Two Ideas That Could Overcome Gridlock

That is theoretically doable because, as it happens, President Obama, in previous budgets, has identified cuts of this that magnitude -- without touching benefit levels. (One caveat: Most of the savings come from trimming Medicare costs, important to keep the program afloat, not as a general spending piggy bank. I'd cut more elsewhere.)

Third Way's carrot for Republicans is reducing the corporate tax rate by four percentage points, to 31 percent. This would be a baby step toward Republicans' desired level of 25 percent. But whereas that leap would require difficult changes to achieve without raising the deficit, Third Way's proposal would get there simply by limiting tax deductions for the wealthiest individuals.

If this sounds controversial, consider: It's Mitt Romney's 2012 tax proposal, to cap deductions at $50,000 (excluding charitable contributions) for those earning more than $250,000. This would raise, not coincidentally, $400 billion.

Both sides get something they want, in exchange for something they can swallow. It's worth a look.

So, too, is a recent proposal by the more traditionally liberal Center for American Progress (CAP) and a who's who of Democratic health care experts. It proceeds from two assumptions: first, that, despite the recent slowdown in health care spending, further changes will be required; second, that "given the current political gridlock," federal oversight isn't forthcoming. Republicans want to control costs by cutting coverage, the CAP paper notes, while Democrats are inclined to deny the need for additional measures to contain costs.

So the CAP plan borrows a traditionally Republican approach: giving power -- and incentives -- to states to control costs. States would have the option to become "Accountable Care States" that would limit the growth in overall (public and private) health care spending. Health spending would be pegged to long-term economic growth, and linked to quality. States that meet cost reduction targets would receive a bonus, a share of the savings to the federal government.

If the same number of states opt into the program as signed up for the Medicaid expansion, CAP predicts, the total savings could exceed $1.7 trillion in the first decade and the federal government could save more than $350 billion. As with the Third Way proposal, adopting this program would require congressional action, but it is hard to see, other than sheer intransigence, grounds for ideological opposition.

The likelihood that these specific proposals will be enacted? Not high. The possibility that there is some productive legislative path through the gridlock? Not as slim as we have allowed ourselves to be beaten down into believing.

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Ruth Marcus' email address is ruthmarcus@washpost.com.