists solely as a political document - basically, he gets first crack at starting the debate over how we spend money, but ultimately, it means nothing beyond that.

While we're at it, Congress will start working on their version of the budget soon. Believe it or not, it will mean relatively little as well. Many years, they don't even bother finishing the budget (I don't think last year's was voted upon). It is a little more meaningful than the President's, however. It does have the impact of setting an overall cap to how much the Appropriations Committee can spend during that budget's fiscal year. However, how and where that money gets spent is solely up to the Appropriations Committee. They do, however, typically use their budget to set their 302 (b) allocations, which do cap the amount that can be spent by a subcommittee on the appropriations bill that comes under their jurisdiction.

To sum things up - the budget means very, very, very little and it has no force of law. Politically, it might be a powerful tool, but it is only a tool.

[pinto]

1. Yeah, thanks for the reminder. The President's budget is a political blueprint.

A heads up to Congress along the line of "here's where I want you to take us". Congress picks up the ball from there as far as actual spending legislation and the process that follows.

[tritsofme]

2. Thank you for this post.

There seems to be some thinking going on here that the budget is a magic bullet. It is not.

[DuaneBidoux]

3. I would like to get a little input on some things that I find puzzling.

(and it's possible nobody really is getting the story straight)

I hear the budget ends the mortgage deduction. That does not at all seem to make sense when you are trying to get the housing market going again and put a floor under prices. It also doesn't make sense to me to take away a middle class tax deduction while lowering taxes on the same people somewhere else.

The other thing, and this concerns me a great deal more--is the reduction to doctors under medicare and medicaid. This especially goes for GPs, who are not at the core of our healthcare problems and are having trouble making it now (my own gp makes about $110,000 for about 50 hour weeks, and don't forget, he is self employed).

What has been happening, especially in rural areas where there is already a shortgage and where expenses are high for gps is that doctors have quit accepting new medicare patients. My father, who is 73 recently had a small stroke in a rural region of Arkansas. They had to drive almost 70 miles to find a doctor who was taking new medicare patients. The medicare payments are already money losers for GPs and this is not acceptable to me.

There are a lot better places to get this money than on the back of GPs.

[crimsonblue]

4. Doctors aren't getting reductions in medicare/medicaid.

In fact, as a result of the Stimulus Bill, Doctors get 2% extra of the medicare payments. Plus, if every person has health insurance, then doctors will make more money, as non-payments go down and the need for bill collectors is eradicated.

[DuaneBidoux]

12. Thanks for clarifying. I'm sure there will be a lot of bs swirling around this for a long time.

[FrenchieCat]

6. I haven't heard that the budget ends the mortgage reduction,

only that it ends it for the top tier in a progressive manner....i.e., the higher your income beyond $250,000, the less of a deduction you get.

[lumberjack_jeff]

7. "money losers" is a relative term.

Certainly there are more profitable patients, than those on medicare, but I don't think that $110k is inadequate.

[DuaneBidoux]

9. Don't forget, most of these doctors enter practice with six digit debt.

My own friend had $210,000 in medical school debt and this is exactly why he decided to go another year and a half and then became and anethesiologist (he now makes nearly $400,000 (and not only could he afford some cut in income he is progressive and is willing to do some sacrificing)).

I do know for a fact that for many medicare patients they are now literal money losers (for GPs only).

[lumberjack_jeff]

5. It is a political blueprint...

... from a president in the majority party who enjoys almost 70% approval for his major initiatives.

It won't get passed verbatim, but it's not meaningless.

[Nicholas D Wolfwood]

11. As I said, it is a political tool, but it has no real force outside of that. (nt)

[damonm]

8. True, yet bear in mind...

The appropriations and budget are bills all, and cannot become law until they are signed by the President.
I wouldn't call that meaningless. He can stop a budget and/or appropriations though the veto, and thus has a good deal of say in the final product.

[Nicholas D Wolfwood]

10. President cannot veto the budget.

Because the budget is never signed into law.

[damonm]

13. I'm sure Bill Clinton would be surprised...

...since he did precisely that:

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C02E1DF1F39F934A35751C1A963958260

And W. apparently didn't need to sign the budget bill into law in 2006:

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=35316


Moreover, the President can veto any appropriations bill.

Care to try again?

[Nicholas D Wolfwood]

14. Budget Reconciliation is NOT the same as a budget.

Try again yourself. The budget reconciliation is a deficit reducing measure that actually does have the force of law and effectively either cuts spending or raises taxes. It's an entirely different piece of work.

[damonm]

15. OK, stipulated that the budget itself does not have force of law -

but the appropriations (the actual spending) do - and THOSE are subject to veto, and are a De Facto veto of the budget. And the President can veto any appropriations that DON'T include healthcare, so it still works until we have the 60+ seat majority in 2011. Then we can put it into law over the backbencher's heads.

[Nicholas D Wolfwood]

17. He can veto them, sure.

But that would wind up in a government shut down, in which, historically speaking, the instigator never wins. Obama would certainly be the instigator under those circumstances.

Bush vetoed last year's appropriations bills, which is why they're just now passing the omnibus spending package for FY 2009.

[damonm]

18. But we speak here of...

having a GOP Congress during Obama's term.

Honestly, how likely is that?
The've had the shit kicked out of them in 2 straight election cycles, and their poll numbers are in the toilet and heading down. Prospects as of now look as if the Democrats will pick up at LEAST one seat in the Senate, as Robin Carnahan has a solid lead over any GOPer in the run for Kit Bond's MO seat. OH and FL could go either way. Sam Brownback's KS seat may be picked up by Kathleen Sebelius.
So, putting healthcare in the budget for now is a smart move. Later, not so much.

[Nicholas D Wolfwood]

19. I'm not entirely sure we'd get 100% Dem support on this.

I'm not saying anything about it being a smart move - surely it is. I'm just saying not to act like it's fait accompli just because it showed up in the budget.

[Nicholas D Wolfwood]

16. Here's info on the budget reconciliation process

http://www.rules.house.gov/archives/bud_rec_proc.htm
http://fpc.state.gov/documents/organization/52675.pdf