Over the last couple of years, there’s been plenty of talk — far too much, really — about the nation’s long-term fiscal challenges, and it’s true that it’s a problem that we should deal with responsibly in time. But the talk is often overly broad — what we have is a fiscal challenge related to long-term health care costs specifically, not just long-term debt in general.
As Jared Bernstein put it the other day, “As long as health care costs (and, as the population ages, demand for services) continue to spiral up, it’s going to create huge problems.”
To drive the point home, take a look at this image the Bipartisan Policy Center published yesterday.

It may be a little tough to see but there are four lines, showing long-term spending, as a percentage of GDP, on health care, Social Security, discretionary spending, and other mandatory spending. That blue line that shows the sharp increase? That’s health care.
As Sarah Kliff noted in response, “Even as someone who spends a lot of time writing about health policy, this new chart … is still one that gives me a bit of pause.”
This should matter in the context of the debate in Washington, because if policymakers want to address long-term debt issues, they should at least realize, to borrow Willie Sutton’s line, where the money is.
But they should also realize that there are different approaches to controlling health care costs, and Republicans have the policy completely wrong. After all, what does the GOP propose? Three things: (1) repeal the Affordable Care Act; (2) raise the age of Medicare eligibility; and/or (3) end Medicare and replace it with a privatized voucher system.
And what’s wrong with this? Well, first, the ACA is already working to lower costs, and eliminating the law would increase the deficit and reverse the progress on curtailing costs. Second, raising the Medicare eligibility age would actually be a rather dramatic step backwards. And third, the Republican plan to end Medicare wouldn’t save any money at all — it would just shift the burdens onto seniors and their families.
My concern is that some folks, especially on the right, will see the chart like this one and think this somehow bolsters the Republican argument. In reality, it does the opposite.