The editors of the Washington Post point out that the National Academy of Sciences and the National Academy of Public Administration have engaged in a budgeting exercise similar to the one that I conducted not long ago. Their goal was modest: just keep the debt within 60% of GDP. The editors:
Addressing the country’s fiscal situation is a daunting task. Trying to do so by looking at only the spending side of the ledger is achievable, in theory. But it would require far more pain and sacrifice, and a more revolutionary retrenchment, than those who insist on this approach have been willing to acknowledge.
The committee considered four alternative paths:
- An austerity plan in which federal revenues were not increased and federal expenditures trimmed to match.
- What they refer to as the high spending and revenue plan in which federal expenditures are allowed to rise to one-third of GDP and revenues increased to match.
- An intermediate path under whicch federal spending and revenues are allowed to rise to 25% of GDP and Social Security, Medicare, and Medicaid are constrained.
- Another intermediate path under which federal spending and revenues are allowed to rise to 25% of GDP, Social Security, Medicare, and Medicaid are constrained a little less, and other spending is cut.
All four of those scenarios are totally unacceptable to some major constituency. All four plans demand that federal healthcare spending be limited and we currently have no mechanism for doing that. The latter three plans all require tax increases which would be opposed bitterly by Republicans in Congress and spending reductions which would certainly be opposed bitterly by Democrats in Congress and it’s possible that Republicans would join them.
The bottom line message of this report is that there is no easy or painless way to bring fiscal sanity to our budget (let alone balance it) and that cutting healthcare spending by the federal government is the sine qua non of reform. That was the argument that I made during the fifteen months during which healthcare reform was debated. The progressive caucus in Congress may reckon the passage of healthcare reform as a great achievement; I consider it a squandered opportunity.
Caught between Republicans who take the position that tax increases are completely unacceptable and Democrats who view cuts in entitlement spending as equally unacceptable, the Congress is less a deliberative body and more an institution for the fiscally insane.