Tag Archives: debt

Is There a Need for Urgency in Fixing Medicare?

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In the February 27, 2013 edition of the New York Times the economics analyst Eduardo Porter writes that “Medicare Needs Fixing but not Right Now”. He shows that cost increases have slowed down recently and that there are huge disparities between Medicare reimbursement rates as well as hospital utilization rates by Medicare enrollees in different parts of the country.  Therefore we should first focus on operating Medicare more efficiently before making big changes in its finances.

But a recent study by Michael Chernew, Richard Frank and Stephen Parente, “Slowing Medicare Spending Growth: Reaching for Common Ground”, points out that historically Medicare costs have been growing much faster than GDP.  And now, with demographic pressure from retiring baby boomers, the only way to stabilize Medicare costs as a percentage of GDP, will be to hold per-beneficiary cost increases below the overall rate of GDP increase.

Chernew, Frank and Parente also point out that there are many similarities between the Republican voucher plan for cost control and the Democratic proposal to move away from the fee for service model to either a fixed payment per episode model or global payment per beneficiary model.  A voucher plan shifts responsibility for cost control to beneficiaries and their insurers while the global payment model shifts this responsibility to providers.

Conclusion: yes, it is an urgent matter to slow the growth in Medicare costs and also, yes, there is lots of common ground between the two parties in getting this done.  So let’s insist that our national leaders take Medicare reform seriously and accept no excuses for further delay!

Updated Simpson Bowles Plan versus the February 2013 CBO Report

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Erskine Bowles and Alan Simpson have just released an updated version of their two year old plan to bring our national debt under control.  The new plan is called A Bipartisan Path Forward to Securing America’s Future.   It is very worthwhile to compare their new plan with a recent Report from the Congressional Budget Office.

Bowles and Simpson propose additional deficit reduction of $2.4 trillion over 10 years (which includes the $1.1 trillion in the sequester cuts currently scheduled to take effect on March 1, 2013).  This would have the effect of reducing the national debt from its current level of 76% of GDP in 2013 to 73% in ten years.  The CBO report presents three different scenarios.  Their middle route would require an additional $2 trillion in deficit reduction over and above current law (i.e. assuming  that the $1.1 trillion in sequester spending cuts will take place as scheduled).  This CBO middle route would reduce the Debt/GDP ratio to 67% by 2023.

In other words, for an additional deficit reduction of $700 billion over ten years, we’ll get an additional 6% of Debt/GDP reduction.  These numbers have huge practical significance.  Simpson-Bowles says that we need an additional $1.3 trillion in deficit reduction over and above the sequester cuts, which presumably will soon be enacted,  just to stabilize the national debt over a ten year period at the historically very high level of 73% of GDP.  That’s $130 billion a year for ten years.  Many people are complaining about the approximately 5% cuts in discretionary spending which will be required by the sequester.  But just to stabilize, not really shrink, the Debt/GDP ratio over ten years will require more than twice as much deficit reduction as the sequester.

To even mildly shrink the Debt/GDP ratio to 67% by 2023 will require yet an additional deficit reduction of $70 billion per year.  In other words, we will essentially have to triple the size of the sequester effect in order to achieve real debt reduction over ten years.  And all of this assumes favorable economic conditions such as steady growth and continued low inflation.

Do our national leaders have the will to do what should be easily understood as needed by anyone looking at the numbers with any degree of objectivity?  Let’s hope so because the future of our country depends on it!

Why $16 Trillion Only Hints at the True U.S. Debt

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In an Op Ed article last fall in the Wall Street Journal two former Congressmen, Chris Cox and Bill Archer, point out that the total US government debt, now over $16 trillion, is only a fraction of the total unfunded liabilities of the government, which now exceed $87 trillion.  The unfunded liabilities represent future expected payments for Social Security, Medicare benefits for currently employed workers as well as current retirees and also the future retirement benefits of current federal employees and retirees.

If this enormous sum of already obligated future payouts is not bad enough, even scarier is the rate of growth of these unfunded liabilities.  In calendar year 2011, the accrued expense was $7 trillion, double the entire current revenue of the federal government of about $3.5 trillion.  In other words this awful problem is getting much worse every year.

The House Republican majority is trying to address our almost incomprehensibly bad debt problem.  Will they be able to generate enough public support to force the Senate and the President to take the problem seriously?  Right now the odds do not look very good for effective action to be taken.  An enormous crisis is almost on our doorsteps.  How bad will it have to get before public opinion demands action?  It is very hard to remain optimistic about the future of our country when we appear to lack the collective will to take the action which is so obviously needed

The Myth of Government Default

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The moment of truth is rapidly approaching and House Republicans need to crank up their resolve to force a real long term solution to the debt crisis of our federal government.  As David Rivkin and Lee Casey describe in the January 11, 2013 issue of the Wall Street Journal, the threat of government default is greatly exaggerated.  $200 billion in tax revenue is coming into the federal government every month, more than enough to keep making interest payments on the national debt as well as paying many other bills.

Far too many national leaders are in a state of denial about the seriousness of our fiscal problems.  House Speaker John Boehner says that “The American people do not support raising the debt ceiling without reducing government spending at the same time.”  The “Boehner Rule” stipulates that an increase in the debt limit must be paired with spending cuts of equal size over a ten year period.  This is an excellent framework for kicking off a national discussion to persuade the American people to support cutting back spending on entitlements and social programs as well as defense spending.

Every economic unit whether it be an individual, a family, a business, a community or a larger political subdivision, has to learn to live within its means.  This elementary rule of common sense applies to our whole country just as much as to any other social group.  Republicans have the clearest grasp of this basic truth at the present time and now need to exhibit the courage of their political convictions.  The future of our country depends on it!

The Magnitude of the Mess We’re In

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In an opinion piece last fall in the Wall Street Journal, George Schultz, and several colleagues from Stanford University’s Hoover Institution, very cogently describe the horrendous economic and fiscal mess in which the United States is now embedded.  Trillion dollar deficits for four years in a row, now going on five, a persistently weak recovery from the great recession of 2008, several rounds of quantitative easing by the Federal Reserve now totaling over three trillion dollars, and worst of all, a complete lack of consensus by political leaders on how to respond to this dangerous situation.

The President and the Democratic majority in the Senate, flush with victory after the November 2012 elections, believe that they have a mandate to continue their present expansionist policies.  The Republican majority in the House of Representatives, only slightly diminished by the 2012 elections, feels equally strongly that it has a mandate to continue applying the brakes.  As a fiscal conservative I agree with the Republicans that we must return to the sound fiscal and monetary policies advocated so eloquently in the above WSJ article.

What strategy can the House Republican’s follow to move federal policy in this direction?  House Speaker John Boehner has suggested that any increase in the debt limit be matched dollar for dollar by cuts in federal spending over a ten year period.  For example, the “Boehner Rule” would require that an increase in the debt limit of $1 trillion, enough to last about one year, would be offset by spending cuts of $100 billion a year for 10 years.  If such a regimen were then repeated a year from now, another $100 billion in spending cuts per year would be needed as well, and so on.

Taking into account the baseline budgeting process in Congress, whereby budgets are automatically increased from one year to the next by the anticipated rate of inflation, and also the occasional need for emergency appropriations to cover natural disasters and other dire events, the Boehner Rule would have the likely effect of holding spending approximately constant from one year to the next in absolute terms.  While this is not the same as what most people would understand by actual spending cuts, nevertheless it does represent significant restraint in federal spending, compared to recent patterns.

As the economy continues on its current growth trajectory of about 2% per year, this would mean that new tax revenues would eventually catch up with relatively flat spending levels and eventually lead to a balanced budget.

It sounds good but does he mean it?

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In today’s Omaha World Herald, Representative Lee Terry explains why he voted against the fiscal cliff deal just approved by Congress a few days ago.  It is because “raising taxes with little to no spending cuts does not make for a balanced agreement.”

Of course he is entirely correct in this assessment.  But will he stand firm in the next two months as a new deal is negotiated to either implement or replace sequestration which makes across the board spending cuts?  Will he stand firm when conservatives complain about cutting defense and liberals complain about cutting social programs?  Will be stand firm when the AARP complains about cutting entitlements?  We need to do all of these things and more!

House Speaker John Boehner has said that Republicans will be “singularly focused on the deficit and the debt” in the next two months.  But the President has said that he will not “play games” with raising our nation’s debt limit.  Will Mr. Boehner, Mr. Terry and the Republican majority in the House be prepared to withstand withering criticism from the mainstream press if the default deadline grows close without agreement for significant spending cuts?

We are rapidly approaching the moment of truth.  The future of our country depends on the fiscal responsibility of our national leaders.  Let’s hope that enough of them are made of the right stuff!

One Cheer for Lee Terry

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Congress has averted the immediate Fiscal Cliff but no significant action was taken to address our long term fiscal problems.  According to the Wall Street Journal, the deficit will shrink slightly below $1 trillion for a few years and then continue its inexorable rise. The can was kicked down the road for two months by delaying sequestration until March 1.  In other words this was a bad deal and Republicans in the House of Representatives should have voted it down and held out for a much better deal.

At least, Nebraska’s 2nd District Congressman, Lee Terry, voted against it.  Speaker John Boehner declared that the new 113th Congress would make the federal debt and deficit its singular focus.  Let’s hope that Mr. Boehner means what he says and that Mr. Terry supports him when the chips are down.

One year ago Mr. Terry voted to extend the payroll tax holiday for two months (annual cost $110 billion) and then voted against a full year extension two months later, after the die was cast.  Shenanigan’s like this are unacceptable and should be interpreted as complacency and deviousness about addressing serious problems.

House Republicans are in an incredibly difficult position.  We’ve just re-elected a President whose basic economic policy is more artificial stimulus (government spending), which just makes the deficit and debt that much worse.  The Republican House is now the sole bastion of common sense economic and fiscal policy.  We have to hold their feet to the fire.  Our survival as a strong nation depends on it.

Is Growth Over?

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                                             Is Growth Over?

In a recent New York Times op-ed column, Is Growth Over?, the Keynesian economist Paul Krugman argues that our current information technology revolution may not be potent enough to increase our economic growth rate beyond the American historical average of about 2%.

As much as we hope for a faster rate of growth, let’s assume that he is correct.  In fact our average rate of growth for 2010 – 2012 (since the recession ended in June 2009) is 2.1%.  What are the economic implications of 2% growth indefinitely into the future?  They are slower job growth, higher unemployment and therefore lower tax revenue.

High unemployment is bad enough for the millions of unemployed and underemployed.  But the fiscal implications are much worse because they affect the entire country.  We’ve already had four years in a row of trillion dollar deficits and the 2013 budget projections don’t look any better.  So continuing our present course presents a grim outlook, to say the least.

What are the alternatives?  We have two choices.  One is to boost the private sector with measures like pro-growth tax reform, relaxing onerous regulations, boosting domestic energy production and promoting international trade.  If such pro-growth policies are not politically doable, then the alternative is massive tax increases and spending cuts.

Our first priority must be to rapidly shrink the federal deficit down to zero.  Otherwise we are inviting fiscal calamity which can hit at any time without warning.  Fiscal conservatives should always remain focused on this #1 problem.  If no agreement can be reached for a rational plan to significantly reduce the deficit, then get the job done anyway that is possible.

We have got to wake up the American people to our urgent fiscal condition.  If going over the cliff is what it takes, then so be it!

No Deal is better than a Bad Deal

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It is beginning to look like President Obama and House Speaker Boehner may not be able to negotiate an acceptable deal by December 31st to avoid going over the Fiscal Cliff.  The President wants tax rates to rise for incomes above $400,000.  The Speaker has offered to raise tax rates for incomes over $1,000,000 but it is not clear if House Republicans will go along with this, even if accepted by the President.

What is the effect of such increases in tax rates?  According to the Wall Street Journal, raising taxes for incomes over $500,000 would affect 750,000 small business owners, while an income cutoff of $1,000,000 would affect 311,000 small business owners.

What will be the economic impact of restoring Clinton era tax rates on small business owners?  A recent study by Ernst & Young predicts that employment would fall by 710,000 jobs and that economic output (GDP) would decrease by 1.3% on an annual basis.

Conclusion:  although more tax revenue is needed, as well as significant spending cuts, to get our fiscal house in order, it matters where this new revenue comes from.  What we really need is pro-growth tax reform.  This means lowering marginal tax rates and curtailing deductions and loopholes.

Yes, it is preferable to avoid going over the fiscal cliff.  But a deal needs to be structured which puts us on a sound fiscal and economic track for the long term.  Principle matters.  No deal is better than a bad deal.

Avoiding the cliff and restoring confidence

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New York Mayor Michael Bloomberg has proposed a sensible way forward with an Op Ed column, “Avoid the ‘Cliff,’ Restore the Confidence” in the December 12, 2012 edition of the Washington Post . His thesis is that businesses took on too much risk in the run up to the 2008 crash but now they are sitting on hordes of cash because they lack confidence that our political leaders can come up with a serious, credible plan to reduce the deficit and put our country on a sustainable path to economic growth and fiscal health.

His proposal for accomplishing this task is remarkably similar to that outlined by David Walker and discussed in my previous post on December 10, 2012.  That is, we should adopt the Simpson-Bowles framework, including tax increases and spending cuts.  At least a significant down payment on this plan should be agreed to before the end of the year.  The agreement would include a commitment to enact broader-based tax reform and entitlement reforms in 2013.

With trillion dollar deficits for four years in a row, now going on five, we definitely need more tax revenue as well as large spending cuts.  The biggest challenge in implementing this general framework is to figure out how to raise tax revenue in the least damaging way to the economy.

The tradeoff here is between raising tax rates versus eliminating tax deductions and loopholes.  Democrats (apparently) prefer raising tax rates rather than eliminating deductions.  This is unfortunate since it is well established in economic theory, as well as plain common sense, that the lowest possible marginal tax rates will provide the greatest stimulus to private risk taking and investment. This is the only sound way to create more jobs.

Democrats may have the strongest political position in the current negotiations but the Republicans have the soundest basic economic principles.  If the Republicans are able to keep the focus on the fundamentals, we will succeed in finding the way out of our current predicament.