In a divided Congress reflecting a divided country, passing a healthcare plan that wins support from all competing interests is impossible.
That will become more apparent this week as the U.S. Senate struggles to pass its version of healthcare reform to replace Obamacare. Even if the Senate gets a bill passed, the House and Senate will both have to agree on a final version – which will be very difficult.
The basic challenge is the same dilemma facing nearly every debate in government – how much can we spend to help people in need before we hit the point of diminishing returns caused by high taxes and skyrocketing deficits.
The health care debate is incredibly complicated. But, bottom line, it’s mostly about money — in particular how much governments at state and federal levels should spend on Medicaid and other health care subsidies to help disadvantaged people.
The appetite to help is great. But how much can society afford before taxes and deficits damage the economy and reduce incentives to work and be productive?
Republican leaders are trying hard to strike the right balance. But a lot of members of Congress think government needs to do more. And others think government is trying to do too much. Amid such division, finding 50 votes will be very difficult this week.
I don’t profess to know just where that balance should be. I do think it’s much easier to be a generous liberal on this issue than to be a conservative Grinch. It’s easy to err on the side of doing more and more and more. Until the country is in serious financial trouble.
It’s easy to spend because the money spent is mostly hypothetical, ethereal, at least in our minds. It doesn’t seem to be money out of our pockets. It’s “government” money, which seems to somehow appear out of nowhere to take care of government programs. Spending such money is easy.
Health care needs are here and now, especially as we watch news stories about the very real people who will be hurt if subsidies decline. Deficits are something we’ll worry about later. Deficits seem so theoretical.
Much federal money does actually appear out of nowhere. It is borrowed. Sen. Rand Paul says the federal government borrows a million dollars a minute. Our taxes don’t come close to paying for federal government programs. It’s like a family earning $10,000 a month, but spending $12,000 a month, year after year. We get more benefits than we pay for.
The national debt is now $20 trillion, increasing by the minute. But so what. Many of us won’t have to pay it back. At my age, I certainly won’t.
But my grandchildren will.
So it’s easy to spend freely. We want to be generous. It makes us feel good to help. And it isn’t hurting our pocketbooks. Borrowing is so easy. And we won’t have to pay it back. What a nice arrangement.
The problem is, one day the bills will come due — inevitably. And that generation of taxpayers and citizens will be in trouble. This reality has been demonstrated in many countries throughout history. And then economies implode. Jobs are scarce. Governments collapse. Social unrest spreads. Hunger and deprivation occur. And sometimes autocrats arise.
While I’m not smart enough to know where the line is between spending too much and spending too little, I believe the debate ought to be more balanced. Most of the debate today is about all the people who may be hurt if federal spending is reduced.
At last some of the debate ought to be about taxes, deficits, and the bleak future awaiting our children and grandchildren if we keep borrowing and spending.