But look at the other line. Under that scenario, which in fact happens to be current law (meaning all the Bush tax cuts expire, for example), debt stabilizes as a share of the economy in a few years and then starts down a slow glide path. And Medicare, Medicaid, and Social Security as we know them today are all in that bottom line.
Under that scenario taxes go up and spending is restrained compared to the alternative baseline. Some of the assumptions — like we allow Medicare payments to doctors to fall sharply or all the tax cuts permanently expire next January — are wholly unrealistic. But there are unrealistic assumptions under the other scenario too (the federal gov’t is not going to be spending 36% of GDP by 2037 (the historical average is about 21%)).
But generally speaking, and with some tweaks, there’s no reason why something like that bottom line’s baseline couldn’t prevail. The Bush tax cuts would all have to eventually sunset, and we’d need to continue-and ramp up-what looks like early progress on slowing the growth of health care spending.
But aside from dysfunctional politics feeding a largely misleading public debate, we could do this. If we, as a nation, decide that we want to achieve fiscal sustainability and preserve the entitlement programs, along with government’s other critical functions, it is well within our means to do so.