The War, Health Insurance, And The Budget

In a rare and welcome sign that the WaPo editorial board is responsive to readers, Fred Hiatt's outfit published the following editorial last Saturday:

A reader recently challenged us to explain what he sees as a contradiction in our editorial positions. We support the goal of universal health care, but argue that President Obama must keep his pledge not to pay for it with borrowed money. We have also backed Gen. Stanley A. McChrystal's request for additional troops and other resources for Afghanistan -- but without specifying how the reinforcements should be funded. Why is it okay to finance wars with debt, asks our reader, but not to pay for health care that way?

Good question, no? Here's their short version of the answer:

Wars end, and the spending for them tapers off; entitlement programs must be funded in perpetuity. Wars compel decisions, like the one now at hand; new entitlement programs can be phased in or delayed. And the nation's security must be the president's first priority.

But the war on terror has been defined as unending. And although the Cold War is over, American troops remain all over the globe, in vast numbers in Germany and South Korea, and still - remember! - in Iraq and now more and more in Afghanistan. The truth is: wars are for ever, or at least as for ever as any budgetary process can determine. And secondly, the question of whether a war is vital for national security is an open one in any particular case.

Just because a president says it's necessary - as Bush did with Iraq - doesn't make it so. Assume that, say, that the war in Afghanistan could prevent another 9/11 attack (I'm not sure exactly how, but bear with me). Such an attack killed 3,000 people. As Greenwald points out, plenty of studies find that as many or more people die each year in the US for lack of health insurance. Are deaths from terrorism somehow more of a problem than deaths from lack of healthcare? Especially when the federal government actually has a feasible plan for saving those lives but has no convincing plan for victory in Afghanistan, whatever victory might now mean?

I think the WaPo is right to insist that universal health insurance be budgeted so that taxes are either raised or other spending cut to accommodate it (unlike the last actual entitlement, the Republican Medicare Prescription Act). But it seems to me essential that warfare not continue to be treated as some kind of rare and one-off expenditure. An empire that is running an annual deficit of over $1 trillion cannot make decisions about national security without also assessing the economic and fiscal costs. The time for delegating this to deciders is surely over. And the time to give deference to mere mentions of the words "national security" is surely over as well.