[Government bankruptcy] is not inevitable; it is theoretically possible to raise taxes to cope with Medicare growth, though it would be extraordinarily painful to do so. In the face of fiscal crisis, it might also be possible to make Medicare cuts that we have otherwise been unable to stick with. But as any competent development economist will be happy to tell you, every dollar you add, or interest group you create, makes it less likely that this sort of resolution will happen.
Matt Steinglass counters:
Right now, Medicare cuts are politically off-limits. You need to have a countervailing political claim to make them possible. The need to create universal health insurance coverage is that countervailing claim. Our political system has never been able to approach the idea of cuts to Medicare. Until now. Barack Obama is the first president who may be able to pass Medicare cuts, because he’s doing it as part of a bid for universal health insurance.