David Brooks is very upset about the possibility that the cost of Medicare will prevent the United States from being as large a military force in the world in the future as it has been in the past. He tells readers:

"Medicare spending is set to nearly double over the next decade. This is the crucial element driving all federal spending over the next few decades and pushing federal debt to about 250 percent of G.D.P. in 30 years. ...

"So far, defense budgets have not been squeezed by the Medicare vice. But that is about to change. Oswald Spengler didn’t get much right, but he was certainly correct when he told European leaders that they could either be global military powers or pay for their welfare states, but they couldn’t do both."

Of course fans of arithmetic everywhere know that the basis for these projections is the assumption that per person health care costs, which are already more than twice the average for other wealthy countries, will increase to three or four times the cost in other countries. This means that our health care system will become ever more dysfunctional.

While that is of course possible, the problem is not the American people getting what they want, as Brooks asserts, it is the health care industry using its political power to extort incredible sums from the rest of us. If our health care costs were in line with costs in other countries, we would be looking at budget surpluses, not deficits.

In principle we should be able to reform our health care system to get its costs in line with those in other countries. However Brooks never even considers this possibility. (Actually, health care costs in recent years have come in way below projections, suggesting that we may already be on a slower growth path.) Alternatively, if our political system is too corrupt to allow reform we could allow Medicare beneficiaries to buy into the more efficient health care systems in other countries and split the savings with the government. However, Brooks is not interested in this option either.

Brooks would rather see people denied care under the argument that it is necessary to preserve the country's military standing in the world. In reality, we should make sure that we are not wasting trillions of dollars paying more than necessary for our health care. We should also decide what sort of military involvement we want the United States to have in the world. It may not be desirable to be intervening widely and fighting wars on different continents even if we can in fact afford the cost.