By Mike Dorf
My latest Verdict column asks what issue or issues should frame President Obama's second term. I end up advocating what I call a "cost-internalization" agenda, but before coming to that proposal I consider and reject the notion that whatever grand bargain emerges from the fiscal cliff negotiations should be the centerpiece of the second term. I agree that it is important to avoid the fiscal cliff but I express disagreement with the conventional wisdom that appears to be accepted by all parties: that it's important to dramatically reduce the deficit now. Instead, I note that the long-term driver of the deficit (and other economic ills) is health-care cost inflation.
How did we arrive at the conventional wisdom? Some substantial portion of the responsibility belongs to Warren Rudman, who passed away yesterday. Rudman was a genuine patriot who cared deeply about the country, but he was also a deficit hawk whose legacy has arguably made us worse off. Various memorials to Rudman have rightly noted that he was no partisan. A Republican, he teamed up with Democrat Fritz Hollings (and Republican Phil Gramm) to write deficit-curbing legislation. With Democrat Paul Tsongas, Rudman founded the Concord Coalition to urge "fiscal responsibility." And indeed, the single-most important legacy of Rudman is probably the acceptance--by Democrats no less than Republicans--of the view that reducing the federal deficit should be a national priority.
I nonetheless say that Rudman's legacy is mixed rather than negative for two reasons. First, Rudman gave the nation a magnificent gift. When President George H.W. Bush's White House Chief of Staff John Sununu was looking for a "stealth" Supreme Court nominee, Sununu accepted the recommendation of his fellow New Hampshirite Rudman to nominate David Souter. Rudman and Souter were great friends and it apparently did not occur to Sununu that Souter was not the conservative that would have appealed to the Republican base. Souter served with enormous distinction and though he retired far too early for my taste, he did so on President Obama's watch, ensuring that a seat that could have gone to a conservative has remained liberal.
Second, although I disagree with many of the normative views of the Concord Coalition, it is a "reality-based" organization. Within the context of advocating fiscal responsibility, it accepts that tax increases are not invariably evil and also that medical care cost inflation is the single greatest driver of the deficit.
The question is how to bring down the rate of medical care cost inflation. I don't have a comprehensive answer but I do have a big piece of it. As Americans sit down tomorrow to over-eat and, more importantly, to eat large quantities of foods derived from animals, I'll take this opportunity to note that if large numbers of Americans ate a healthier diet (by which I mean a vegan diet rich in a wide variety of unprocessed plant-based foods), we could not only bring down the cost of health care but actually be healthier.
Rest in peace, Senator Rudman, and a happy Thanksgiving to all of my readers.