The Uncertainty Meme

Why does the economy continue to suck? The LA Times is hosting a symposium on the topic today, and USC business professor Ayse Imrohoroglu says the answer is uncertainty:

Businesses don't know what will happen to interest rates. They have trouble calculating what new workers will cost in light of potential new healthcare mandates and costs. They don't know what will happen to tax rates, which could rise dramatically. They are uncertain about increasing financial regulation and the possibility of a carbon tax. And as if that isn't enough, the soaring deficits and national debt raise very real questions about the federal government's long-term ability to meet its debt obligations.

OK, let's take these one by one:

  • Interest rates will remain very low for a very long time. The Fed has made this as clear as any central bank possibly could.
  • PPACA has no impact on small businesses and only a minuscule impact on large businesses. Medium-sized businesses face a modest penalty if their workers use federal subsidies to enroll in private insurance programs via the exchange. In other words, the overall financial impact on the business community is pretty modest. What's more, there's really not much uncertainty here. The broad impact of PPACA's rules is already clear, and they don't take effect until 2014 anyway. This is not having a significant impact on business investment decisions in 2010.
  • There's no excuse for Congress leaving tax policy up in the air for as long as it has. But even with that said, the Bush tax cuts affected personal tax rates, not business rates. And despite demagoguing to the contrary, even if the Bush tax cuts expire completely the effect on small businesses would be close to zero.
  • Financial reform was a fairly modest affair, and in any case its effect is almost entirely restricted to the financial sector. Its effect on the rest of the business community is slight.
  • There is no possibility in the near future of a carbon tax.
  • There is no question about the federal government's long-term ability to meet its debt obligations, and even if there were this would have very little effect on short-term investment decisions by American businesses.

The uncertainty meme is just mind boggling. Businesses always have a certain amount of regulatory uncertainty to deal with, and there's simply no evidence that this uncertainty is any greater now than it usually is. (It is, of course, entirely believable that business owners who spend too much time watching Fox or reading the Wall Street Journal editorial page might believe otherwise, but that's a whole different problem — and one that Imrohoroglu should spend his time debunking, not promoting.) The only significant real uncertainty that American businesses face right now is financial uncertainty: that is, whether there will be enough consumer demand next year to justify hiring more workers and buying more equipment today. PPACA and carbon taxes rank very far down the list.

UPDATE: Let me add something that I just mentioned in an email to a friend. The main sources of regulatory change during Obama's term so far have been PPACA and financial reform. During George Bush's first five years, he approved No Child Left Behind, the PATRIOT Act, McCain-Feingold, Sarbanes-Oxley, the Homeland Security reorganization, Medicare Part D, bankruptcy reform, and two big tax bills. He also tried and failed to pass major changes to Social Security. And all this was in addition to the usual background hum of agency regulatory hearings and rulemaking changes — including a heap of financial deregulation that eventually contributed to an epic banking meltdown.

And yet, no one complained about regulatory uncertainty back then. Why? Because the economy was growing. Businesses like some regulatory changes and dislike others, but it's mainly financial uncertainty that keeps them from hiring and investing.

The Great IOR Mystery

I'd like to second this comment from Matt Yglesias:

If the country’s political press could redirect 10 percent of the attention currently being paid to the House Democratic leadership race and the GOP pre-campaign for 2012 to one thing I would suggest the Federal Reserve’s interest on reserves program.

....In late 2008, the Fed for the first time ever said that if banks wanted to hold extra reserves they would get interest payments in exchange for doing so. Then they raised the interest rate. And then they raised it again. Via Scott Sumner, Louis Woodhill makes a very strong argument that this has been a massively underrated factor in producing the recession. The IOR payments led to a steep decline in the velocity of money, which in turn led to a collapse in Aggregate Demand.

Now, I think Woodhill's argument is overstated in two ways. First, the Fed didn't just raise the IOR rate and then raise it again. The IOR rate is based on the fed funds rate, and the Fed raised the IOR rate at the same time that it was reducing the fed funds rate, producing a sort of choppy up and down trajectory for a couple of months in 2008. Overall, though, between October and December of 2008 the nominal IOR rate dropped from 0.75% to 0.25%.

Second, I have my doubts that this was responsible for the great collapse of 2008. Woodhill bases his argument on coincidental drops in stock market prices, but this is fairly weak tea. The stock market was both very volatile and generally falling during this entire period, and the drops following the IOR increases were made up pretty quickly. It's not impossible that the fluctuation in the IOR rate was driving some of the stock market changes, but the evidence is thin. [See update below.]

That said, however, the general argument here seems unassailable: regardless of whether bouncing IOR rates affected the stock market badly in 2008, the fact that the IOR rate today is greater than zero seems very, very strange. As Woodhill says:

The Fed knows that IOR is contractionary. Chairman Bernanke has testified that raising the IOR interest rate is one option for fighting inflation. Two Fed staff economists issued a report in July 2009 ("Why Are Banks Holding So Many Excess Reserves?") that describes how paying IOR at the Fed Funds target rate would stop the "money multiplier" process dead in its tracks.

....In the absence of IOR, there is an incentive for anyone who receives a dollar to immediately pass it on by doing another transaction. There is also an incentive for banks to lend out their excess reserves....The payment of IOR at an "above market" interest rate (which has been the case for the past two years) short-circuits the processes described above. IOR creates a "roach motel" for money — the dollars go in and they don't come out.

In other words, if the IOR rate is zero, banks might as well lend their money and hope to make a profit on it. It's better than nothing. Conversely, if they can earn a safe return on their reserves just by parking them at the Fed, that might seem like the better deal. And so credit tightens and businesses have a hard time getting loans.

Control over the IOR rate, which was given to the Fed in 2006, is an important monetary lever. So why would the Fed announce a quantitative easing program designed to stimulate a weak economy at the same time that it keeps the IOR level set at a mildly contractionary level? It doesn't make sense. Once the Fed has officially announced that it believes the economy is stuck ("Pace of recovery...continues to be slow...high unemployment, modest income growth, lower housing wealth, and tight credit....Employers remain reluctant to add to payrolls. Housing starts continue to be depressed"), why wouldn't it use the IOR lever in addition to the QE lever? Why have them pointing in opposite directions?

I suppose one reason this doesn't get very much attention is that there's nothing much to say about it. The Fed won't comment on it, members of Congress are mostly unaware it even exists, Glenn Beck hasn't devoted a show to it, and there's nothing to say in a news story other than "once again, the Fed has taken no action on the IOR rate." Your editor won't let you write that story very often.

Still, it's a pretty interesting question. Why is the IOR rate still stuck at 0.25% instead of zero? Is it because the Fed believes that lending is constrained by demand and the IOR rate isn't playing a role? Is it because they think providing a steady source of profit for the banking system is still Job 1? Is it because they consider IOR's effect on lending to be pretty trivial at 0.25% and not worth bothering with? Or what? It is indeed mysterious.

UPDATE: My intent in this post was to agree with Matt Yglesias's point about the IOR rate being too high without also implicitly buying into the Louis Woodhill argument that he links to. That's the only reason I spent any time on it at all. However, Niklas Blanchard thinks my skepticism was too mild:

IOR policy wasn’t the driver of the collapse in 2008, inadvertently tight monetary policy was. If you are hardcore about monetary disequilibrium, like I am, then that was the key to the entire recession (contra what was happening with financial intermediation). The IOR policy was just heaping gasoline on a fire, so to speak.

I mostly agree, and I should have been more pointed about this. The great collapse of 2008 was largely driven by economic fundamentals. Regulatory issues played a role in making the collapse worse than it had to be, but it would have happened regardless. Likewise, IOR fluctuations may have affected stock market prices in late 2008 — though even that's not indisputable — but the recession had been underway for nearly a year by that time, the financial system had come close to collapse a month earlier, and the IOR policy, at worst, might have made things slightly worse. The argument that it caused the collapse just doesn't hold water.

Baubles vs. Hard Truths

Derek Thompson is disappointed with liberal reaction to the deficit commission report. For example, liberals like me:

The third most frustrating criticism comes from folks like Kevin Drum, who claims that any effort to reduce the deficit that isn't 98% health care reform isn't serious. The fact is, there are no feasible ways to definitively curb health care inflation starting today (if Kevin has some in mind we need to hear them!). We can shoot a thousand arrows at the medical inflation monster — health care reform, to its great credit, does. We can nudge providers and customers away from pay-for-service, which rewards over-treatment. We can increase cost-sharing to help patients react to prices, increase transparency and quality through exchanges, and so on. But these are efforts, not answers. If we waited for the messianic Answer to health care inflation, we might never act on the budget. I can't imagine that's what Kevin would prefer. Instead, we should make the changes we can make today, slowly.

This is fair up to a point. But only up to a point. Here's the problem: most plans to reduce the long-term deficit consist of three things: shiny baubles, smoke and mirrors, and actual deficit reduction measures. You want to minimize the former and emphasize the latter, and on that score I don't think Simpson-Bowles does very well.

Their discretionary cuts are a combination of baubles and smoke and mirrors. The baubles are the trivia, like cutting printing costs and eliminating earmarks. The smoke and mirrors comes from vague non-choices like cutting the federal workforce 10% or pretending that a spending cap will actually accomplish anything. Discretionary spending isn't really a long-term problem in the first place, but if you're going to address it anyway, then address it by proposing actual program cuts. You think manned space exploration is a boondoggle and you want to cut NASA's budget in half? Fine. You think ethanol subsidies are outrageous and you want to eliminate them? Great. You think our nation would be safe with nine supercarrier groups instead of a dozen? Preach it. But that's what it takes to cut the discretionary budget: cuts to real programs, not handwaving about caps and generic rollbacks.

Next up are their tax reform proposals, which are almost entirely smoke and mirrors. You can make any deficit reduction plan easier by proposing a tax system that (you claim) will boost growth rates by 1% per year. Run that out over 50 years and economic growth will take care of half your problem. Hooray! But the evidence that this will actually happen is close to zero. Our current tax system just isn't that inefficient. Pretending that a better tax regime will supercharge economic growth isn't as bad as relying on the infamous troika of waste, fraud, and abuse, but it's close.

Their Social Security proposal is.....actually not bad. With one change I could probably accept it as is.1 Still, even though I favor taking action on Social Security now, this is basically a bauble. It's reponsible for only a small part of the long-term deficit, and it's not something that rises forever. It's a one-time increase associated with the retirement of the baby boomer generation.

And then you get to healthcare. This is the big one. This is 90% of our long-term deficit problem. I don't have any real problem with tackling inefficient discretionary programs or sprucing up the tax code or fixing Social Security. But burbling on at length about this stuff mainly serves to allow us to avoid talking about our real problem. Because, as Derek says, it's too hard. But that's like an alcoholic nattering on about putting a taxi service on speed dial or remembering to take his vitamins every day. Those are great ideas, but they're basically distractions that prevent you from facing up to the fact that you need to stop getting hammered every night.

The whole point of a deficit reduction commission is that they can address the hard truths that a bunch of politicians can't. If Simpson-Bowles were really dedicated to hard truths, their report would have said two things in no uncertain terms. First, we're not going to waste too much time on discretionary spending or Social Security. They're shiny baubles that distract us. So here are links to half a dozen good plans for reining in both of them. Go ahead and read them at your leisure.

Second, healthcare costs are going up. We're getting older, medical technology is advancing, and the spending curve on healthcare heads to infinity if we don't do something about it. So we've decided that essentially our entire report is going to be about healthcare because we want to rub your faces in the fact that you have to deal with it whether you like it or not. This means, at a minimum, two things: (1) distilling the best ideas around for reining in rising healthcare costs, and (2) acknowledging that costs are going to go up anyway and we're going to have to raise taxes to deal with it.

But as hard truths go, I guess that's a little too hard. Tax increases! Paying doctors less! Telling the American public that they can't have every procedure they want just because they want it! Besides, we just spent over a year passing healthcare reform, and we're all exhausted. PPACA made only modest progress on cost controls, and that was hard enough. Better to just do some handwaving about a cap on growth rates and call it a day.

I get it. No one wants to dive back into that briar patch right now. But that's too bad. So go ahead: take a whack at reducing discretionary spending by 2% if it makes you feel virtuous. Go ahead and reform the tax code. It needs it. And sure, fix Social Security just as a warmup to prove that you can hit AA pitching before you move on to the show.

But don't pretend that you've really done much of anything about the long-term deficit. For that, we're going to need a whole bunch of straight talk about tax hikes nobody likes and cost controls that everybody hates. But isn't straight talk like that exactly what Simpson and Bowles were supposed to give us?

1I would ditch the increase to the retirement age and pay for it by gradually increasing payroll tax contributions from 12.4% to 13%. The rest of their proposal strikes me as fairly reasonable.

Friday Cat Blogging - 12 November 2010

On the left, Inkblot has claimed ownership of the newly reupholstered reading chair. Surprisingly, it took him a couple of days. Usually it takes more like a couple of minutes when something new comes through the door. In any case, it's his now. On the right, Domino takes advantage of our current November warm spell to enjoy the outdoor sunshine while she can.

In other feline news, four engineers have finally figured out how cats lap up water. Dogs, of course, merely scoop it up crudely in their tongues, but cats, it turns out, have a far more elegant method based on subtle considerations of fluid dynamics, a remarkably fast tongue speed of 78 cm/sec, and the need to keep their whiskers dry. Pretty much as you'd expect. Explanation and pictures here. There's even a formula for lapping frequency:

This turns out to be about 3.5 times per second for your average housecat, somewhat less for your kings of the jungle. So be sure to take a closer look the next time your cat ambles on by to the water dish. It's all in the name of science.

Earmarks, Schmearmarks

I am, of course, thrilled to see conservatives beating each other senseless over earmark reform. They've spent years demagoguing Democrats over it, and the spectacle of Sen. James Inhofe now complaining that he's being demagogued over earmarks is pretty priceless. Still, Inhofe makes an unassailable point: earmarks direct spending, they don't increase it. Actual overall appropriation levels are set separately, and earmarks merely take a bit of spending authority away from the federal bureaucracy and hand it directly to members of Congress. Over at The Corner, however, Stephen Spruiell offers a novel argument about why Inhofe is wrong:

Proponents of reform will readily concede that earmarks direct rather than add spending. But that is the problem: As long as powerful appropriators are getting to direct their share, they are less concerned with the overall size of the spending package. I think it’s fairly hard to dispute that point. The number of congressional earmarks doubled between 2001 and 2005, coinciding exactly with the years that congressional Republicans let non-defense discretionary spending grow at a rate not seen since the early seventies.

Senator Inhofe attempts to minimize the importance of this correlation by producing one of his own: “Over the course of the last several years, the overall number and dollar amount of earmarks has steadily decreased. During that same time, overall spending has ballooned by over $1.3 trillion.” Well, let’s just put it this way: Special inducements and temptations aren’t necessary to get a Democrat-controlled Congress signed up for more spending. The lesson of 2001 to 2005 is that earmarks hypnotize Republican majorities into spending like Democrats. Earmarks are our problem, not theirs.

"Earmarks hypnotize Republican majorities into spending like Democrats." I love that. It's yet another example of a creative conservative argument that never would have occurred to me. It also suggests that Republicans are really cheap dates. Apparently all it takes to get them to spend like drunken sailors is a few million dollars each in earmarks. That's some party you have there, Stephen.

In any case, I don't really have a dog in this fight. Giving members of Congress some limited amount of say over how money is spent in their districts actually seems defensible to me, as long as it's public and transparent. On the other hand, the opportunities for mischief are pretty obvious too, so doing away with earmarks wouldn't bother me much. What's more, deep sixing earmarks entirely would have the salutary effect of (a) forcing alleged deficit hawks to talk about something a little more serious, and (b) putting an end to pretzel-bending arguments like Spruiell's. Count me in, I guess.

In Which I Praise the Deficit Commission

Via Andrew Sullivan, Bulworth defends the deficit commission's Social Security proposal from a progressive point of view:

This Social Security package would restore long term solvency, go a long way towards protecting it from would-be privatizers, and enhance benefits for the lowest lifetime earners through two new provisions. It also includes a tax max increases, which progressives tend to support. The benefit formula reduction — which some Progressives erroneously liken to "means-testing" — is actually just an extension of the already existing progressive benefit structure.

This criticism seems particularly odd coming from progressives who normally want the more well to do to bear the brunt of any Social Security fixes. Progressives can't clamor for higher payroll taxes or higher limits to the "tax max" while simultaneously criticizing benefit reductions that affect higher-than-average earners. In short, this is overall a pretty progressive package of changes to the program, which Progressives and Democrats should support.

For what it's worth, I agree. The co-chairs' Social Security proposal is not the one I'd make, but it's pretty solidly in the mainstream of reasonable takes on shoring up Social Security's finances. Basically, it's a collection of small revenue increases and small benefit cuts, with the cuts focused on high earners and everything phased in over several decades. The worst part of their plan is the increase in retirement age — I think there are much better ways of reducing benefits — but the increase they propose is pretty modest: full retirement goes from 67 to 68 by 2050. That's not Armageddon.

If it were up to me I'd do a bit more on the revenue side, possibly increasing the payroll tax from 12.4% to 13%, for example. But as a discussion draft, Simpson-Bowles is OK, and it's a good demonstration of my point that fixing Social Security is pretty easy if both sides are even minimally serious about finding a compromise.

Other aspects of the plan still strike me as unserious. The 21% cap is just a sop to conservative dogma, not something related to deficit reduction. Ditto for the tax plan. The discretionary cuts are mostly pie in the sky, and in any case don't really deserve much space in a document concerned with long-term deficit reduction. And the healthcare discussion is woefully underpowered.

But the Social Security proposal? It's not bad.

Taxes and the Deficit Commission

Criticism of the deficit commission report continues apace. Matt Yglesias:

The flipside of the Simpson-Bowles document’s unsound aggregate cap on revenue is that they were very uncreative in their exploration of revenue options. For example, what about a tax on greenhouse gas emissions? The mere fact that the conservative movement is currently engaged in a massive fit of pretending that greenhouse gas emissions aren’t a problem doesn’t change the fact that greenhouse gas emissions are, in fact, a problem. Taxing them would reduce the quantity of greenhouse gas emissions and help mitigate the problem. It also creates revenue.

In fairness, they do recommend a gasoline tax. It's a small one, but at least it's there as a talking point. So I guess they deserve a bit of credit for that.

But that brings up another point: one entire section of the report is devoted to comprehensive tax reform. Why? Broadening the base of the tax system and reducing marginal rates might or might not be a good idea, but it doesn't really have anything to do with deficit reduction.1 In fact, the only tax-related subject that's germane to deficit reduction is increases in total tax revenue. The report mainly addresses this in its discussion of reducing tax expenditures, which is a perfectly defensible way of raising more revenue. But why go beyond that to a root-and-branch proposal for tax reform that's essentially revenue neutral?

As with the entire report, the answer is ideological: this is less a report on reducing the deficit than it is a report on remaking the government in a conservative image. Which, again, is fine, if you're a conservative think tank and this is what you believe. But it's not what a report should be if it's a supposedly nonideological effort to reduce deficits. That kind of report should focus solely on cutting spending and increasing revenue, not on remaking the tax system.

1The co-chairs' argument — though it's articulated only glancingly in the body of the report — is that their version of tax reform would spur economic growth and thus help reduce the deficit. This is a defensible argument, but it's also a highly ideological one. It's really not appropriate in a document that's supposedly a neutral take on deficit reduction.

World Meets, Does Nothing

Here's a shocker:

Leaders of the world’s biggest economies agreed on Friday to curb “persistently large imbalances” in saving and spending but deferred until next year tough decisions on how to identify and fix them.

Still, I suppose merely acknowledging the problem in a big public forum represents a bit of progress. A "single," as President Obama puts it.

By the way, if you want to reduce the federal deficit, guess what else has to happen? The trade deficit has to come down. This is one bellwether of seriousness on the budget deficit: if you mention the trade deficit, you're serious. If you don't, you're not. So without looking, anyone want to place a bet on whether the Simpson-Bowles deficit commission report mentions the trade deficit? I'd take bets on this with all comers, but I'd be cheating. I already looked.1

1Answer: no it doesn't. This is yet another stake in the heart of the report's supposed seriousness.

Is Our Kids Learning?

Another day, another confusing magazine article about American education. This one is by Amanda Ripley in the Atlantic, and it focuses solely on how our top performing students do compared with those in other countries. In particular, how do our top students do in math?

We’ve known for some time how this story ends nationwide: only 6 percent of U.S. students perform at the advanced-proficiency level in math, a share that lags behind kids in some 30 other countries, from the United Kingdom to Taiwan. But what happens when we break down the results? Do any individual U.S. states wind up near the top?

Incredibly, no. Even if we treat each state as its own country, not a single one makes it into the top dozen contenders on the list. The best performer is Massachusetts, ringing in at No. 17....“If all American fourth- and eighth-grade kids did as well in math and science as they do in Massachusetts,” writes the veteran education author Karin Chenoweth in her 2009 book, How It’s Being Done, “we still wouldn’t be in Singapore’s league but we’d be giving Japan and Chinese Taipei a run for their money.”

Aha! Massachusetts may not be up there with Taiwan or Japan, but they're better than any other state in America. So what's their secret?

Is it because Massachusetts is so white? Or so immigrant-free? Or so rich? Not quite. Massachusetts is indeed slightly whiter and slightly better-off than the U.S. average. But in the late 1990s, it nonetheless lagged behind similar states — such as Connecticut and Maine — in nationwide tests of fourth- and eighth-graders. It was only after a decade of educational reforms that Massachusetts began to rank first in the nation.

What did Massachusetts do? Well, nothing that many countries (and industries) didn’t do a long time ago. For example, Massachusetts made it harder to become a teacher, requiring newcomers to pass a basic literacy test before entering the classroom. (In the first year, more than a third of the new teachers failed the test.) The state also required students to pass a test before graduating from high school — a notion so heretical that it led to protests in which students burned state superintendent David Driscoll in effigy. To help tutor the kids who failed, the state moved money around to the places where it was needed most. “We had a system of standards and held people to it — adults and students,” Driscoll says.

Wait a second. The literacy test sounds like a good idea, but it seems fairly disconnected from the performance of our top math students. California has required new teachers to pass both a literacy and math test for nearly 20 years and we rank barely above Turkey in advanced math proficiency. Ditto for a high-school graduation exam, which plainly doesn't have any impact on top-tier students who have been performing above the basic graduation level all along.

And that's it. Maybe Massachusetts did some other stuff, but I assume Ripley chose to highlight their most important reforms, not the trivia. And their most important reforms seem pretty unlikely to have affected the math scores of our crème de la crème. So what's the deal? Once again, after reading a popular account of education reform, I'm more confused than I was when I started.

Hard Truths

I want to make a followup point to my post last night about the deficit commission. Mainly, that post said that if you're serious about the long-term deficit, you need to be serious about healthcare costs. That's pretty much the whole ballgame. The rest is fluff. Matt Steinglass comments:

Mr Drum writes for a liberal magazine. And here he is saying that the main thing we need to do in order to restrain growth in the deficit and in government spending, which will otherwise bankrupt us, is to cut the biggest government entitlement programme, Medicare....Shouldn't this be big news for our contrarian press? "Liberals Call for Cuts to Entitlements!" Aren't we amazed that supposedly big-government liberals want to slash the projected Medicare budget? What an example of responsible bipartisanship on their part!

And yet the press pays absolutely no attention to this. In general, liberals are given no credit whatsoever for acknowledging reality and calling for cuts in social-welfare entitlement programmes. So here's what I'm hoping. I'm hoping some of you read my initial comment about wanting to retweet what Kevin Drum wrote on this and thought, "Well obviously a liberal who writes for Mother Jones would be saying that in the long term massive budget deficits threaten our future, and the only way to seriously reduce that long-term deficit is to slash Medi...wait a minute." Just take that "wait a minute", and maybe give people some credit for coming to reality-based conclusions.

Actually, this is only half the story. It's true that I think we need to rein in spending on both Medicare and healthcare spending in general. Be amazed, conservatives! But there's a flip side to this: the American population is aging and medical care is getting more expensive. This is simply a fact, and it means that even if we slow the rate of healthcare inflation we're going to need more money for healthcare. You want Hard Truths? That's a hard truth. We need to rein in healthcare spending and we need to raise taxes to pay for the higher healthcare costs of an aging population. Anybody who's serious about addressing the long-term deficit needs to deal with this instead of indulging in fantasies.

But fantasies are largely what we get from the co-chairs' report. Nick Baumann takes a closer look at what kinds of cost cutting they recommend for Medicare and concludes that it's (a) politically unrealistic and (b) ineffective anyway:

This is seriously third-rail stuff. There's medical malpractice reform....strengthening the Independent Payment Advisory Board [which is] already under attack by Senate Republicans....Seniors' copays and deductibles would increase.

....After putting forth proposals that will irk trial lawyers, doctors, hospitals, and seniors, the co-chairs still aren't done — they also want to take on Big Pharma....The rest of the co-chairs' health care proposals include ticking off veterans, whose copays would increase; medical colleges, who would receive less in federal subsidies; and states, which would receive less money to cover long-term care for poor seniors. In short, the chairs' health care proposals will force nearly every significant interest group in America to take a haircut.

The kicker is that, under the co-chairs' proposal, a large part of the health care "savings" would be immediately spent [on the "doc fix"]....This is the ultimate proof of Kevin's point: even though our main budget problem is that health care costs too much, the deficit commission wants to spend most of its controversial health care "savings" on making sure that doctors keep getting paid at a level that satisfies the American Medical Association. It's more evidence of just how difficult the long-term deficit problem really is.

In other words, they've offered up a plan that's almost impossible to envision passing, and even at that it would accomplish barely anything. This deserves far more serious attention from centrist deficit hawks, and it deserves attention on both sides of the deficit equation. On the cost control side it means thinking bigger, and on the revenue side it means acknowledging that taxes will have to go up regardless. Liberals will naturally resist a lot of the cost cutting proposals, but at least they acknowledge that cost cutting has to happen. That's a start. But conservatives? I don't have to tell you their position. This makes reducing the long-term deficit impossible. Dealing with healthcare spending can only be done if both sides have political cover, and that means both sides have to make those famous Tough Choices we hear so much about. That will only happen when conservatives start acknowledging demographic reality.