On the one hand I tip my hat to Republican Paul Ryan for actually submitting a proposal for the federal budget which addresses some of the important issues that are looming. On the other hand he did a really bad job. So it's a mixed bag.
The fundamental problem is that he puts fiscal responsibility squarely on the backs of the poor and elderly, mostly by slashing Medicare and Medicaid and lowering taxes on the rich. Nor does his plan address "defense" spending, which is a subject we've addressed before here.
We pretty much exhausted the health care debate here last year, but it bears mentioning once again that there is a very good argument that a single payer system would do more to solve our entitlement-budget problems than anything else. A single-payer system would save costs in a few of ways. First, you would immediately slash most of the administrative overhead that is currently a massive drag on the system. Second, you remove the perverse profit motive that skews the system and leads to appalling results. Third, by covering everyone the risks are spread evenly and fairly amongst all Americans and the uninsured can no longer crash the party without paying in. Fourth, since everyone is covered preventive care is universally available. Fifth, bankruptcies as a result of medical emergencies no longer exist.
There are other points, and counterpoints, but that gives a pretty good idea of where health care savings might come from in a single payers system.
The United States currently pays more per capita for health care than developed countries which have a single payer system, without the benefits of actually better health. We should have no problem studying those systems and creating one that works for us. I understand that there trade-offs for universal health care, but none I'm not willing to pay.
A single payer health care system is a nice, elegant way of both fixing the broken health care system and taking a huge step towards fixing the federal budget.