There are no other issues. This is the issue.

At a critical moment in The Verdict perhaps the best Boston movie ever made (considerably better, anyway, than the wildly overrated The Departed), Paul Newman’s character, a Boston defense attorney, is advised by his mentor (played by the incomparable Jack Warden, who, as you movie buffs out there may know, played the grandfather in one of the all time great cheesy movies, Problem Child) that there will be other cases. In response, Newman repeats over and over, more to himself than to Jack Warden, that “There are no other cases. This is the case. There are no other cases. This is the case.”

I was reminded of this scene this morning reading Ed Moscovitch’s op-ed in the Boston Herald, Soaring health costs sicken school reform. Dr. Moscovitch’s point is simply that as health care costs for school employees across Massachusetts rose 12.3% annually between 2002 and 2006 they crowded out other spending priorities, such as textbooks and professional development.

I have made the point before and been scoffed at, but, at the continuing risk of my colleagues’ scorn, I will say it again and again: There are no other issues. This is the issue. There are no other issues. This is the issue.

The United States spends roughly 16% of GDP on health care. Health care accounts for more than 25% of the Massachusetts state budget. By 2050, local, state and federal government health care spending will roughly equal today’s local, state and federal government budgets. A recent Pew study put the cost of pension and health care benefits state governments have made to public employees at $2.73 trillion (that’s correct, trillion with a tr), of which $731 billion is conservatively estimated to be outstanding liability.

If, as a nation, we are unable to reign in health care spending, we will have very little money to spend on anything else – education, homeland security, national defense, it doesn’t matter. There are no other issues. This is the issue.