But at the moment, we don't have anyone working to stop it -- not the Republicans, not the Democrats. In the late 1990s, President Bill Clinton seemed ready to work with Sen. Pat Moynihan to put an investment component in Social Security and with Sen. John Breaux to institute market reforms in Medicare. But Clinton, at the behest of the liberals who rescued him by opposing his impeachment, pulled back, even though the political stars were otherwise aligned.
George W. Bush came to office with plans for market reform in Social Security and health-care finance. But he got only a little of the latter -- health savings accounts and demonstration projects in the 2003 Medicare law. On Social Security, he was stymied by united Democratic opposition in 2005.
White House domestic adviser Allan Hubbard argues that health savings accounts are being rapidly embraced and can inject more market mechanisms in health care. Maybe so. Health-care finance in this country is not one single system that never changes, but many systems that change every year in response to government regulation and market pressures. But no one has the political stomach to tackle what many recognize as a major problem -- the link between health insurance and employment. Until that happens, health-care costs, and Medicare and Medicaid, will likely grow faster than the economy.
The far-sighted Charles Murray suggests another solution: Replace all entitlements with payments of $10,000 a year to every adult -- enough he says, to enable them to provide for their own retirement and health-care needs. Plausible but not, as Murray admits, politically feasible anytime soon.
Meanwhile, presidential candidates aren't addressing these issues as much as did Bush in 2000 or even Clinton in 1992. Some Democrats want us to move toward the model of France, and many Republicans calculate that any long-term gain is not worth the short-term political price. Bad news if we don't want our grandchildren to live in a country more like today's France than today's United States.