Skip to Content
Streetsblog USA home
Streetsblog USA home
Log In
Public Health

An Orszag-ian Principle: Transportation Reform is Health Reform

During the Washington budget debate earlier this year, a phrase widely attributed to White House budget director Peter Orszag was rolling off many a reporter's keyboard: "Health reform is entitlement reform."

Orszag's idea, in a nutshell, is that controlling the nation's skyrocketing health care costs, which are fueled in part by the obesity epidemic, would ultimately slow the growth in spending on Medicaid and Medicare, two of the government's three main entitlement programs.

What's happening in the background during Congress' health care debate this summer can be summed up similarly (with credit to Orszag for the terminology): Transportation reform is health reform.

The link between walkable, bikeable, denser communities and public health is explored in depth by reporter Christopher Steiner, whose new book cites research by University of North Carolina economist Charles Courtemanche that found a causal relationship between the price of gas and U.S. obesity.

For every long-term $1 increase in gas prices, the national obesity rate drops by 10 percent, according to Courtemanche. That relationship goes a long way towards explaining why the House and Senate health care bills include "community transformation" grants to entice cities and towns into building bike paths, playgrounds, and other pedestrian-friendly improvements.

The grants are not assured of surviving the intense health care negotiations now going on in the Capitol, however, because they have become a full-fledged talking point for GOP critics in the House and Senate.

With congressional transportation wonks are focusing much of their energy on the battle over reauthorizing federal transport programs and the climate change bill, but it's worth noting that they also have a dog in the health care fight.

Stay in touch

Sign up for our free newsletter

More from Streetsblog USA

Friday’s Headlines Got DOGE’d Again

Amidst uncertainty about future federal funding, Amtrak is cutting $100 million and 450 jobs.

May 9, 2025

Friday Video: Where Was the First Public Bus Route in the World?

...and which surprising historical figure helped launch it?

May 9, 2025

Talking Headways Podcast: ‘Normal’ is Not Correct, Someone Died Here

After a crash, the debris is quickly cleaned up and everyone moves on (usually too quickly). But these two experts are asking us to all slow down.

May 8, 2025

Thursday’s Headlines Are Not Gonna Pay a Lot for This Truck

President Trump's tariffs, along with rising insurance costs, are driving down Americans' interest in owning a car.

May 8, 2025

How One Suburb is Using Transit to Transform Into a True City

A Washington State suburb may be poised to evolve into a true transit-oriented hub – and offer lessons for other bedroom communities, even during an anti-transit era.

May 8, 2025
See all posts