…even if Obamacareproves stunningly effective at restraining health-care costs, it won’t work in a day, a year or even 10 years. Bringing down health-care costs will be a multidecade project no matter how we approach the task. Success will be defined by health-care spending growing a bit faster than the economy rather than much faster. Health care’s share of the economy will still grow — which means the government’s share will probably grow, too.
“Eighteen percent may be a long-term historical average,” Alice Rivlin, a former White House budget director, said this week, “but it’s not a realistic average looking forward.”
The need for tax receipts to grow underscores the necessity of finding an efficient way to collect them. Experts say that should include tax reform and new tax sources that take the pressure off the income tax, such as a value added tax or a carbon tax.