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Sunday, June 24, 2018

If even the architect of Medicare privatization can admit rising health care costs are driving our fiscal problems, maybe there is common ground for reform.

The Washington Post’s Wonkblog had a brilliant idea to ask 18 economists and policymakers to submit their “favorite” — as in most revealing — charts or graphs of 2011. Our own Mike Konczal had a good entry, but I was particularly intrigued by this entry from Rep. Paul Ryan.

“Health care costs are the primary drivers of the debt,” the chart declares, and Ryan explains that “Relentlessly rising health care costs (coupled with demographic changes) are driving the growth of these programs.”

It’s easy to see this as just a veiled argument for Ryan’s plan to end Medicare (yes, I said it; come and get me, Politifact), but we should also acknowledge that there’s a big shift here in language about the long-term deficit. A few years ago, we were told that it was an “entitlement crisis” — and demographic changes were not an afterthought, but an essential fact — that made changes to Social Security and Medicare necessary. We just couldn’t afford benefits for all those people. It was liberals like Henry Aaron of the Brookings Institution and Peter Orszag during his stint at the Congressional Budget Office who began to produce charts like Ryan’s. “There is no entitlement crisis other than health care,” Aaron insisted. “There is no practical way to deal with public health-care spending other than by general health-care financing reform.”