I discuss many different national issues on this blog. But, I do believe that the biggest long-term problem our country faces is the uncontrolled growth of the national debt. Thus, I am highly intrigued by a proposal from Brian Riedl of the Manhattan Institute to stabilize our debt over the next thirty years at no more than 100% of GDP.
First, the rationale for his plan:
Annual budget deficits are already approaching $2 trillion annually and are headed toward $3 trillion per year just 10 years from now (see chart below). There is a way to avert our looming debt crisis without broad-based tax increases or significant cuts to antipoverty and social spending. However, this involves acting quickly to reform both Social Security and Medicare, as every year four million more baby boomers retire into these programs. The fiscal consolidation in this report calls for some SS and Medicare benefits for upper-income recipients to be trimmed.
The debt problem is not caused by falling tax revenues. Federal tax revenues have averaged 17.4% of GDP since 1960 and are projected by CBO to be 17.9% of GDP by 2054. Instead, the entire increase in long-term debt will come from surging SS, Medicare, and other government healthcare spending (see chart below).
This demographic challenge is worsened by rising healthcare costs and repeated benefit expansions. Today’s typical retiring couple has paid $214,000 into Medicare and will receive $635,000 in benefits because Medicare’s physician (Part B) and drug (Part D) benefits are not prefunded with payroll taxes and are only partially funded by retiree premiums. A similar discrepancy applies to SS.
This year SS and Medicare will collect $1,701 billion in payroll taxes and premiums and pay out $2,349 billion in benefits. Add in $21 billion in interest payments on this shortfall and SS and Medicare will contribute $651 billion to the FY 2024 deficit. In just 10 years from now, this entitlement deficit will increase to $2.2 trillion (see chart below).
Keep in mind that most seniors are not poor. Senior incomes have grown 60% (faster than inflation) since 1980, compared with 15% for the average worker. Simplistic solutions to our debt problem must be rejected. For example, Medicare-for-all. There is no evidence that single-payer healthcare could reduce American healthcare expenditures. A single-payer system would simply shift $32 trillion in private health expenditures over the next decade to the federal government.
The Riedl Plan achieves most of its savings from mandatory programs as follows:
- SS early and normal eligibility ages (currently 62 and rising to 67) are raised by 3 months per year, beginning in 2030, until they reach 64 and 69 in 2037.
- Canceling SS annual cost-of-living adjustments for seniors whose incomes in the previous year exceed $100,000 per individual or $200,000 per couple.
- Make Medicare more efficient by implementing a premium support system for Parts A (hospitals) and B (physicians). This creates a healthcare market where insurers must compete for retirees.
- Raise total senior premiums to cover 50% of Medicare Part B costs and 30% of Medicare Part D. Monthly premiums would rise on a sliding scale based on current, post-retirement income.
- Medicare eligibility age remains 65. The Medicare payroll tax, currently 2.9%, would increase by 1% to contribute to Medicare’s huge cash shortfall, including the overall gradual increase in the cost of healthcare.
- Medicaid reimbursements to the states would be capped at an annual per-capita increase in costs, rather than reimbursing a preset percentage of overall state Medicaid costs.
Conclusion. The Riedl Plan caps our national debt at its current level of 100% of GDP and gradually reduces the debt to 73% of GDP by 2054 (see chart). Well-off retirees would shoulder most of the costs of bringing SS and Medicare finances, which comprise most of our debt problem, to a sustainable level. The Riedl Plan shows that our debt problem can be solved mostly with relatively modest changes in entitlement programs.
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