Making the tough decisions

As all of you know, the President-elect has proposed a plan to reform this country's health care system. According to PricewaterhouseCoopers' Health Research Institute, Obama's plan could cost up to $1 trillion dollars over the next decade (http://www.bizjournals.com/nashville/stories/2008/11/10/daily34.html). While some might argue that this is a reasonable price to pay for such a plan, what about other priorities that this money could be spent on? Making decisions about the allocation of government resources is incredibly challenging; Sarah and I just got through a three-week long simulation exercise where we were assigned roles of members of the US House of Representatives and had to pass a budget resolution aimed at decreasing the national debt to $42B by the year 2012. Sarah was John Boehner, and I was Nancy Pelosi (yes, our friendship survived). We were given a copy of CBO's 2008/2009 "Budget Options" handbook that outlined the programs and revenue options we had to work with in designing our proposals. This was one of the hardest things I have ever done. The rest of the Democratic leadership and I solicited feedback from our party members (there were 36 Democrats and 24 Republicans), and went about designing our budget. Everyone was assigned a role, and had to make decisions based on how their member of Congress would make his or her decisions. Balancing these was, at times, painful. My friend Evan (James Clyburn in the simulation) and I had at least two twelve-hour days where we had to go through the options and weigh things like whether we wanted to cut Medicare funding for patients with ESRD or cancel the military's F-35 Joint Strike Fighters (these are actual options in CBO's handbook). It sounds absurd, but we had to make cuts and balance the interests of an extremely diverse group of Democrats (and, in the end, moderate Republicans). It was a fun, if somewhat exhausting, exercise, and it taught me a lot about negotiating and compromise, and the importance of understanding why you have made a decision, and being able to defend your stance. If any of you are interested, you should take John Ellwood's PP250 course next fall!