American National Priorities

2005

2005-11-14-USAT-Wolf-Walker

A ‘fiscal hurricane’ on the horizon
By Richard Wolf
USA Today, 2005-11-14

2007

2007-08-14-FT-Grant-Walker

Learn from the fall of Rome, US warned
By Jeremy Grant in Washington
Financial Times, 2007-08-14

The US government is on a ‘burning platform’
of unsustainable policies and practices
with
fiscal deficits,
chronic healthcare underfunding,
immigration and
overseas military commitments
threatening a crisis if action is not taken soon,
the country’s top government inspector has warned.

David Walker, comptroller general of the US,
issued the unusually downbeat assessment of his country’s future
in a report that lays out what he called “chilling long-term simulations”.

These include
“dramatic” tax rises,
slashed government services and
the large-scale dumping by foreign governments of holdings of US debt.

Drawing parallels with the end of the Roman empire, Mr Walker warned
there were “striking similarities” between
America’s current situation and
the factors that brought down Rome,
including

• “declining moral values and political civility at home,


• an over-confident and over-extended military in foreign lands and


• fiscal irresponsibility by the central government”.

“Sound familiar?” Mr Walker said.
“In my view, it’s time to learn from history and
take steps to ensure the American Republic
is the first to stand the test of time.”
Mr Walker’s views carry weight because he is a non-partisan figure
in charge of the Government Accountability Office,
often described as the investigative arm of the US Congress.

While most of its studies are commissioned by legislators, about 10 per cent –
such as the one containing his latest warnings –
are initiated by the comptroller general himself.

In an interview with the Financial Times,
Mr Walker said he had mentioned some of the issues before
but now wanted to “turn up the volume”.
Some of them were too sensitive for others in government to
“have their name associated with”.

“I’m trying to sound an alarm and issue a wake-up call,” he said.
“As comptroller general I’ve got an ability to look longer-range
and take on issues that others may be hesitant,
and in many cases may not be in a position,
to take on.

“One of the concerns is obviously we are a great country
but we face major sustainability challenges
that we are not taking seriously enough,”
said Mr Walker,
who was appointed during the Clinton administration to the post,
which carries a 15-year term.

The fiscal imbalance meant the US was
“on a path toward an explosion of debt”.
“With
the looming retirement of baby boomers,
spiralling healthcare costs,
plummeting savings rates and
increasing reliance on foreign lenders,
we face unprecedented fiscal risks,”
said Mr Walker, a former senior executive at PwC auditing firm.
Current US policy on
education, energy, the environment, immigration and Iraq
also was on an “unsustainable path”.

“Our very prosperity is placing greater demands on our physical infrastructure.
Billions of dollars will be needed
to modernise everything from highways and airports
to water and sewage systems.
The recent bridge collapse in Minneapolis was a sobering wake-up call.”

Mr Walker said he would offer to brief the would-be presidential candidates
next spring.

“They need to make fiscal responsibility and inter-generational equity
one of their top priorities.
If they do, I think we have a chance to turn this around but if they don’t,
I think the risk of a serious crisis rises considerably”.

2007-08-15-Raimondo-Walker

Decline and Fall
U.S. comptroller general: America is Rome
by Justin Raimondo
Antiwar.com, 2007-08-15

[This is Justin Raimondo’s retelling of, and expansion on,
David Walker’s 2007-08-14-FT-Grant-Walker warnings.]

2008

2008-01-09-Samuelson

Promises They Can't Keep
By Robert J. Samuelson
Washington Post Op-Ed, 2008-01-09

[Paragraph numbers and emphasis are added.]

[1]
The big lie of campaign 2008 -- so far -- is that
the presidential candidates, Democratic and Republican,
will take care of our children.
Listening to these politicians, you might think they will.
Doing well by children has now passed motherhood and apple pie
as an idol that all candidates must worship.

[2]
“We will do whatever it takes to make America a better country,
to give our kids a better future,”
says Mike Huckabee, winner of the Republican Iowa caucuses.

[3]
“We will deliver for our children, our grandchildren
and our great-grandchildren,”
claims Sen. Barack Obama, the Democratic winner in Iowa.

[4]
“We’re going to reclaim the future for our children,”
says Democratic Sen. Hillary Clinton.

[5]
Actually, these are throwaway lines, completely disconnected from reality.

[6]
Our children face a future of

• rising taxes,


• squeezed -- and perhaps falling -- public services and


• aging -- perhaps deteriorating -- public infrastructure
  (roads, sewers, transit systems).

Today’s young workers and children are about to be engulfed by
a massive income transfer from young to old
that will perversely make it harder for them to afford their own children.

[7]
No major candidate of either party proposes to do much about this,
even though the facts are well known.

[8]
Social Security, Medicare and Medicaid --
three programs that go overwhelmingly to older Americans --
already represent more than 40 percent of federal spending.
A new report from the Congressional Budget Office projects that
these programs could easily grow to about 70 percent of the budget by 2030.
Without implausibly large deficits,
the only way to preserve most other government programs would be
huge tax increases (about 40 percent from today’s levels).
Avoiding the tax increases would require draconian cuts in other programs
(about 60 percent).
Workers and young families, not retirees,
would bear the brunt of either higher taxes or degraded public services.

[9]
Similar pressures, though less ferocious,
exist at the state and local levels.
Schools, police, libraries and parks will be squeezed by
the need to pay benefits for retired government workers.
A study by the Pew Charitable Trusts found that
states have promised retired workers
$2.7 trillion in pension, health care and other benefits
during the next three decades.
Only about $2 trillion has been set aside;
the rest would come from annual budgets.

[10]
Medicaid,
a joint federal-state program with states paying about 40 percent of the costs,
represents another drain;
about two-thirds of its spending stems from the aged and disabled.
Roads, water and mass transit may also be shortchanged.
States and localities pay about three-quarters of their costs.

[11]
But facing these facts would expose candidates to three daunting problems.

[12]
First:
Lightening the burden on the young requires
cutting retirement benefits for the old --
raising eligibility ages,
being less generous to richer retirees and
making beneficiaries pay more for Medicare.
Simply increasing taxes or cutting other programs won’t work.
The problem is not just closing the budget deficit.

[13]
Second:
We can’t wait.
Ideally, prospective retirees would have received several decades’ warning,
but we’ve delayed too long.
We need to cut benefits for baby boomers and even some existing retirees.
They are the source of mounting costs.

[14]
Third:
Even if retirement benefits were cut,
pressures for higher taxes and lower public services would not disappear.
Social Security and Medicare are part of the nation’s social fabric.
Although individuals’ benefits can be responsibly trimmed,
the growth in the elderly population (a doubling by 2030)
and rapidly rising health-care costs
would still expand total spending.
The increases would simply be smaller.

[15]
A moral cloud hangs over our candidates.
Just how much today’s federal policies,
favoring the old over the young
and the past over the future,
should be altered ought to be a central issue of the campaign.
But knowing the unpopular political implications,
our candidates have lapsed into calculated quiet.

[16]
They pay lip service to children
but ignore the actual programs that will shape their future.
The hypocrisy is especially striking in Obama.
He courts the young, promises “straight talk”
and offers himself as the agent of “change.”
But his conspicuous omissions constitute “crooked talk”
and silently endorse the status quo.
[But don’t forget “Mr. Straight Talk”, John McCain.]

[17]
The insidious nature of this problem is that
because the spending increases for the elderly occur gradually,
the pressures on taxes and other government programs
will also intensify gradually.
A crucial moment to clarify the stakes
and compel politicians to make choices
probably won’t occur until it’s too late.

[18]
The longer we delay -- and we’ve done so now for several decades,
because the strains created by an aging society have been obvious that long --
the more likely that eventual “solutions” will be unfair to both young and old.
To acknowledge that and to come to grips with it
would constitute genuine “change.”

2008-07-09-Samuelson

The Candor Gap
By Robert J. Samuelson
Washington Post, 2008-07-09

2008-07-14-NYT-Peterson

Spending $1 Billion to Restore Fiscal Sanity
By JOHN HARWOOD
New York Times, 2008-07-14

[An excerpt; emphasis is added.]

[Peter G. Peterson] aims to startle voters and politicians alike,
and summon them to the task of closing
the long-term imbalance between
what the government will take in and
what it has promised to pay out,
most notably through Social Security and Medicare.
...

“Has something fundamental happened to the character of our people
or our societal structure,
or has no one stepped up to provide the leadership?”
Mr. Peterson asked.
“We’re not going to know that until we try.”

...

In a recent Pew Research Center poll,
the federal deficit ranked behind
the economy, education, jobs,
health care, energy, Social Security and Iraq
among voters’ priorities.

Those rankings are precisely what Mr. Peterson hopes to change.
The Web site of the Peter G. Peterson Foundation flashes a frightening fiscal fact:
The looming retirement of 78 million baby boomers
has generated unpaid entitlement obligations
that are triple the size of the entire economy —
$175,000 for each American.

2008-10-22-Samuelson

Young Voters, Get Mad
By Robert J. Samuelson
Washington Post, 2008-10-22

[Its conclusion; emphasis is added.]

What should you -- the young -- do?

First, get angry --
at the media and think tanks
for discussing this problem in misleading euphemisms
(for instance, the problem is not an “entitlements crisis”;
it’s excessive benefits for the old);
at the candidates for exploiting your innocence; and
at yourself for your gullibility.

Next, start picketing AARP.
It’s the citadel of seniors’ political power
and the country’s most powerful “special interest.”
It wields a virtual veto over roughly two-fifths of the federal budget.
Your activist groups ought to be there every day with placards reading
“Give Us Generational Justice” or “Get Off Our Backs.”
Ask direct questions of federal candidates about what benefits they’d cut,
which they’d keep and why.

You need to appeal to the shame and guilt of older Americans
by reminding them that their present self-absorption
is not a victimless exercise.
Only if older Americans act on their rhetorical pledges
of worrying about their children
will the political climate change.
If you -- the young -- don’t stand up for yourselves, believe me,
your elders and your politicians won’t.

2009

2009-03-29-Lachman

Welcome to America, the World’s Scariest Emerging Market
By Desmond Lachman
Washington Post Outlook, 2009-03-29

[1]
Back in the spring of 1998, when Boris Yeltsin was still at Russia’s helm,
I led a group of global investors to Moscow
to find out firsthand where the Russian economy was headed.
My long career with the International Monetary Fund and on Wall Street
had taken me to “emerging markets”
throughout Asia, Eastern Europe and Latin America,
and I thought I’d seen it all.
Yet I still recall the shock I felt at a meeting in Russia’s dingy Ministry of Finance,
where I finally realized how a handful of young oligarchs
were bringing Russia’s economy to ruin
in the pursuit of their own selfish interests [cf.],
despite the supposed brilliance of Anatoly Chubais,
Russia’s economic czar at the time.

[2]
At the time,
I could not imagine that anything remotely similar
could happen in the United States.
Indeed, I shared the American conceit that
most emerging-market nations had poorly developed institutions
and would do well to emulate Washington and Wall Street.
These days, though, I’m hardly so confident.
Many economists and analysts are worrying that
the United States might go the way of Japan,
which suffered a “lost decade”
after its own real estate market fell apart in the early 1990s.
But I’m more concerned that

the United States is coming to resemble
Argentina, Russia and other so-called emerging markets,
both in what led us to the crisis,
and in how we’re trying to fix it.

[3]
Over the past year, I’ve been getting Russia flashbacks
as I witness the AIG debacle
as well as the collapse of Bear Sterns and a host of other financial institutions.
Much like the oligarchs did in Russia,
a small group of traders and executives at onetime venerable institutions
have brought the U.S. and global financial systems to their knees
with their reckless risk-taking -- with other people’s money --
for their personal gain.

[4]
Negotiating with Argentina’s top officials
during their multiple financial crises in the 1990s
was always an ordeal,
and sparring with Domingo Cavallo,
the country’s Harvard-trained finance minister at the time,
was particularly trying.
One always had the sense that, despite their supreme arrogance,
the country’s leaders never had a coherent economic strategy
and that
major decisions were always made on the run.
I never thought that was how policy was made in the United States --
until, that is, I saw how totally at sea
Treasury Secretaries Henry Paulson and Timothy F. Geithner and
Federal Reserve Chairman Ben S. Bernanke
have appeared so many times during
our country’s ongoing economic and financial storm.

[5]
The parallels between U.S. policymaking and what we see in emerging markets
are clearest
in how we’ve mishandled the banking crisis.
We delude ourselves that our banks face liquidity problems,
rather than deeper solvency problems,
and we try to fix it all on the cheap
just like any run-of-the-mill emerging market economy would try to do.
And after years of lecturing Asian and Latin American leaders
about the importance of consistency and transparency
in sorting out financial crises,
we fail on both counts:
In March 2008, one investment bank, Bear Stearns,
is bailed out because it is thought to be
too interconnected with the rest of the banking system to fail.
However, six months later, another investment bank, Lehman Brothers --
for all intents and purposes indistinguishable from Bear Stearns
in its financial market inter-connectedness --
is allowed to fail,
with catastrophic effects on global financial markets.

[6]
In visits to Asian capitals
during the region’s financial crisis in the late 1990s,
I often heard Asian reformers
such as Singapore’s Lee Kuan Yew or Japan’s Eisuke Sakakibara
complain about how the incestuous relationship
between governments and large Asian corporate conglomerates
stymied real economic change.
How fortunate, I thought then,
that the United States was not similarly plagued by crony capitalism!
However, watching
Goldman Sachs’s seeming lock on high-level U.S. Treasury jobs
as well as the way that Republicans and Democrats alike
tiptoed around reforming Freddie Mac and Fannie Mae --
among the largest campaign contributors to Congress --
made me wonder if
the differences between the United States and the Asian economies
were only a matter of degree.

---

[7]
On Wall Street there is an old joke that
the longest river in the emerging-market economies is “de Nile.”
Yet how often do U.S. leaders
respond to growing signs of economic dysfunctionality
by spouting nationalistic rhetoric
that echoes the speeches of Latin American demagogues
like Peru’s Alan Garcia in the 1980s and Argentina’s Carlos Menem in the 1990s?
(Even Garcia, currently in his second go-around as Peru’s president,
seems to have grown up somewhat.)
But
instead of facing our problems we
extol the resilience of the U.S. economy,
praise the most productive workers in the world, and
go on and on
about America’s inherent ability to extricate itself from any crisis.
And we ignore our proclivity as a nation to

spend, year in year out, more than we produce,
put off dealing with long-term problems, and
engage in grandiose long-term programs
that as a nation we can ill afford.

[8]
A singular characteristic of an emerging market heading for deep trouble is
a seemingly suicidal tendency
to become overly indebted to foreign creditors.
That tendency underlay
the spectacular collapse of the Thai, Indonesian and Korean currencies in 1997.
It also led Russia to default on its debt in 1998
and plunged Argentina into its economic depression in 2001.
Yet we too seem to have little difficulty
becoming increasingly indebted
to the tune of a few hundred billion dollars a year.
To make matters worse, we do so to countries like
China, Russia and an assortment of Middle Eastern oil producers --
none of which is particularly well disposed to us.

[9]
Like Argentina in its worst moments,
we never seem to question whether
it is reasonable to expect foreigners to keep financing our extravagance,
and we forget
the bad things that happen to the Argentinas or Hungarys of the world
when foreigners stop financing their excesses.
So instead of laying out a realistic plan for increasing our national savings,
we choose not to face up to the Social Security and Medicare crises
that lie ahead,
embarking instead on massive spending programs that --
whatever their long-run merits might be --
we simply cannot afford.

[10]
After experiencing a few emerging-market crises,
I get the sense of watching the same movie over and over.
All too often, a tragic part of that movie is
the failure of the countries’ policymakers to hear
the loud cries of canaries in the coal mine.
Before running up further outsized budget deficits,
should we not heed the markets that now see a 10 percent probability that
the U.S. government will default on its sovereign debt in the next five years?
And should we not be paying close attention to
the Chinese central bank governor’s musings that
he does not feel comfortable with the $1 trillion of U.S. government debt
that the Chinese central bank already owns,
let alone adding to those holdings?

[11]
In the twilight of my career, when I am hopefully wiser than before,
I have come to regret how
the IMF and the U.S. Treasury all too often lectured leaders in emerging markets
on how to “get their house in order” --
without the slightest thought that
the United States might fare no better when facing a major economic crisis.
Now, I fear time is running out for our own policymakers
to mend their ways
and offer real leadership
to extricate the United States from its worst economic calamity since the 1930s.
If we insist on improvising and not facing our real problems,
we might soon lose our status as a country to be emulated
and join the ranks of those nations we have patronized for so long.

Desmond Lachman, a fellow at the American Enterprise Institute,
was previously chief emerging market strategist at Salomon Smith Barney
and deputy director of
the International Monetary Fund’s Policy and Review Department.

2009-06-02-Examiner-Healey-problems-due-to-voters

Voters are the cause of America’s fiscal mess

By: Gene Healy
Washington Examiner, 2009-06-02

[A column that points out that it is wrong to just blame politicians
for the financial disaster coming.]

[1]
There’s plenty of blame to go around for the fiscal mess we’re in. By ramming through a prescription drug benefit to Medicare, President George W. Bush launched the biggest expansion of entitlements in four decades.

[2]
President Obama has added insult to injury by pushing through a $789 billion “stimulus” package, and attempting to, as the New Republic’s John Judis puts it, transform “the American relationship of state to economy,” with a budget that envisons a public sector more like France’s or Sweden’s.

[3]
The result is that, in the midst of the Baby Boom generation’s retirement, we’re facing a 2009 deficit of nearly $1.8 trillion--larger than the entire federal budget in 2000.

[4]
There’s no end of finger-pointing in our Red-Team/Blue-Team battles over fiscal incontinence. But there’s one group that rarely gets the blame it merits. That’s us. When you look at the positions embraced by the ordinary American voter, you start to suspect that we’re getting the government we deserve.

[5]
Sixty percent of Americans say the federal government has too much power and too much money, according to a Rasmussen poll released last month. And they’re right. But what are they willing to do about it?

[6]
In 2007, the Harris polling firm looked into that question, and the answer was “not much.” Very few of us are willing to support the spending reductions necessary to get our fiscal house in order. Harris reports that “hardly anyone would cut Medicaid (4%)... Social Security (2%) or Medicare (1%)”--among the biggest chunks of the federal budget.

[7]
The overwhelming majority of respondents to the Harris poll rejected higher taxes to handle the deficit; the only increases they’d support are in “sin” taxes on alcohol and tobacco. Fair enough: taxes are far too high as it stands.

[8]
If you’re not going to increase revenue, though, you’ve got to reduce spending. So what does the public want to slash? “Space programs top the list by a wide margin (51%).” Keep in mind that NASA spends less than $18 billion out of a $3.9 trillion federal budget.

[9]
The GOP is known as the party of smaller government, and polling results reflect that sentiment. In the Pew Research Center’s 2007 political values survey, 68 percent of self-identified Republicans said they’d rather have a smaller government providing fewer services; only 28 percent of Democrats said the same.

[10]
But the Harris data show that Republicans don’t support cuts in any area that represents a large percentage of the federal budget. Democrats were more willing to trim Pentagon outlays (22 percent of federal spending), but overall, fewer than one in three Americans would support defense cuts.

[11]
Add up defense, health care, and Social Security, and you find that the public has declared more than two-thirds of the federal budget off limits. Nondefense discretionary spending--the territory on which most budget fights take place--is 17 percent.

[12]
We could (and should) shutter the departments of Agriculture, Commerce, Education, Energy, and Homeland Security (for starters) but even that wouldn’t begin to dig us out of the hole we’re in.

[13]
Analyzing two recent government reports on Social Security and Medicare, economist Bruce Bartlett reports that “federal taxes would have to rise by roughly 81% to pay all the benefits promised by these programs under current law.”

[14]
Yet the American voter wants to head off our looming fiscal apocalypse by giving a haircut to NASA and raising taxes on booze and smokes. Sure, that’ll cover it.

[15]
Few politicians can get through a speech without lavishly praising “the wisdom of the American people.” Interestingly, the people themselves are less sure that they’re quite so wise.

[16]
The Pew survey reports that “the public is increasingly suspicious of itself,” with fewer Americans than ever expressing confidence in “the wisdom of the American people when it comes to making political decisions.”

[17]
H.L. Mencken once described democracy as “the theory that the common people know what they want and deserve to get it good and hard.” We’re going to get it “good and hard” in the coming decades, and it won’t be pleasant. But the pain we’ll suffer may help us learn a badly needed lesson.

Examiner columnist Gene Healy is a vice president at the Cato Institute and the author of The Cult of the Presidency.

2009-12-07-Samuelson-health-care-nation

Health-care nation
Medical spending threatens everything else
By Robert J. Samuelson
Washington Post Op-Ed, 2009-12-07

[1]
President Obama’s critics sometimes say that
he is engineering a government takeover of health care
or even introducing “socialized medicine” into America.
These allegations are wildly overblown.
Government already dominates health care, one-sixth of the economy.
It pays directly or indirectly for roughly half of all health costs.
Medicine is pervasively regulated, from drug approvals to nursing-home rules.
There is no “free market” in health care.

[2]
What’s happening is the reverse, which is more interesting and alarming:
Health care is taking over government.
Consider:
In 1980, the federal government spent $65 billion on health care;
that was 11 percent of all its spending.
By 2008, health outlays had grown to $752 billion --
25 percent of the total, one dollar in four.

[The figures get even more dramatic if you go back to, say, 1950.
As to the priorities back then,
I can recall no political angst over
the far lower spending on health-care back then.
Where were the politicians arguing over it back then,
or the newspaper headlines concerning it?
The only major health-care concern then was polio.]

[3]
Even without new legislation, the health share would grow,
as an aging population uses more Medicare (insurance for the elderly)
and Medicaid (the joint federal-state insurance for the poor,
including the very poor elderly).
Obama would magnify the trend by expanding Medicaid
and providing new subsidies for private insurance.
Thirty million or more Americans would receive coverage.

[4]
All this is transforming politics and society.
The most obvious characteristic of health spending
is that government can’t control it.
The reason is public opinion.
We all want the best health care for ourselves and loved ones;
that’s natural and seems morally compelling.
Unfortunately, what we all want as individuals may harm us as a nation.
Our concern sanctions open-ended and ineffective health spending,
because everyone believes that cost controls are heartless and illegitimate.
The recent furor over proposals to reduce mammogram screenings
captures the popular feeling.

[5]
One consequence is
a slow, steady and largely invisible degradation
of other public and private goals.
Historian Niall Ferguson, writing recently in Newsweek,
argued that the huge federal debt
threatens America’s global power by
an “inexorable reduction in the resources” for the military.
Ferguson got it half right.
The real threat is not the debt
but burgeoning health spending
that, even if the budget were balanced,
would press on everything else.

[6]
“Everything else” includes
universities, roads, research, parks, courts, border protection and --
because similar pressures operate on states through Medicaid --
schools, police, trash collection and libraries.
Higher health spending similarly
weakens families’ ability to raise children,
because it reduces households’ discretionary income
either through steeper taxes or lower take-home pay,
as higher employer-paid premiums squeeze salaries.

[7]
A society that passively accepts constant increases in health spending
endorses some explicit, if poorly understood, forms of income redistribution.
The young transfer to the elderly,
because about half of all health spending goes for those 55 and over.
Unless taxes are increased disproportionately for older Americans
(and just the opposite is true),
they are subsidized by the young.
More and more resources also go to a small sliver of the population:
In 2006, the sickest 5 percent of Americans accounted for
48 percent of health spending.

[8]
Political power in this system shifts.
It flows to groups that promote and defend more health spending --
AARP, the lobby for Americans 50 and over,
and also provider organizations such as the American Medical Association (AMA), which represents doctors.
Predictably, AARP has been active in the present debate.
It claims to have participated in 649 town-hall and other meetings
and to have reached more than 50 million people through ads this year.
Not surprisingly,
AARP and the AMA recently conducted a joint TV ad campaign.

[9]
The rise of health-care nation
has confounded America’s political and intellectual leaders,
of both left and right.
No one wants to appear unfeeling
by denying anyone treatment that seems needed;
no one wants to endorse openly meddling with doctors’ independence.
It’s easier to perpetuate and enlarge the status quo
than to undertake the difficult job of
restructuring the health-care system
to provide better and less costly care.

[10]
Obama’s health-care proposals may be undesirable (they are),
but it’s mindless to oppose them -- as many Republicans do --
by screaming that they’ll lead to “rationing.”
Almost everything in society is “rationed,”
either by price (if you can’t afford it, you can’t buy it)
or explicit political decisions (school boards have budgets).
Health care is an exception; it enjoys an open tab.
The central political problem of health-care nation
is to find effective and acceptable ways to limit medical spending.

[11]
Democrats are no better.
Obama talks hypocritically about restraining deficits and controlling health costs
while his program would increase spending and worsen the budget outlook.
Democrats congratulate themselves on caring for the uninsured --
who already receive much care --
while avoiding any major overhaul of the delivery system.
The resulting society discriminates against the young
and increasingly assigns economic resources and political choice to
an unrestrained medical-industrial complex.

2009-12-27-NYT-Braem-letter

To the Editor
by Alan Braem
New York Times Letter to the Editor, 2009-12-27

Frank Rich’s column doesn’t mention
the most important fictions we have been led to believe in:

• there are no lasting consequences
  to our national and personal debt levels;


• we can afford our government programs,
  and several huge new ones to boot;


• our global military presence and the distant wars we engage in
  do not create grave risks by making us an enemy to millions; and


• our above-average living standards can be maintained
  no matter how energetically we squander our capital.

We have only begun to pay for these delusions.
The hucksters Mr. Rich mentions are amateurs
compared with our reckless politicians.

Alan Braem
Kendall Park, N.J., Dec. 20, 2009

2010

2010-01-03-Ignatius

When political dysfunction threatens the economy
By David Ignatius
Washington Post Op-Ed, 2010-10-03

What worries me, looking ahead,
is what might be called the “Californiazation” of America --

the growing tendency of our political system
to make promises in social spending programs
that it isn’t prepared to pay for with tax increases.

…

So will Washington become like California?
Some would argue that has already happened,
with the fiscal disaster masked by
the federal government’s ability to sell its massive debt cheaply and
print money to pay its bills.
[A process that ends in disaster.]
And you see in Washington the same dysfunctional political process
that’s at work at the state level --
Democrats who get elected by delivering services and
Republicans who get elected by delivering tax cuts.

...

We should judge President Obama and Congress this year on
whether they’re paying for the promises they make --
and providing real reform that cuts costs,
rather than another political goody bag.

2010-03-28-WP-Pelosi

Why did health-care reform pass?
Nancy Pelosi was in charge.
By Vince Bzdek
Washington Post Outlook, 2010-03-28

[1]
Congress had tried to hammer together a national health-care initiative for a century, but it wasn’t until a woman ascended to a key position of power in Washington that a plan actually passed.

[2]
This is not a mere historical coincidence. Sure, President Obama pushed health-care reform to the top of the country’s agenda, and the Democratic majorities in the House and the Senate were essential to passing the bill. But make no mistake: The overhaul happened because Nancy Pelosi wanted it to happen, deep in her DNA.

[3]
This wasn’t just another piece of legislation for Pelosi --
this was the culmination of
a crusade she has been waging her entire career
to reorder Washington’s priorities.

Pelosi’s animating ambition has been to put
so-called women’s and family issues such as
health care, education and the welfare of children
on the same level as
homeland security, foreign relations and defense.

[4]
The tenacity with which she fought for health-care reform is directly tied to her gender. The belief that women, and the agendas they tend to support, are underrepresented has provided much of the rocket fuel that propelled her rise through Congress over 22 years. In 1984, Pelosi ran for the Democratic Party’s national chairmanship and lost; party leaders told her she would have won if she had been a man. Since then, the Californian has been on a mission to smash the old-boy network in Washington.

[5]
When Pelosi made expanding health care one of her top priorities, friends and colleagues say it was, without question, because she is a woman and a mother.

[6]
“It’s personal for women,” Pelosi announced on the House floor during final arguments on the health-care bill March 21. In an interview the next day, she said, “My sisters here in the Congress, this was a big issue for us.”

[7]
Pelosi said her fellow “caregivers” had a lot invested in reform, since they are the ones who provide most of the health care for their families and are acutely aware of problems in the system.

...

And on the House floor, she said,
“After we pass this bill,
being a woman will no longer be a preexisting medical condition.”
In a recent roundtable discussion,
Pelosi explained that
insurance companies charge women higher premiums than men
by “gender rating” conditions such as
giving birth, having a C-section or being a victim of domestic violence.
These “preexisting conditions” also allowed the companies to refuse coverage;
they can’t do that anymore.

[No doubt that’s part of the reason
why insurance companies charged women more than men,
but it’s hardly the whole story.
For example, consider the story
“Premenstrual dysphoric disorder
makes some women a bit crazy every month”
by Anne Miller.

Here is the lead paragraph:

“Every month I battle a monster.
I gird myself with a healthful diet and a couple of pills,
but the personality switch comes, like a lamp switched on,
three weeks into my menstrual cycle.
If most women get a little bloated, a little cranky, maybe a little confused,
I swell an entire dress size and try to ban my husband from any room I’m in.
Deciding what to eat for dinner so overwhelms me
that I’ve broken down crying in the frozen food aisle.”

So while insurance companies no doubt considered the conditions Pelosi mentioned,
I have no doubt that they also looked at
the overall greater use of the healthcare system by women.
(For another example, consider this story.)]

2011

2011-01-21-NYT-Poll-entitlements

Poll Finds Wariness About Cutting Entitlements
By JACKIE CALMES and DALIA SUSSMAN
New York Times, 2011-01-21

[Please also note this excellent, informative graphic detailing the results.]

[1]
As President Obama and Congress brace to battle over how to reduce chronic annual budget deficits, Americans overwhelmingly say that in general they prefer cutting government spending to paying higher taxes, according to the latest New York Times/CBS News poll.

[2]
Yet their preference for spending cuts, even in programs that benefit them, dissolves when they are presented with specific options related to Medicare and Social Security, the programs that directly touch the most people and also are the biggest drivers of the government’s projected long-term debt.

[3]
Nearly two-thirds of Americans choose higher payroll taxes for Medicare and Social Security over reduced benefits in either program. And asked to choose among cuts to Medicare, Social Security or the nation’s third-largest spending program — the military — a majority by a large margin said cut the Pentagon.

[4]
While Americans are near-unanimous in calling deficits a problem — a “very serious” problem, say 7 out of 10 — a majority believes it should not be necessary for them to pay higher taxes to bridge the shortfall between what the government spends and what it takes in. But given a choice of often-discussed revenue options, they preferred a national sales tax or a limit in the deduction for mortgage interest to a higher gasoline tax or taxing employer-provided health benefits.

[5]
Americans’ sometimes contradictory impulses on spending and taxes suggest the political crosscurrents facing both parties as they gird for debate over how to address the fiscal woes of a nation with an aging population, a complex tax system and an accumulated debt that is starting to weigh on the economy.

...

[This is certainly interesting,
but I wish they would show a breakdown of these results along demographic lines as well,
in particular between men and women.
My suspicion is those would differ on entitlements versus defense spending,
but it would be interesting to see the actual results.]