Let me second the remark that E. J. Dionne made in his recent column. Healthcare reform will pass:
Let’s start at the end. Despite all the dire words being spoken, some version of health reform will pass simply because failure is not an option for Democrats who care about staying in power (which happens to be all of them).
Republicans such as Sen. Jim DeMint and conversative commentator William Kristol have been immensely useful in clarifying this — DeMint by saying defeating reform would “break” Obama, and Kristol by defining the GOP’s position succinctly with the words “kill it.” That’s why Obama was eager to quote them last night.
However, merely passing a healthcare reform bill isn’t enough. If we divide the things that must happen from the things which we might like to happen in a healthcare reform bill, we might like to extend healthcare insurance coverage to more people (we might not). We must control costs.
Unless we reduce both the rate of increase in healthcare costs but the costs themselves, in 2012 the Medicare trust fund which by law consists of a huge stack of IOU’s from the Treasury Department will start paying more out than it takes in. At that point we’re going to have to divert money in the budget from other expenditures to healthcare spending, raise taxes to increase the amount of money available, borrow more, or some combination of all three. Regardless of which of those choices we make it means there will be less money available to spend on education or roads or the military or even just less economic growth.
State and local governments are in even more serious straits. Here in Cook County if healthcare costs were only growing at the general rate of inflation (which includes healthcare costs) we wouldn’t have a budget problem. We wouldn’t have increased sales taxes which, as I predicted when they were enacted, will drive retail sales out of the county and will not realize the revenues they were expected to. We wouldn’t drive people from their homes with real estate taxes, whose rates are all but sure to increase as assessed values decline. Since state and local governments are heavily dependent on sales taxes and property taxes and both retail sales and property values are declining nearly everywhere, this isn’t just a problem in Cook County. It’s a problem practically everywhere.
So, regardless of who you are or what your political beliefs, you should demand healthcare reform. The status quo is both intolerable and unsustainable.
Update
As quoted in today’s Washington Post editorial, President Obama thinks so, too. I can only hope he will fit actions to words:
Presidents have made promises of fiscal sanity before, of course. This time, Mr. Obama said, “I actually think that, sadly, decisions are going to be forced upon us.” We only hope the political system can act before those outside pressures, from financial markets or foreign governments, become too damaging.
