EJ Dionne's column today, as usual, is good, but one thing kinda bugged me: No. 1: Extending President Bush's tax cuts to eternity will make the long-term problem much worse. Hint No. 2: The hardest part will be how -- simultaneously -- to meet the fiscal need to rein in health costs and the social need to get health insurance to everyone. Hint No. 3: Most Democrats don't like to talk about it, but somebody's taxes are going to have to go up. He sets up the "social need" for universal health insurance in tension to the "fiscal need" to rein in health costs, but I'm not so sure that's the right relationship. As I tried to write yesterday, there's some evidence that a greater role for the government would help bring down health care costs across all sectors in the long term. Anyway, I confess my ignorance of the mechanisms involved here. But doesn't this seem like the perfect silo-crossing issue? It'd be nice if health care wonks helped us ignorant budget wonks understand this aspect of universal coverage better. The best I can do is put Jacob Hacker's summary of the argument for cost-containment after the jump.

We last left the subject of budget and entitlement reform in 2006 (here and here) amid muted congressional response to bids by OMB Director Rob Portman and Treasury Secretary Henry Paulson to discuss concrete solutions.

Robert Samuelson bashes his generation in today’s Washington Post: Shame on us [baby boomers]. We are trying to rob our children and grandchildren, putting the country's future at risk in the process. On one of the great issues of our time, the social and economic costs of our retirement, we have adopted a policy of selfish silence. *Sigh* What is Samuelson so exercised about? He’s huffing and puffing over something that may or may not happen 33 years from now.

On Monday, Paul Krugman wrote a good column ($) on government outsourcing. A key point: It's now clear that there's a fundamental error in the antigovernment ideology embraced by today's conservative movement. Conservatives look at the virtues of market competition and leap to the conclusion that private ownership, in itself, is some kind of magic elixir. But there's no reason to assume that a private company hired to perform a public service will do better than people employed directly by the government.