Tag: federal deficit

Bending the Cost Curve: Ryan’s Roadmap Would Succeed Where ObamaCare Fails

From my oped in today’s Investors Business Daily:

Rep. Paul Ryan’s (R-Wis.) “Roadmap for America’s Future” proposes even tighter limits on Medicare’s growth, leading columnist Bruce Bartlett to opine, “the Medicare actuaries have shown the absurdity of the Ryan plan by denying that Medicare cuts already enacted into law are even worthy of projecting into the future.”

On the contrary, experience and public choice theory suggest that the Ryan plan has a better shot at reducing future Medicare outlays than past efforts, because the Roadmap would change the lobbying game that fuels Medicare’s growth.

For more on Ryan’s Roadmap, click here.  For more on Medicare, read David Hyman’s Medicare Meets Mephistopheles.  For more on public choice economics, click here.

USA Today Abets ObamaCare Supporters’ Misinformation Campaign

An article in today’s The USA Today titled, “With Many Still in Dark, Groups Shed Light on Health Care Law,” aims to correct misinformation about ObamaCare.  Ironically, the article is itself a monument to misinformation.

It begins:

True or false: The new health care law will cut Medicare benefits for seniors. It will slash Medicare payments to doctors. It will ration health care.

In three polls conducted last month, large percentages of Americans answered “true” to each statement. All three are false.

In fact, two of the three statements are 100-percent true.

First, ObamaCare will cut payments to the private health insurance companies that provide coverage to the 20 percent of Medicare enrollees who participate in the Medicare Advantage program.  That will eliminate many types of coverage for seniors in Medicare Advantage.  That should be painfully obvious, but if you require confirmation, visit FactCheck.org.  ObamaCare will also ratchet down the price controls that Medicare uses to pay hospitals and many other health care providers.  It should likewise be obvious that that will reduce access to services that are ostensibly “guaranteed” to all enrollees.  But again, if you need confirmation, check in with Medicare’s chief actuary, who works for President Obama.  We can debate whether that’s good or bad.  What’s not up for debate: ObamaCare in fact “will cut Medicare benefits for seniors.”

Second, it is also true – ipso facto – that ObamaCare “will ration health care.”  To ration is to limit consumption.  When ObamaCare reduces coverage for Medicare Advantage enrollees and reduces access to care for all Medicare enrollees, it limits seniors’ consumption of medical care.  We can debate whether that’s good or bad.  What’s not up for debate: that is rationing.

Finally, yes, it is technically false that ObamaCare “will slash Medicare payments to doctors.”  But since current law will slash Medicare payments to doctors if Congress does nothing, and since an earlier version of ObamaCare would have eliminated those cuts, but ObamaCare’s architects dropped that provision so as to make ObamaCare appear deficit-neutral… well, perhaps the public can be forgiven if it confuses “eliminating a provision that would have prevented cuts in Medicare payments to doctors” with “slashing Medicare payments to doctors.”

USA Today continues:

The debunked idea raised by opponents during congressional debate that “death panels” could make end-of-life decisions is seen as real by nearly half of those surveyed.

I’ll rate this statement misinformed and misleading.

First, Sarah Palin’s claim about “death panels” was true at the moment she said it, even if she didn’t know why.

Second, by rationing Medicare enrollees’ access to medical services (see above), ObamaCare will effectively make end-of-life decisions for seniors.  According to Medicare’s chief actuary, ObamaCare could force one in six hospitals to stop accepting Medicare patients.  If ObamaCare results in there no longer being a hospital bed waiting for Grandma at the end of her life, that’s an end-of-life decision.  It wasn’t a personalized decision.  It’s not even necessarily the wrong decision.  But let’s drop this nonsense about ObamaCare not making end-of-life decisions for seniors.  And ObamaCare did create a panel that will make many of these implicit rationing decisions.  It’s called the Independent Payment Advisory Board.

But my guess is that people tell pollsters that ObamaCare will make end-of-life decisions because they understand the Golden Rule, and that he who pays the piper calls the tune.  So long as the government purchases medical care, it will be the government that decides who receives it and who doesn’t.  And ObamaCare gave government a lot more of the gold.

USA Today packed a lot of misinformation into this one sentence:

The National Council on Aging posed 12 questions about the law to 636 seniors and found that fewer than 17% of them knew half the answers.

Actually, it’s NCOA that doesn’t know the answers.  Here are a few of their poll’s true-false questions:

  • “The new law will result in future cuts to your basic Medicare benefits.” A plurality of seniors (42 percent) responded “true.”  And they’re right: as Medicare’s chief actuary has explained and as NCOA should know, ObamaCare will reduce access to care for Medicare enrollees.  That’s a benefit cut, unless you think “coverage without care” counts as a benefit.  Yet according to NCOA, the correct answer is “false.”  Just 22 percent of seniors agreed.
  • “Under the new health reform law, Medicare Advantage plans will cut benefits and increase premiums.” NCOA says the correct response is “don’t know,” and that’s the answer that 56 percent of seniors gave.  Perhaps seniors haven’t read the chief Medicare actuary’s report, which found that ObamaCare “will result in less generous benefits packages” in Medicare Advantage and “when the MA provisions will be fully phased in, enrollment in MA plans will be lower by about 50 percent.”  But NCOA should have read that report, and should therefore know that the correct answer is “true.”
  • “The new law is projected to increase the federal budget deficit over the next ten years and beyond.” Again, a plurality (49 percent) responded “true.”  Again, they’re right.  Yet NCOA thinks the correct response is “false.”  No doubt NCOA would point to the Congressional Budget Office projections that ObamaCare will reduce the deficit.  But those projections are valid only if  ObamaCare “remain[s] unchanged throughout the next two decades, which is often not the case for major legislation.” The CBO wrote this would particularly be a problem with ObamaCare, which “would maintain and put into effect a number of policies that might be difficult to sustain over a long period of time.”  So one could reasonably interpret the CBO to have projected an increase, not a decrease in the deficit.  Alternatively, seniors could have been thinking about former CBO director Douglas Holtz-Eakin, who projected in The New York Times that ObamaCare “would raise, not lower, federal deficits, by $562 billion.”  There are lots of reasons why “true” is in fact the correct answer.  (One of them is that NCOA used the passive construction “is projected.”)  Only 14 percent of seniors agreed with NCOA.
  • “As a result of the new law, the solvency of the Medicare Trust Fund will be extended by about 9 years to 2026.” A majority of seniors responded “don’t know” (54 percent), while another 22 percent responded “false.”  Either answer is more correct than NCOA’s preferred answer (“true”).  There are no assets in the Medicare “trust fund.”  Thus there is no date by which those non-assets will be exhausted.  Indeed, the “trust fund” has absolutely no effect on Medicare’s solvency.  The very premise of this question is a fraud.  Someone needs to educate seniors about the Medicare trust fund, but NCOA is not the group to do it.
  • “The health care reform law will cut Medicare payments to doctors.” A plurality of seniors responded “true” (45 percent), while only 14 percent of seniors gave NCOA’s preferred response (“false”).  But again, perhaps seniors can be forgiven on this one (see above).

USA Today should have dug a little deeper.

More misinformation:

More than four in 10 people in the Kaiser poll wrongly believe the law included a government panel to make end-of-life decisions for Medicare patients.

Again, ObamaCare does include a panel that would implicit rationing decisions, including for Medicare patients at the end of life (see above).

More misinformation still:

As the Department of Health and Human Services issues the regulations needed to implement the law, it’s trying to get the facts out through its website, healthcare.gov. The Centers for Medicare and Medicaid Services is helping, most recently with a cable TV ad featuring Andy Griffith.

FactCheck.org found that Andy Griffith used “weasel words” to “mislead” seniors about ObamaCare.  How is USA Today not aware of that?

How Big Were the Bush Tax Cuts?

The debate on extending the Bush tax cuts has begun. Those opposed to extension argue that the cuts would greatly increase the federal deficit.

The first thing to note is that extending all the 2001 and 2003 tax cuts would lose the government about $216 billion a year in 2012 and rising amounts after that (see page 16). By contrast, federal spending in 2011 will be almost $2 trillion higher than in 2001 when the first Bush tax cuts were passed. Thus, in a rough sense, spending increases have had a nine times greater impact on our changed budget situation since 2001 than have tax cuts.

How big were the Bush tax cuts compared to previous tax legislation? One way to compare different tax bills is to look at the initial projections of the effects when they were passed. I assembled the figure below based on official scores of past tax legislation, as reported by the CBO at the time. The revenue effects of each tax bill are measured over the first five years as a share of GDP.

The figure shows that the Bush tax cuts were small compared to the Reagan tax cuts of 1981. The Revenue Act of 1978 was also a big tax cut. Note that the Tax Reform Act of 1986 was scored as being revenue neutral, and thus isn’t shown.

The figure also shows that the combined effect of tax cuts from 1997 forward were not large enough to offset the tax hikes under Reagan and the first Bush between 1982 and 1993.

I have a detailed discussion of federal tax policy between 1994 and 2004, here.

GOP Spending Cap

Republicans on the Senate Appropriations Committee have announced support for caps on the discretionary spending portion of the federal budget. According to press reports, discretionary spending under the cap for fiscal year 2011 would be approximately $20 billion less than what the president has proposed.

Appropriators – often referred to as the “third party” in Washington – exist to do one thing: spend other people’s money. Getting appropriators to agree to place any sort of limit themselves is a plus.

However, it’s hard to get excited about spending $20 billion less than the president. As the following chart shows, discretionary outlays have soared in the past decade:

With three months still to go in the current budget year, the federal deficit has already hit the trillion dollar mark. By year’s end the government will have borrowed about $1.4 trillion. It’s like the entire discretionary budget – defense and hundreds of other activities – are all financed by borrowing from the next generation.

Republicans apparently want agitated voters to see this gesture as evidence that the party is serious about out-of-control spending and deficits. But capping spending at the already exorbitant levels that Republicans helped reach isn’t exactly a big reform. Instead, Republicans need to propose the elimination of entire agencies and major programs for them to be taken seriously as a party willing to confront the nation’s looming financial crisis.

Fed Ed on the Move

There’s a lot to learn about what’s going on in federal education policy today, and none of it is good.

First, Steven Brill offers a revealing look at the Race to the Top evaluation process in a piece that can be added to the ever-growing pile of evidence that Race to the Top isn’t even close to the objective – or, I’d add, powerful – catalyst for meaningful reform that the Obama administration insists it is.

Second, it appears that congressional Democrats are preparing to pass a Harkin-proposed, Obama-endorsed, $23 billion bailout for teachers by attaching it to an “emergency” appropriation for the war in Afghanistan. (Passing major – and highly suspect – education legislation by attaching it to something totally unrelated? Sound familiar?) And what’s the nice thing about “emergency” legislation? No need to worry that the outlay would add to our already insane federal deficit; that can’t be allowed to interfere with saving the world (or public schooling lard).

Finally, looming on the horizon is the release of final standards from the Common Core State Standards Initiative. The Obama administration is trying to coerce all states to adopt the standards by linking adoption to Race-to-the-Top competitiveness and, potentially, Elementary and Secondary Education Act funding.

The good news is that on June 2 – potentially the very day the standards will be released – you can catch what has sadly been a rarity so far in the push for national standards: a real debate about whether national standards will actually improve educational outcomes.  My answer is that there is no meaningful evidence that national standards drive superior results, but joining me to debate that right here at Cato will be the Heritage Foundation’s Lindsey Burke, Sandra Boyd of Achieve, Inc., and the Fordham Foundation’s Michael Petrilli. It will be a debate that must be replicated across the country before we make any further move to adopt one standard for every public school in America. You can register here to see our debate live, or catch it online at Cato.org.

The feds are on the move in education, and the more we learn about their plans, the more obvious it is that they must be stopped.

By Pulling His Punches, Bernanke Shatters ObamaCare’s Credibility

Federal Reserve Chairman Ben Bernanke gave a speech in Dallas yesterday where he inadvertently discredited claims that ObamaCare would reduce health care costs and the federal deficit.  According to The Washington Post:

Federal Reserve Chairman Ben S. Bernanke warned Wednesday that Americans may have to accept higher taxes or changes in cherished entitlements such as Medicare and Social Security if the nation is to avoid staggering budget deficits that threaten to choke off economic growth…

While the immediate audience for the speech was the Dallas Regional Chamber, his message was intended for Congress and the Obama administration…

Bernanke has urged Congress to address long-term fiscal imbalances in congressional testimony before, but usually only when he is asked about them by lawmakers. His speech Wednesday aimed to reach a broader audience, steering away from technical economic speak and using plain, sometimes wry, language – a rare thing for a Fed chairman.

The non-partisan Congressional Budget Office projects the annual federal deficit will be at least $700 billion in each of the next 10 years.  Deficit spending is a form of taxation without representation, because it increases the tax burden of generations who cannot yet vote (often because they are as yet unborn).  Bernanke wants us to end deficit spending.  Kudos to him.

But consider the timing of his speech.  Why wait until April 7, 2010, to deliver that message directly to the public?  Why not give that speech in January? Or February? Or any time before March 21?

The reason is obvious: Bernanke held back to appease his political masters.

Until three weeks ago, the nation was locked in a debate over whether Congress should enact ObamaCare, the most sweeping piece of social legislation in American history.  That law includes two new health care entitlements – the very type of government spending driving the federal budget further into the red.  Democrats rigged the bill so that the CBO was obliged to score it as deficit-reducing, but 87 percent of the public weren’t buying it.

If Bernanke really wanted to warn the American public about the dangers of rising budget deficits, then a congressional debate over creating two new entitlement programs would be the most important time to deliver that message.  Democrats would have responded that ObamaCare would reduce the deficit.  But since voters believe ObamaCare to be a budget-buster, Bernanke’s warning would have dealt ObamaCare a serious blow.

Had Bernanke delivered his populist warning before January 28, it could have jeopardized his confirmation by the Senate to a second term as Fed chairman.  Had he done so between January 28 and March 21, he would have suffered a storm of criticism from Democrats (and possible retribution when his term came up for renewal in 2013) because his sensible, responsible warning would have made moderate House Democrats more skeptical about ObamaCare’s new entitlements.

So Bernanke pulled his punches.  As Dick Morris would put it, anyone who doesn’t think that political concerns affected Bernanke’s timing is too naive for politics.

Bernanke’s behavior thus reveals why ObamaCare’s cost would exceed projections and would increase the deficit.

Knowledgeable leftists, notably Tom Daschle and Uwe Reinhardt, recognize that Congress is no good at eliminating wasteful health care spending because politics gets in the way.  (Every dollar of wasteful health care spending is a dollar of income to somebody, and that somebody has a lobbyist.)

The Left’s central planners believe they can contain health care costs by creating an independent government bureaucracy that sets prices and otherwise rations care without interference from (read: without being accountable to) Congress.  ObamaCare’s new Independent Payment Advisory Board is a precursor to what Daschle calls a “Health Fed,” so named to convey that this new bureaucracy would have the same vaunted reputation for independence as the Federal Reserve.

Yet Fed scholar Allan Meltzer reports, and Bernanke’s behavior confirms, that not even the hallowed Federal Reserve can escape politics:

In reading the minutes of the Fed and watching what they do, the Fed has always been very much afraid of Congress…The idea of having a really independent agency in Washington, that’s just not going to happen…[The Fed] is very much concerned — always — about what the Congress is doing, and doesn’t want to deviate very far from that.

Politics affects Bernanke’s behavior and the Fed’s behavior.  Politics will defang the Independent Payment Advisory Board, and many of  ObamaCare’s other purported cost-cutting measures.  ObamaCare’s cost will outpace projections. The deficit will rise.

Repeal the bill.

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