It's the children, stupid.

The 1992 Clinton Campaign made famous the phrase, "It's the economy stupid". It was his theme for defeating President George Bush Sr.

I think a modified phrase, "It's the children stupid" applies to an analysis of the future well-being of our society.

I know folks on the left love to trumpet children to expand spending on social programs though many of the initiatives are often anti-children, e.g. pro-abortion policies and funding kill unborn children, birth control advocacy results in fewer children, and gay "marriage" intentionally denies what children need most - both their mom and their dad in their lives.

Ross Douthat conservative columnist with the New York Times has an interesting article on the declining birth rates in the US, "More Babies, Please."

First, the US's birth rate has geopolitical implications.

In the eternally recurring debates about whether some rival great power will knock the United States off its global perch, there has always been one excellent reason to bet on a second American century: We have more babies than the competition.

It’s a near-universal law that modernity reduces fertility. But compared with the swiftly aging nations of East Asia and Western Europe, the American birthrate has proved consistently resilient, hovering around the level required to keep a population stable or growing over the long run.

America’s demographic edge has a variety of sources: our famous religiosity, our vast interior and wide-open spaces (and the four-bedroom detached houses they make possible), our willingness to welcome immigrants (who tend to have higher birthrates than the native-born).

It implicates economic growth.

And it clearly is an edge. Today’s babies are tomorrow’s taxpayers and workers and entrepreneurs, and relatively youthful populations speed economic growth and keep spending commitments affordable. Thanks to our relative demographic dynamism, the America of 50 years hence may not only have more workers per retiree than countries like Japan and Germany, but also have more than emerging powers like China and Brazil.

 But now it's dropping dramatically.

If, that is, our dynamism persists. But that’s no longer a sure thing. American fertility plunged with the stock market in 2008, and it hasn’t recovered. Last week, the Pew Research Center reported that U.S. birthrates hit the lowest rate ever recorded in 2011, with just 63 births per 1,000 women of childbearing age. (The rate was 71 per 1,000 in 1990.) For the first time in recent memory, Americans are having fewer babies than the French or British.

The plunge might be temporary. American fertility plummeted during the Great Depression, and more recent downturns have produced modest dips as well. This time, the birthrate has fallen fastest among foreign-born Americans, and particularly among Hispanics, who saw huge amounts of wealth evaporate with the housing bust. Many people may simply be postponing childbearing until better times return, and a few years of swift growth could produce a miniature baby boom.

 Immigrants won't fill the gap.

But deeper forces than the financial crisis may keep American fertility rates depressed. Foreign-born birthrates will probably gradually recover from their current nadir, but with fertility in decline across Mexico and Latin America, it isn’t clear that the United States can continue to rely heavily on immigrant birthrates to help drive population growth.

Among the native-born working class, meanwhile, there was a retreat from child rearing even before the Great Recession hit. For Americans without college degrees, economic instability and a shortage of marriageable men seem to be furthering two trends in tandem: more women are having children out of wedlock, and fewer are raising families at all.

 Then he discusses why it's happening.

Finally, there’s been a broader cultural shift away from a child-centric understanding of romance and marriage. In 1990, 65 percent of Americans told Pew that children were “very important” to a successful marriage; in 2007, just before the current baby bust, only 41 percent agreed. (That trend goes a long way toward explaining why gay marriage, which formally severs wedlock from sex differences and procreation, has gone from a nonstarter to a no-brainer for so many people.)

 What can be done to change it, by the government?  Some things but the problem goes much deeper.

Government’s power over fertility rates is limited, but not nonexistent. America has no real family policy to speak of at the moment, and the evidence from countries like Sweden and France suggests that reducing the ever-rising cost of having kids can help fertility rates rebound. Whether this means a more family-friendly tax code, a push for more flexible work hours, or an effort to reduce the cost of college, there’s clearly room for creative policy to make some difference.

  Then he points out that low birth rates are a symptom of -- decadence.

More broadly, a more secure economic foundation beneath working-class Americans would presumably help promote childbearing as well. Stable families are crucial to prosperity and mobility, but the reverse is also true, and policies that made it easier to climb the economic ladder would make it easier to raise a family as well.

Beneath these policy debates, though, lie cultural forces that no legislator can really hope to change. The retreat from child rearing is, at some level, a symptom of late-modern exhaustion — a decadence that first arose in the West but now haunts rich societies around the globe. It’s a spirit that privileges the present over the future, chooses stagnation over innovation, prefers what already exists over what might be. It embraces the comforts and pleasures of modernity, while shrugging off the basic sacrifices that built our civilization in the first place.

Such decadence need not be permanent, but neither can it be undone by political willpower alone. It can only be reversed by the slow accumulation of individual choices, which is how all social and cultural recoveries are ultimately made. 

 Strong words but it's important we face these developments square on.

If Obama and Cong. Democrats pass a health care bill will it solve our health problems? Douthat says will merely kick problem down the street.

Are the problems with our nation's health care system going to be resolved if Obamacare is passed with or without a public option? It may reduce the number of people who don't have health insurance but it won't resolve the under cost problems driving premiums upward. In other words, it will give the appearance of a solution but in fact make the overall situation worse.

That's the analysis of the situation by New York Times columnist Ross Douthat, who in a column published in the Star Tribune, does a good job of giving an overview of the situation. He says:

Three major problems plague American health care. The cost of premiums is eating up an ever larger share of take-home pay. The cost of our public health care programs is eating up an ever larger share of the federal budget. And millions of people who need insurance are priced out of the market.

Now that Max Baucus’s version of health care legislation has been blessed, at least provisionally, by the hands of Senator Olympia Snowe of Maine, it’s increasingly likely that Congress will pass reforms that address the third problem, while making the first two problems somewhat worse.

What will the Baucus type bill do?

If a Baucus-esque bill passes into law, we should expect a significant decline in the number of Americans without health insurance. But for Americans who have employer-based insurance — still the lion’s share of the working-age population — premiums could climb more swiftly than ever.

That’s exactly what’s happened under Massachusetts’s recent reform, the best state-level parallel to what Congress is attempting. The Baucus bill includes measures that might partially counteract this trend — delivery system reforms, for instance, and an excise tax on the highest-premium plans. But their effects are speculative; the Bay State’s swiftly rising premiums are facts on the ground.

Meanwhile, our long-term fiscal trajectory will remain as unsustainable as ever. Baucus’s legislation is revenue-neutral only under rosy political assumptions, and it adds another entitlement to an already-groaning system.

He points out what the reform won't do.

But any lawmakers voting “yes” should have no illusions about what they’re voting for. This version of reform probably won’t make health care more affordable for most Americans, or place the system on firmer footing for the long run. Despite all the talk about a once-in-a-generation opportunity, our political class will have barely finished congratulating itself before rising costs will force everyone back to the negotiating table to consider more radical approaches.

He also touches what many view as the liberals endgame and how a public option moves us closer to -- federal government takeover of health care through a single payer plan.

We know what one such approach would look like. It’s the eventual endgame that liberals pushing a “public option” are aiming for: a federal takeover of the health-insurance sector, paid for by rising tax rates, in which the government guarantees universal access while using its monopoly power to hold down costs.

Douthat has an alternative which he thinks will address the concerns of both those on the right and the left.

But there’s another path, equally radical, that’s more in keeping with the traditional American approach to government, taxation and free enterprise. This approach would give up on the costly goal of insuring everyone for everything, forever. Instead, it would seek to insure Americans only against costs that exceed a certain percentage of their income, while expecting them to pay for everyday medical expenditures out of their own pockets.

Such a system would provide universal catastrophic health insurance, in other words, while creating a free market for non-catastrophic care. In the process, it would marry a central conservative insight — that we’ll never control spending so long as Americans are insulated from the true price of their medical care — to the admirable liberal premise that nobody should go bankrupt paying for life-saving treatment.

The details would vary depending on your political predilections. Under the more free-market approach, championed by Harvard’s Martin Feldstein, the government would provide vouchers for the purchase of private catastrophic plans. Under a more liberal version, like the one sketched out by Berkeley’s Brad DeLong, the government itself would act as the insurer. And liberals and conservatives would no doubt disagree about where to set the income threshold, and what additional interventions to support.

I don't think his suggestion won't gain much support from President Obama and Democrat leaders in Congress who see this as their opportunity to push through what they want.