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This Is How You Define Fiscal Responsibility

Word that the Obama administration was planning a summit next week on entitlements and fiscal responsibility sent shudders through the progressive community. Didn't we just get rid of the guy who wanted to gut Social Security? But Obama has said consistently that the federal government doesn't have an entitlements problem. It has a health care problem.

The cost of medical care is skyrocketing. This is turning Medicare and Medicaid into massive drains on the federal treasury. To bring those costs under control, the government needs to change the way we deliver and pay for medical care. And, eventually, it has to be all medical care, not just the kind government pays for, because different parts of the system are so intertwined. Fortunately--or, at least, conveninently--rising health care expenses are also bankrupting the private sector. So comprehensive reform makes sense.

But you know that. And so, thankfully, do the people working for Obama. Here's Budget Director Peter Orszag making that argument to Politico's Ben Smith, in an article posted early this morning:

Social Security faces an actuarial deficit over the next 75-100 years. In the past I’ve resisted the term ‘crisis’ to describe that kind of situation. This is not quantitatively as important as getting healthcare done.

So what's up with this fiscal responsibility summit? It's all about education--and, yes, some public relations. Obama wants to signal that he is serious about fiscal responsibility and he wants to make clear the linkage between fiscal responsibility and health care. Ezra Klein has the goods on this:

Monday's fiscal reform summit, which has caused a lot of heartburn in progressive circles, is not, according to sources in the administration, going to actually upset them. "The most likely outcome at this point," says one senior administration official, "is that we focus on health care, given that it's the key to our fiscal future."

This doesn't mean progressives should shut up. On the contrary, it's important that liberals make their position clear. As my erudite colleague John Judis argued the other day, Obama needs strong voices pushing the political debate to the left--or at least keeping the debate from moving to the right. But it does mean that progressives shouldn't panic, either.

Note to readers: If the administration decides to lower its ambitions on health care in the next week or two, I'll pull out the panic button.

--Jonathan Cohn