The other tendency, one less frequently mentioned, concerns the type of taxes legislators use to meet PAYGO rules. Recent revenue-raising measures to make energy and children's health legislation deficit-neutral (the barebones goal of PAYGO) include taxing deferred compensation earned from offshore tax havens, delaying a phase-in of a tax deduction for U.S. multinational companies, and increasing the federal tax on cigarettes. In other words, not the most robust of tax reforms. Legislators bound by PAYGO or deficit-neutral rules often target small groups for tax increases or use gimmicks (like delays in tax cuts) to satisfy the rules. The situation is familiar to anyone paying attention to the struggles of state and city governments who are trying to close budget gaps (most state and local governments are not allowed to run deficits). Taxes on plastic bags, gambling, junk food, and soda have become all the rage.

This is not to say that certain of these tax increases are not desirable (or, for that matter, that they are). But budgetary rules of the PAYGO type can cause legislators to lose sight of the actual aims of the legislation at hand. As Orszag struggled to explain yesterday in a press briefing about PAYGO, the deficit neutrality of health care reform is not the determining factor of the administration's support for the measure. There are other goals - not least important of which is improved health outcomes for more people - that will result from reform.

Not all revenue-raising measures need be germane to the spending portion of a law. But one wonders, given past experience, if one-off solutions for budget neutrality really generate good legislation. This is especially important for any large, long-term, and important changes to the programs - Social Security, Medicaid, Medicare - that many Americans rely on to make ends meet and to which the administration's PAYGO rules will apply.