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America must spend big on health care and other pressing issues because doing nothing will cost more | COMMENTARY

Sen. Bernie Sanders speaks during the Democratic presidential debate at the Paris Theater in Las Vegas earlier this month. At left is Sen. Elizabeth Warren. Some say both candidates' ideas for making the country better are expensive, but if we don't pay for America's problems now the cost will be greater in the future.
Sen. Bernie Sanders speaks during the Democratic presidential debate at the Paris Theater in Las Vegas earlier this month. At left is Sen. Elizabeth Warren. Some say both candidates' ideas for making the country better are expensive, but if we don't pay for America's problems now the cost will be greater in the future.(Erin Schaff/The New York Times)

In last week’s Democratic debate, former South Bend, Indiana, Mayor Pete Buttigieg charged that Sen. Bernie Sanders’ policy proposals would cost $50 trillion. Holy Indiana.

Larry Summers, formerly the chief White House economic adviser for Barack Obama, puts the price tag at $60 trillion. "We are in a kind of new era of radical proposal," he told CNN.

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Putting aside the accuracy of these cost estimates, they omit the other side of the equation: What, by comparison, is the cost of doing nothing?

A Green New Deal might be expensive, but doing nothing about climate change will almost certainly cost far more. If we don't launch something as bold as a Green New Deal, we'll spend trillions coping with the consequences of our failure to be bold.

Medicare for All will cost a lot, but the price of doing nothing about America's increasingly dysfunctional health care system will soon be in the stratosphere. A new study in The Lancet estimates that Medicare for All would save $450 billion and prevent 68,000 unnecessary deaths each year.

Investing in universal child care, public higher education and woefully outdated and dilapidated infrastructure will be expensive too, but the cost of not making these investments would be astronomical. American productivity is already suffering, and millions of families can’t afford decent child care, college or housing — whose soaring costs are closely related to inadequate transportation and water systems.

Focusing only on the costs of doing something about these problems without mentioning the costs of doing nothing is misleading, but this asymmetry is widespread.

Journalists wanting to appear serious about public policy continue to rip into Mr. Sanders and Elizabeth Warren (whose policies are almost as ambitious) for the costs of their proposals but never ask self-styled moderates like Mr. Buttigieg how they plan to cope with the costs of doing nothing or too little.

A related criticism of Mr. Sanders and Ms. Warren is that they haven’t come up with ways to pay for their proposals. Mr. Sanders “only explained $25 trillion worth of revenue, which means the hole in there is bigger than the size of the entire economy of the United States,” Mr. Buttigieg said during last week’s debate.

Mr. Sanders’ and Ms. Warren’s wealth tax would go a long way toward paying for their plans.

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But even if the wealth tax paid a small fraction of the costs of their proposals, so what? As long as every additional dollar of spending reduces by more than a dollar the future costs of climate change, inadequate health care and insufficient public investment, it makes sense to spend more.

Republican administrations have doled out gigantic tax cuts to big corporations and the wealthy without announcing specific cuts in public spending or other tax increases because — despite decades of evidence to the contrary — they claim the cuts will generate economic growth that will more than make up for any lost revenue.

Yet when Ms. Warren and Mr. Sanders propose ambitious plans for reducing empirically verifiable costs of large and growing public problems, they are skewered by fellow Democrats and the press for not having ways to pay for them.

A third line of criticism is that Mr. Sanders’ and Ms. Warren’s proposals are just too big. It would be safer to move cautiously and incrementally.

This argument might be convincing if the problems Mr. Sanders and Ms. Warren address were growing slowly. But experts on the environment, health education and infrastructure are nearly unanimous: These problems are worsening exponentially.

Young people understand this, perhaps because they will bear more of the costs of inaction. An Emerson poll of Iowa found that 50% of Democrats under the age of 50 support Mr. Sanders, and 10% favor Ms. Warren. In New Hampshire, Mr. Sanders won more voters under 30 than the other candidates combined, according to CNN exit polls. In Nevada, he captured an astonishing 65% of voters under 30.

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The reason to support Mr. Sanders’ and Ms. Warren’s proposals isn’t because they inspire and mobilize voters. It is because they are necessary.

We can no longer pretend that climate change, a wildly dysfunctional health care system and a yawning deficit in public investment pose insignificant challenges. Doing nothing or doing too little will make them far worse.

Obsessing about the cost of addressing them without acknowledging the cost of failing to address them is dangerously irresponsible.

Robert Reich’s new book, “The System: Who Rigged It, How We Fix It,” will be out in March.

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