After supercommittee failure: figure out how to cut health costs

We have had a demonstration of the nation's failure to govern itself. But what about our failure to control our health care costs, which make it impossible to compete internationally?

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Health is about more than the doctor or the instruments

We have had a demonstration of the nation's failure to govern itself. But what about our failure to control our health care costs, which make it impossible to compete internationally?

A simple statement from the two co-chairs of the Joint Select Committee on Deficit Reduction. “After months of hard work and intense deliberations, we have come to the conclusion today that it will not be possible to make any bipartisan agreement available to the public before the committee’s deadline.”

And, they continued, “despite our inability to bridge the committee’s significant differences, we end this process united in our belief that the nation's fiscal crisis must be addressed and that we cannot leave it for the next generation to solve.  We remain hopeful that Congress can build on this committee’s work and can find a way to tackle this issue in a way that works for the American people and our economy.”

But let’s be clear about this statement, the committee, and Congress itself. This represents a failure to govern. There is a structural inability to make difficult choices about what the country needs to do to finance its operations. The so-called supercommittee is no different than the country and its citizenry. We are divided, locked into a struggle with significant differences about what to do next.

Some of us believe that we should balance two competing ideas: We should invest in jobs. Now. Again. And keep doing that until everyone who wants a jobs has access to one. Then, and only then, the government should begin a long-term strategy of rethinking promises made through entitlement programs.

The other view says cut government now. Shrink government, period. Don’t raise a single dime in new taxes — and let the economy grow again (after it crashes).

Now we will read over the coming weeks and months about the tragedy of automatic budget cuts as the real numbers surface. Some will complain about how much smaller our military must become. Others will note the deep unfairness in cutting domestic programs that serve people who are at the lowest end of the economic spectrum. The president has already promised to veto any bills that try to get around the automatic budget cuts.

But the real problem, the much bigger issue, is that this exercise represents a failure to govern. Congress could not reach a decision last summer, so it passed on extraordinary powers to the so-called supercommittee. Before that the administration passed on its authority to a bipartisan committee charged with coming up with a financial plan.

So failure becomes the norm in our political discourse, we are defined by our inability to forge consensus.

I live in rural Idaho and listen to local talk radio. The people who call the station cannot understand, let alone appreciate, any differences about how other citizens approach these difficult fiscal issues. It’s the same in the Blue Cities, only opposite. That divide makes it nearly impossible to acknowledge areas of common ground. This is not new in our history. Divides this great were present before the election of 1812 (some call it the second revolution), before the civil war, and before Prohibition was incorporated into the Constitution.

Take health care. If we really want to fix the deficit in a way that will last, we need to reduce the cost of health care. We cannot afford to spend $7,538 per person when the rest of the industrial world spends under $4,000. Or, looking at it another way, we cannot compete in a world economy where we spend 16 percent of our Gross Domestic Product on health care when France pays 11.2 percent or Japan 8 percent.

We need to make health care sustainable. That’s how we fix our budget. If we do this one thing, our budget problems will shrink into a manageable form. But we cannot even agree on the baby step we took last year with the Affordable Care Act. Perhaps that should be the only issue we debate during the 2012 election because it’s the only way to really get the cost of government under control.


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