Tyler Cowen’s weekend critique of the Obama administration’s health reform agenda is a bit odd. Basically, the administration is saying that while providing health insurance to the currently uninsured will cost money up front, that systematic reform has the potential to slow the rate of health care cost growth and reap large benefits. Importantly, this is the only way to prevent Medicare from bankrupting the entire country. Cowen’s critique of this is, in essence, that it will be very politically difficult to achieve the sort of cost controls Obama is talking about.
And indeed it will. But it seems strange to characterize this as a problem with Obama’s plan. What we have here is a Democratic president advocating for some tough reforms that will reduce public expenditures over the long run. Those reforms will be hard to implement. And one reason they’ll be hard to implement is that, as Ezra Klein notes, conservative politicians who ought to be the core constituency for endeavors to slow the growth of Medicare costs seem more interested in drawing blood from Obama than in slowing the growth of government. It seems to me that the most useful intervention from a right-of-center economist might be to try to build support in Congress for these politically difficult measures, not to attack the administration for putting unrealistic proposals on the table.