$634 billion for health care in Obama's budget

Obama said he was serious about health care. His budget is serious about health care. Very serious:

President Obama is proposing to begin a vast expansion of the U.S. health-care system by creating a $634 billion reserve fund over the next decade, launching an overhaul that most experts project will ultimately cost at least $1 trillion.

The "reserve fund" in the budget proposal being released today is Obama's attempt to demonstrate how the country could extend health insurance to millions more Americans and at the same time begin to control escalating medical bills that threaten the solvency of families, businesses and the government.

Obama aims to make a "very substantial down payment" toward universal coverage by trimming tax breaks for the wealthy and squeezing payments to insurers, hospitals, doctors and drug manufacturers, a senior administration official said yesterday.

Embedded in the budget figures are key policy changes that the administration argues would improve the quality of care and bring much-needed efficiency to a health system that costs $2.3 trillion a year.

By first identifying a large pot of money to underwrite health-care reform -- before laying out a proposal on who would be covered or how -- Obama hopes to draw Congress to the bargaining table to tackle the details of a comprehensive plan. The strategy is largely intended to avoid the mistakes of the Clinton administration, which crafted an extensive proposal in secret for many months before delivering the finished product to lawmakers, who quickly rejected it.

I'm impressed by the strategy -- and the number.

UPDATE: Health Care for America Now, a campaign with the sole mission of obtaining "quality, affordable health care we all can count on," is also impressed with this first major step:

"It's one thing to talk about doing comprehensive health care reform this year, but President Obama's proposing a $634 billion down payment on health care shows true commitment to getting it done in 2009," said Richard Kirsch, National Campaign Manager for Health Care for America Now. "The budget is just the beginning. Now we join President Obama in asking Congress to start work on legislation that guarantees quality, affordable health care for all with the choice of a public health insurance plan and standard, comprehensive benefits that meet our needs. We also challenge Members of Congress determined to counter the President no matter what he proposes to put aside petty political gamesmanship and do something valuable for the people they've been elected to represent. The health of our families, our businesses, and our economy depends on it."