Don't Touch the Budget, Just Fix Health Care

Matt Steinglass of The Economist has an interesting defense of liberals who dislike the debt reduction plan because it isn't 98 percent Medicare reform. Liberals want to cut Medicare, he writes. Shouldn't they get credit for that?

[Kevin Drum thinks] the main thing we need to do in order to restrain growth in the deficit and in government spending, which will otherwise bankrupt us, is to cut the biggest government entitlement programme, Medicare.

Of course our long-term budget problem is mostly a health care inflation problem. But we don't know how to solve our health care inflation problem. At least, nobody I've had on the phone from the Brookings Institution, the American Enterprise Institute, the Urban Institute, the Heritage Foundation, or the Treasury Department knows how to fix it. Maybe Kevin and Matt have a politically feasible plan to bend the curve so that health care spending doesn't consume the federal budget by mid-century. If they do, they should stop being coy and publish that plan!

In the meantime: that debt. It's growing. And in some matter of time, it is very likely to spark a fiscal crisis that even the Affordable Care Act cannot solve on its own. To be sure, we don't need to cut spending now. In fact, I think we should raise spending now. But we should also start thinking seriously about long-term plans to pay for our emergency spending and our emerging promises to adults, and we don't have the luxury of rejecting every plan that isn't 98 percent Medicare transformation -- not least because that plan does not exist, to my knowledge.

Matt says he's frustrated that liberals don't get more credit for asking to cut Medicare:

In general, liberals are given no credit whatsoever for acknowledging reality and calling for cuts in social-welfare entitlement programmes.

But $500 billion in Medicare cuts over the next ten years isn't going toward reducing the deficit. It's going toward paying for half of a new trillion-dollar entitlement. The Affordable Care Act might reduce the deficit over the next 20 years, or it might get declawed by compromises and ineffective reforms. Who knows! In the meantime, the debt is growing because the government is spending a trillion dollars more than we earn every year and, unlike the 1940s when we plugged the gap by winning a war, there is no foreseeable end to this generation's red ink. We don't have luxury of rejecting every idea that doesn't rhyme with Medicare.