Pushed To the Margins, Finally
“Fiscal responsibility” is lost on the Republicans
At the brink of global ruin,many
Americans suddenly seem willing to consider sensible ideas that were
always deemed unthinkable, and to reject foolish notions that were once
deemed brilliant. Soon we may be mature enough to observe how other
developed countries address problems that have baffled us for
Nationalizing major banks, temporarily at least, is a radical notion that today looks far more prudent than handing over hundreds of billions of additional dollars to the clowns and crooks who wrecked the financial system. Privatizing Social Security, which meant turning over another trillion dollars to the Wall Street geniuses whose reckless greed drove us into penury, no longer appears so alluring. Even a few repentant right-wingersâ notably including Alan Greenspan, the former âmaestroâ of moneyânow gaze dolefully into the mirror and wonder where they went so wrong. (Hereâs a hint: The trouble began during those lonely evenings spent perusing the addled works of Ayn Rand.)
So as President Obama convened his âfiscal responsibility summitâ and then delivered his first address to Congress, the voices of free-market fundamentalism were muted in Washington, if not on cable television. The anticipated onslaught against Social Security from those claiming to represent future generations did not materialize at the Obama summitâand neither did the presidential capitulation that liberals had feared. Instead, the White House wonks insisted on discussing the actual threat to Americaâs future solvency, namely the swelling price of health care for the retiring generation of baby boomers and its effect on Medicare and Medicaid.
Figuring Out How to Control Health Care Costs
The problem with these programs, which have done so much to improve the health of Americaâs poor and elderly, is neither the size of the boomer cohort nor even their impending geezerhood. The problem is the rate of cost increase per beneficiary, according to a landmark study released two years ago by the Center on Budget and Policy Priorities (and described with admirable clarity by Ezra Klein on The American Prospect Web site on Feb. 23).
the political spectrum for the accuracy and relevance of its data, that
liberal think tank happens to be the former professional home of Peter
Orszag, the Obama administrationâs budget director. The centerâs
insights into federal spending will inform policy at the highest
levelâwhich means that reforming the way we finance and deliver
medicine will be central to this governmentâs fiscal planning. Although
there are many other matters that must be addressed if we are ever to
regain control of deficits when economic growth resumesâfrom the abuse
of tax shelters by the superrich to the absurd rip-offs by military
contractorsâthe biggest money is in the health sector.
But how can we cope with rising costs when we have yet to achieve the basic national goal of providing universal coverage? Perhaps now Americans will look abroad and notice that other countries provide quality care to all of their citizens, spending less than half what we do and achieving better outcomes.
In the coming decades, countries in Europe, as well as Canada and Japan, will be able to invest their resources in energy and education, while we try to figure out how to borrow enough to keep our hospitals open. What they all have in common is that they do not devote a huge proportion of their health spending to the profits of insurance companiesâand they negotiate budgets with health providers, such as pharmaceutical companies.
The superior performance of these alternatives is at long last coming to the attention of the mainstream media, which has so long ignored it. As always, Congress will resist change on behalf of the insurance and pharmaceutical lobbies, preferring to do nothing. But perhaps in the coming years, the public will realize that such feckless politicians should be told to go do nothing somewhere else.
© 2008 Creators Syndicate Inc.
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