SECRETARY of Health and Human Services Louis Sullivan may have started something with his letter to White House budget director Richard Darman complaining about the program cuts demanded by Mr. Darman. The secretary said the cuts would adversely affect the disabled, poor expectant mothers, and others who rely on HHS funds for basic care. He's probably right. But under last fall's five-year, $500 billion spending-reduction agreement, the kind of chopping here and adding there - without any overall increases - being practiced by Darman is unavoidable. The question is, what should be cut to make room for expansion elsewhere?
Secretary Sullivan's concerns over priorities will echo through the coming deliberations in Washington over the 1992 budget. His concerns are well placed. Medicare payments to inner-city hospitals, prenatal care, nutrition programs are measures of societal compassion for people on the economic fringe. They should be sustained at the highest level possible.
But Office of Management and Budget chief Darman has his own definition of what's possible. Last fall's budget agreement gives him - and hence the administration - tremendous authority to determine what fits within the agreed limits and what doesn't.
However the tussle between HHS and OMB comes out, President Bush doesn't have to worry about budget-busting by Congress. The spending ceilings are in place.
That sounds like a straitjacket, but in fact many in Congress may welcome the opportunity to tell constituents that it wasn't their fault a favored program got cut - it was the new system at work.
For his part, the president can stand aside during the next year and let Congress wrestle with the puzzle of how to make things fit. But his relative ease could be short-lived as the recession eats into tax revenues, causing the deficit to grow regardless of spending ceilings.
People pondering whom to vote for in 1992 could start asking who's to blame for government's inability to do anything creative - and expensive - to soften the downturn.