The neoconservatives truly seem to inhabit a world that differs significantly from the place where the rest of us dwell.  David Brooks has yet another astonishing piece in the New York Times, explaining that it is an unreasonable desire on the part of the American people to live forever that is driving up Medicare costs and has caused the budget crisis. As he puts it “…our inability to face death — our willingness to spend our nation into bankruptcy to extend life for a few more sickly months.”  While one might argue that there are certainly medical treatments that are ruinously expensive and that only prolong life for a short time, Brooks ignores the fact that most advanced countries do succeed in providing universal medical care at a reasonably high level while also controlling costs.  Several dysfunctions in the American way of providing health care have been a large part of the costs problem, not necessarily the actual care or treatments provided.

Be that as it may, Brooks has again indicted healthcare as the culprit in the budget imbroglio.  He says that it is the largest part of the Federal budget.  That would be correct only if one ignores special appropriations for fighting wars, which Brooks approves of. In fact, Brooks never once mentions “defense” spending.  In 2010, Medicare and Medicaid combined consumed $793 billion of the Federal budget while military spending was $689 billion.  But, according to the Congressional Research Service, that defense bill was really much larger due to the total $1.283 trillion in supplementary appropriations approved to support the wars in Afghanistan and Iraq as of 2010, plus related costs.  In 2010, the special appropriation was $165 billion, making the total bill for defense plus wars in that year $854 billion. It is also itself an underestimate as it does not include legacy costs like medical care for wounded veterans of the conflicts or borrowing costs.  Another recent estimate for the total costs of Iraq and Afghanistan, arguably wars that the United States should either not have fought or should have long since ended, is $4 trillion.  That also does not include legacy costs and interest.  Other estimates of the total costs of the wars, even if they were to end today, go as high as $7 trillion.

Far be it from me to call a fine Canadian gentleman like David Brooks a hypocrite, but I would like to think that an honorable pundit would rethink his article and rewrite it to reflect the fact that spending on the military actually far exceeds spending on healthcare.  I also wonder about his basic premise about Americans being afraid to die any sooner than necessary.  Would Brooks pull the plug on a family member who had a terminal illness or is he assuming that his New York Times provided insurance will always be exceptional so he will not have to entertain that choice?