Interesting Comparison

Cost of George Bush’s tax cuts, heavily tilted toward upper-income earners: $1.7 trillion.

Cost of war since 2001: $915 billion.

Estimated total cost of Iraq war: $3 trillion.

Estimated gross cost of universal health care coverage: $1 trillion.

Three questions. First, why is it that those who lament the budgetary costs of health care did not raise the alarm bell when it came to costlier spending on war and tax cuts for the rich? Second, does not Catholic social teaching call health care a right, condemn war, and call for a just distribution of income? Third, is it not conventional wisdom among economists that fiscal policy should not be procyclical, in other words, that you should not loosen the constraint when times are good and tighten the corset when times are bad?

I think the answer to these questions is plain. But the fact that they are not asked in this debate is a source of great frustration.

There is one more point to be made on health care costs. I was very careful in describing the cost as a gross cost, as the aim is for health care spending to be budget neutral, possibly paid for by raising taxes on the rich, which again would align with Catholic social teaching. Remember too that a key aim of health care reform is to lower total costs and increase coverage– we must talk about overall health care spending, not just the public part. Most health care spending today comes in the form of lower wages, and so is not transparent. But it is real. And, as Ezra Klein notes, there are a number of areas under discussion that could lower future costs — comparative effectiveness review, development of a new IT infrastructure, the public plan (which will reduce costs through economies of scale, taking out the profit motive, and possibly given the power to bargain for better prices), and the health insurance exchange. These costs cannot be quantified, but we can probably say one thing with certainty — the costs of doing nothing will be far greater. And by “cost” I mean both money costs and social costs.

The status quo lobbies are strong. But let’s not buy into their fearmongering.