Obama can do a lot to promote clean energy in his first 100 days without picking a divisive fight to transform the petroleum industry; the same goes for health care. Before he tries to revolutionize the system, as President Clinton tried to his everlasting regret, Obama ought to consider a few less controversial steps in the right direction. The obvious place to start is the children's health-insurance expansion that Bush vetoed twice last year. With medical errors now the eighth leading cause of death in the U.S., Obama should upgrade medical technology as part of his stimulus package; a VA hospital in Kansas cut its medication-error rates 70% after implementing wireless technology and bar-coding. Obama could appeal to conservatives by doing more to protect doctors — especially obstetricians and emergency-room docs — from lawsuits that make malpractice insurance unaffordable.
To address spiraling health-care costs — which will be 25% of GDP within two decades — Obama should create a Comparative Effectiveness Institute. As dull as that policy shop might sound, the Federal Government desperately needs unbiased research to figure out what's working. Congressional Budget Office head Peter Orszag has been passing around a Medicare graphic illustrating the relationship between the amount of spending and the quality of care by state; the point of his random assortment of dots is that there doesn't seem to be much of a relationship whatsoever. Before Obama risks his presidency to revamp health care, he ought to make sure he understands what's wrong with it.
Of course, liberal Democrats will complain if he doesn't push universal health coverage and strict carbon limits right away. Congressional leaders of both parties will circle their wagons around their beloved highway, water and farm bills. Conservative Republicans will surely accuse him of Big Government socialism at home and weakness abroad. And the austerity scolds will fulminate about the ever expanding debt he'll dump on future generations. But Obama is going to be judged by his results, and it will be hard for him to make things worse. If the country is on the rebound in a couple of years, he'll gather even more political capital to start tightening federal belts and digging out of debt.
Then he can start listening to the austerity scolds.