Robert Kuttner, co-founder and co-editor of The American Prospect magazine and a very smart, progressive economist, lays out in sharp, clear strokes the challenges facing the country as President-elect Obama prepares to take power -- and previews the debate between progressives and conservatives over what to do about them.
Kuttner points to the centrality of health care reform and the fallacy of conflating -- as conservatives are wont to do -- the current economic crisis with the issues surrounding the future funding of Social Security and Medicare. The crisis, Kuttner says, was caused by private-sector profligacy, not federal budget deficits. As for Social Security and Medicare, the former would be swimming in projected surplus but for Bush's tax cuts for the rich (and the resulting substitution of Social Security surpluses for federal income tax receipts); the latter cannot be addressed without tackling the dysfunction of the American health-care system in general:
America now spends 16 percent of our GDP on health, and the number of uninsured and under insured rises every year, in tandem with the costs. Other advanced countries manage to insure everybody for less than ten percent of GDP. They have better health outcomes than we do, because health outlays are efficiently targeted. We have more rationing than any other nation, and we have the most pernicious kind of rationing - rationing based on the private ability to pay for good care.
It's a long-ish piece, but an excellent overview of the coming arguments between conservatives, who will try to use the economic crisis as a springboard for cutting social-insurance costs, and progressives, who see Social Security and Medicare (and Medicaid) as the only major elements of our public-private economic system that are working reasonably well in the wake of the bankers' bust. The only thing I'd add is that a serious investment by the federal government in sustainable energy generation and conservation, a big up-front cost, would reduce future balance of payments deficits by more than $100 billion a year now spent on imported oil. Not to mention the job-creation boost to come from the making and installing of solar panels, wind turbines, and such prosaic items as weatherstripping and caulk.