Easy-peasy, he says.
It’s not at all hard to imagine that improving the incentives to focus on medically effective care could limit cost growth to well below what the C.B.O. is projecting, even now.
And if we can do that, the rise in entitlement spending over the next three decades might be more like 3 percent of G.D.P. That’s not an inconceivable burden. America has the lowest taxes of any advanced nation; given the political will, of course we could come up with 3 percent more of G.D.P. in revenue.
The last time we raised taxes by more than 1.7 percent of GDP was during World War II. So we’re talking about the largest tax increase in generations. And we’d be undertaking it because, for example, we want Social Security benefits for tomorrow’s seniors, even the most affluent, to be larger than they are for today’s. (Do liberals really think this is a better idea than, say, expanding health benefits for the working poor? Or a Green New Deal? Or do they want to bet they can get an even bigger tax hike that funds those things too?)
The only alternative, Krugman explains, is that we “kill” Social Security and Medicare. We can “imagine” our way to a more efficient health system — enough more efficient, and likely enough, that we can avoid taking any steps to prepare for a future in which it doesn’t materialize — but then Krugman’s imagination runs out.