Getting Serious About Deficit Cutting

Getting Serious About Deficit Cutting

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Joe White appropriately seeks to focus our attention on spiraling costs across the U.S. health care system, rather than on the spiraling costs just in federal health care programs. Indeed, the former is largely what drives the latter, for the two systems are closely connected in the ways that he describes. But, he uses a bit of a straw man on the front end and takes his argument too far on the back end.

First, the front end. Despite the impression that White leaves, not all fiscally hawkish institutions and individuals are oblivious to what's driving federal health care spending.

In the private sector, the Center on Budget and Policy Priorities – which frequently issues reports about our dire long-term fiscal situation and urges policymakers to enact deficit-cutting steps to take effect when the economy recovers enough from the recession – has made clear that comprehensive health care reform is the key to controlling health care costs at the federal level and, in turn, addressing the long-term deficit challenge.

In the public sector, President Obama's top economic advisors understand the connection as well, which explains why hawkish Budget Director Peter Orszag has played a leading role in the president's push for comprehensive health care reform.

Nor are these hawks oblivious to the reality that system-wide health care spending increases are economically unsustainable. Some hawks may, as White suggests, ignore the larger picture, but many do not.

Now, the back end. White tells us that "the conventional wisdom that spreads fear about a 'long-term budget crisis' due to an 'aging society' and excess entitlements to health care is badly misguided," and that "for the good of both the country and the budget," policymakers should "get serious about controlling all health care costs, soon – and stop talking about 'entitlement costs' in the future."

Yes, but that's no simple matter, as the current health care debate makes clear. Moreover, no one is terribly sure how to control health care costs – at least in a politically palatable way. White may not be "impressed" by the cost control measures in the pending House and Senate health bills, but some experts believe they include most of the more promising ideas for controlling costs.

Meanwhile, deficits and debt continue to rise, driven by the "Big 3" entitlements – Medicare, Medicaid (ah, those pesky federal health programs!) and Social Security. While comprehensive health reform would prove the most effective deficit-reduction measure over the long term, we may not have the luxury to await its arrival.

Our growing indebtedness weakens our economy, threatens our independence, and raises the risk of an economic calamity. We need to get serious about deficit cutting, with or without health reform. And if that means putting Medicare and Medicaid on the table along with all other spending as well as taxes, then so be it.

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Lawrence J. Haas is former Communications Director to Vice President Gore and, before that, to the White House Office of Management and Budget. He's now a public affairs consultant who writes widely about foreign and domestic affairs, including fiscal policy.

Lawrence Haas
is former senior White House official and award-winning journalist, writes widely on foreign and domestic affairs. His articles have appeared in The New York Times, USA Today, Los Angeles Times, Baltimore Sun, Miami Herald, San Diego Union-Tribune