We’re hearing this in the arguments over health care and climate change. We’re hearing it over the economic stimulus and the expanded war in Afghanistan. We’re hearing these concerns raised in Congress. And we’re hearing them acknowledged by the president, even in speeches like the one President Obama gave on sending more troops to Afghanistan.
This is significant because it’s a question that had almost been ignored in Washington for years. Oh, it would get mentioned, but almost as a rhetorical point. Somehow, the political system always got past that concern. Whether it was more spending or deeper tax cuts, something else always turned out to be more important than balancing the books. We were setting priorities, but the cost of those priorities never seemed to be considered.
Now, at least, the question is being raised, and seriously. There are still two further questions both leaders – and the public – have to wrestle with if we’re going to get out of our financial mess.
One of them is this: “Can we keep the status quo?” Unfortunately, most budget experts, both liberal and conservative, would tell you the answer is no. Most of the people who’ve looked at this issue, whether they’re liberal or conservative, in or out of government, use the same word to describe the federal budget: “unsustainable.” The status quo just can’t continue.
The best example of this is health care. Whether we can afford any of the health care proposals on the table is a legitimate question. But it’s worth remembering that health care will break the federal budget if we do nothing. There are two things driving our long-term budget problem: demographics and health care costs [3]. The population is getting older, so more retired people will be eligible for Medicare and Social Security, even as there are fewer people in the workforce paying in to those programs. And if health care costs continue to go up as they are, our health care spending will double in 10 years if current trends continue, and that means costs for Medicare and Medicaid will rise right along with them.
Most budget experts will tell you that there’s no way we can get out of our long-term budget crunch without doing something to control health care costs. Whether any of the health care proposals on the table does that successfully is another issue, but there’s no doubt that something has to change. From the debate so far on health care, however, it isn’t clear that either Congress or the public has bought into that.
The third question is hardest of all, for both leaders and the public: “Am I willing to give up something I want because the government can’t afford it?” Our current debate hasn’t even started on this one, but it may be the most important. It’s easy to cut programs somebody else wants, or raise taxes that you won’t have to pay. It’s another to actually give up something that matters to you.
Yes, everyone should have dealbreakers, programs or principles that they believe absolutely must be preserved. But it’s just as important to know what’s not a dealbreaker. Our fiscal problems are so huge that something’s got to be sacrificed, and none of the potential choices are going to fly without public support. That means one essential task for political leaders is to help the public think through what the dealbreakers really are as a nation.
When the public starts wrestling with that third question, the setting of priorities, that sense of what’s essential and what’s not, then we’ll be able to make the choices we need to make financially.