The Federal Budget Mess and Healthcare Reform

So here’s the question: How are we supposed to pay for healthcare reform when the national debt is at $9.6 trillion, the budget deficit is expected to top $400 billion both this year and next, and we’ve just promised up to $200 billion to bailout Freddie Mac and Fannie Mae? 

That’s what I’d like to know.  So I asked Scott Bittle of Public Agenda, who is co-author along with Jean Johnson of “Where Does the Money Go?  Your Guided Tour to the Federal Budget Crisis“  (HarperCollins, 2008).  His answer: “With great difficulty.” 

Bittle describes the current budget situation as a classic double-bind.  “You can’t control the long-term budget problem without fixing the healthcare system,” Bittle says.  Yet, fixing the healthcare system will require difficult and costly choices.  

The two Presidential candidates have important philosophical differences in their plans for healthcare reform.  But according to the Tax Policy Center, the cost of the proposals are in the same ballpark.  Obama’s plan would cost $1.6 trillion over 10 years; the McCain plan $1.3 trillion. 

That’s a big nut by any standard, and it ought to spur serious debate.  And that debate needs to happen sooner rather than later, Bittle warns, because “after a certain point, the budget makes the decision.”


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