Steven Pearlstein has a column in Wednesday, May 20's Washington Post called “Budget Scolds Shouldn’t Drown Out the Chorus Calling for Health Reform.” We assume that The Concord Coalition is among his targets given his definition:

"In the political menagerie that is Washington, there exists a species known as the budget scold — analysts, advocates, editorial writers and politicians who possess a fierce determination to bring the federal budget into better balance.

Budget scolds have a wonkish demeanor and a skeptical outlook. They possess an undue fascination with rules and processes, and speak in the arcane language of baselines, sunsets and pay-fors."

Although we don't define ourselves by the fact that we occasionally "scold," the rest of his characterization isn't that far off -- just ask those who run into us at parties. But the point of his article is that Pearlstein is concerned that worries about the budget deficit are going to scuttle health care reform. He writes:

"There have been times when the budget scolds have saved the country from short-...

Now that the Congressional Budget Resolution has passed, there has been a lot of talk about how the reconciliation instructions included in the resolution will make it easier for a health care reform effort to pass.  Particularly since the mechanics of reconciliation provide for a simple majority vote for approval -- instead of the 60 votes that might be needed to overcome a filibusterer in the Senate.

Ironically, considering political motivations, it might be easier to round up 60 votes for a fiscally irresponsible health care reform bill, than to attain the 51 votes for a fiscally responsible bill -- which would be needed to utilize the reconciliation fast track procedure. 

Let me explain. When the modern budget process was established, the idea behind including a lower procedural bar under reconciliation was to facilitate legislation that contained difficult choices resulting in deficit reduction. Only in recent years have legislators deviated from this intention, most notably by the usage of reconciliation to pass large, deficit-increasing tax cuts.

The guidelines put in place by the budget resolution for reconciliation -- in a sense -- navigate this budget procedure closer to its original purpose. Specifically, for Congress to consider any health care reform bill, it must contain...

Although the report doesn’t speculate on the size of the potential cost savings that could be obtained from some of the reform proposals (most of which are not terribly comprehensive or economically “bold”–although elimination of the employer-provided health care tax exclusion would surely be politically “bold”), I found the discussion on pages 118-119 of the health care chapter most interesting:

Spending a rising share of income on health, as has occurred in the United States and other developed countries and is likely to continue occurring, makes economic sense as rising incomes increase the relative benefits of investing in health-care consumption to extend life…[H]ealth care consumption is a superior good…The large and growing size of health spending underscores the importance of ensuring that the sector functions efficiently and equitably.

Today I spoke at an event on Capitol Hill where the OECD’s Economic Survey of the United States was released.  (The policy brief, a condensed summary, is here.)  I was a discussant on the survey’s chapter on health care reform, which explains that the U.S. health...