Washington Post columnist Steven Pearlstein writes:

The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they’ve given up any pretense of being the loyal opposition. They’ve become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.

My own view is that Democrats and Republicans have been misleading and disingenuous throughout the course of the healthcare debate. As James Capretta and Yuval Levin have explained, the premium subsidies that the House Democrats recommend will create an unstable equilibrium. Low-income amilies insured through the health insurance exchange will receive far more generous subsidies than those insured through their employers, and so there will be a rapid shift to the exchanges. That’s not necessarily a bad thing in itself; it will, however, mean that the CBO has in fact underestimated the cost of the proposal.

Does pointing this out make someone a “political terrorist”? Pearlstein continues in this vein.

There are lots of valid criticisms that can be made against the health reform plans moving through Congress — I’ve made a few myself. But there is no credible way to look at what has been proposed by the president or any congressional committee and conclude that these will result in a government takeover of the health-care system. That is a flat-out lie whose only purpose is to scare the public and stop political conversation.

Scaring the public: the Obama administration has made a concerted effort to convince the public that today’s healthcare arrangements are unraveling at a fast clip and that we face a crisis situation that must be resolved through rapid legislative action. I think that this is a reasonable view. But it does involve scaring the public. As for stopping political conversation, my sense is that opponents of the Obama effort are seeking to engage in the political conversation. This isn’t true of everyone: there is a minority that is determined to disrupt political conversation, just as there was in 2005. But to describe Republican leaders and conservative critics as political terrorists seems rather inapt.

Many on the left accused conservatives of seeking to scare the public about the threat of mass-casualty terrorism on domestic soil. Conservatives accuse liberals of seeking to scare the public about the threat posed by climate change. This strikes me as inescapable: democratic politics engenders strong feelings. Naturally, Pearlstein believes that his efforts to scare the public into taking action on a pressing healthcare crisis are profoundly admirable. Conservatives want to avoid, belatedly some will surely argue, a crippling federal debt burden. Hasn’t Sonia Sotomayor reminded us of the value of empathy?

Incredibly, Pearlstein goes on to suggest that CBO cost estimates amount to “a lie.” Or rather he claims that Republicans are responsible for the fact that “most people” believe that the $1 trillion over 10 years will in fact cost $1 trillion every year. This is an interesting view. And he also outlines offsetting savings from the reform plan:

Other parts of the reform plan would result in offsetting savings for Medicare: reductions in unnecessary subsidies to private insurers, in annual increases in payments rates for doctors and in payments to hospitals for providing free care to the uninsured. The net increase in government spending for health care would likely be about $100 billion a year, a one-time increase equal to less than 1 percent of a national income that grows at an average rate of 2.5 percent every year.

Is Pearlstein a liar if these notional savings don’t materialize? Is this not a probabilistic question? He talks about “likely” savings, yet he accuses those who have a different view concerning what is likely and what is not to be liars. While serving in the White House, Lawrence Lindsey predicted that the Iraq War would cost $100 to $200 billion, an estimate that was far higher than numbers then touted by the Bush White House. Suffice it to say, Lindsey’s number turned out to be gross underestimate. To be sure, the range of estimates is presumably somewhat narrower for the health reform effort than for the invasion and occupation of a rogue state. But we’re all flying blind to some degree, and the CBO is trying to play the role of an honest broker. That conservatives will raise tough questions seems reasonable given the scale of the endeavor. We’d all have been better off had conservatives been more forthright about raising these questions during the Bush years.

Moreover, Pearlstein discounts plausible scenarios in which expanded coverage increases cost growth, which Keith Hennessey considers in this post.

I’m in favor of healthcare reform. I think we need to move away from job-based coverage. I think the IMAC proposal can indeed bend the cost-curve downwards. But I also don’t think Steven Pearlstein should be the final arbiter of what can and cannot be said on the question of healthcare reform. I get the impression that Pearlstein believes that considering downside risk amounts to treason.

My guess is that Steven Pearlstein is comfortable with the idea of a political opposition. At the start of the column, he argues that conservatives no longer constitute a loyal opposition. The loyalty involved in being a loyal opposition, however, is to constitutional norms and political procedures and to the integrity of the state, not loyalty to the agenda promoted by the party in power.