This is an interesting opinion piece regarding why the National Debt will get more attention in the coming years... And yet the same Republicans who cried foul when Obama was President are silent now days...
CRFB Summary
G2A Hope Our Kids Forgive Us
CRFB Summary
G2A Hope Our Kids Forgive Us
84 comments:
If the deficit were that big a deal, we wouldn't be cutting taxes.
--Hiram
Essential point: "Rising long-term deficits are driven by rapid growth in spending – particularly spending on health care, retirement, and interest on the debt – well in excess of the growth in revenue. "
Tax revenue is growing. Raise taxes and revenue drops. We have a spending problem, and until Congress gets control of that, we're screwed.
What's growing? Spending? Or health care? Can we cut one without the other?
If we really believed that raising taxes lowered revenue, Republicans would support tax increases, and Democrats would support tax cuts. But we don't believe those things.
--Hiram
CBO Report PDF
The reality is that the GOP cut taxes and revenues while increasing spending... They own this current crisis, and it's long term consequences.
These are the charts that horrify me... As the National Debt grows, the debt service cost grows and the risk increases... As healthcare costs grow... And yet both sides just keep behaving like nothing is wrong...
Figure 2: Federal Debt, Spending, and Revenues
Well, we would love to address health care costs. And Trump said he would use the power of the federal government to push down drug prices, something we support. But that just doesn't happen. I am not a big hypocrisy guy, but I am not impressed with the idea, that while we should reduce health care spending, while spending less on health care. And again, I am not impressed by the argument that we can't afford health care, when we seem to afford tax cuts just fine.
--Hiram
Well Jerry is correct that rising governmental spending is large part of the problem.
Which raises the question, why are tax payers paying the bills of so many citizens?
"The reality is that the GOP cut taxes and revenues while increasing spending."
You don't read your own sources. The problem is that spending increases FASTER than tax revenue when taxes are cut, and MUCH faster than tax revenue when taxes are raised. Taxes are not the problem, spending is, and at least Republicans make noises about curbing the deficit. Oh, sorry, Democrats do NOW, when they are not in charge of it. They never were before.
"And yet both sides just keep behaving like nothing is wrong..."
The Medicare for All plan reduces the amount we'd spend nationally on health expenditures. So no, there is one party that is for fiscal responsibility, but it's not the one we hear about in the fake news media narrative.
Moose
"...why are tax payers paying the bills of so many citizens?"
There you go. The vast majority of the federal budget goes to "entitlements," the transfer of wealth from one individual citizen to another individual citizen. If each of us were to pay our own bills, federal spending would drop by, some estimates, 80%. A more modest proposal would cut 20% fairly quickly, and even the simplest proposal, the 1% plan, would eliminate the deficit (not the debt) in 5 years. The only real "shortfall" here is political will and of politicians facing reality.
The problem with entitlements is that people are entitled to them. No on is entitled to a tax cut.
--Hiram
Moose, Everyone but you has seen the story that "medicare for all" would cost another 3.2 TRILLION $/year, or double the federal budget and double taxes for everybody. That's not fiscally responsible, it's fiscal suicide.
Health care has to be paid for. It's just matter out of which pocket the money comes.
--Hiram
You know my view... It is very important that the money comes from the health care consumer if we truly want to reduce costs.
The consumer is the only one who can live "a healthier life" or not...
There is an asymmetry even an unfairness, with which Republicans have to contend. While things like Social Security and Medicare are entitlements, protected in law and public opinion, massive tax cuts for wealthy donors are not which pay for those things are not. Republicans in their effort to level the playing field between wealth donors and the rest in their efforts to pay for tax benefits for their constituents, with lower pension benefit and reduced health care have difficult, even insuperable barriers to overcome. The solution they have found is to borrow the money for their tax cuts from China.
--Hiram
A human being is not a "health care consumer". But if we must use that term...since it would be a tax, the consumer would in effect be spending the money.
Moose
Moose,
That is way too disconnected...
People who make unhealthy choices need to pay more.
Yes. Those darn people who choose their genetic makeup. How dare they expect anybody else to care?
Moose
so let me understand. Because people cannot choose their genetic makeup, If I am genetically predisposed to breast cancer, the government should deny me the choice to have that cancer treated?
Is that you Jerry?
To answer the question... Of course the government should not prevent her from getting treatment.
On the other hand she should not be prevented from getting treatment just because she is poor. Correct?
The keys are the words "choice" and "deny." Just because someone is poor does not mean they cannot be treated for an illness, it means it may work a financial hardship on them, the cost of which will, in some cases, be borne by someone else- usually a charity of some sort. But they have the choice.
I have been in too many small Canadian towns where there is a contributions jar out on the counter, because the Canadian government won't pay for some needed care for "Jonny" and they DENY him the right to pay for it, so we're taking up a collection to send him to the US where he can get the medical care he needs.
And in the good old USA we have hundreds of thousands of bankruptcies due to medical bills each year and gofundme campaigns and the like.
It’s definitely not better than the Canadian system and likely a lot worse.
Moose
Along those lines... My eldest daughter had to have her gall bladder removed... And the hospital made her pay before the surgery...
Good thing she has insurance and savings.
Yet your daughter GOT her surgery. While in Canada she would wait until after she was dead. Government control of the health care system means exactly that-- that some faceless bureaucrat (hopefully) decides who lives and who dies. Not the way to run a marketplace in goods and services. And before you say it; no, health care is not a right.
Actually the folks I know in Canada are pretty happy with their less expensive healthcare system. They do use triage to prioritize visits, people with serious issues are prioritized...
Not just those people with money... :-)
By the way, in the USA we have some nameless faceless insurance agent who decides one's fate... It is not so different. Well that is if you can afford insurance...
And if you can not afford insurance, then you are back to that nameless faceless bureaucrat...
Back the truck up. Why, because someone cannot afford insurance (remember, it is not related to health CARE), must the taxpayer pick up the tab for their insurance,
OR for their health care? We might do it voluntarily, of course, but why be FORCED to do so by government, on government terms? And that faceless bureaucrat at the insurance company has a contract with you, that you entered into knowingly. If they agree not to cover something, and you accept that, what is the problem, since you can always go elsewhere? If government decides not to cover something, either in general or for you specifically, what is your recourse? It's all in who chooses.
"And before you say it; no, health care is not a right."
But life is.
Moose
Jerry,
Folks can always pay cash somewhere if they don’t like the bureaucrats answer. That is how they handle that issue in much of the world.
Where as if one is poor in our current system they are pretty well screwed.
Well unless they are a child.
Life is a right because you can have it without anyone else "giving" it to you (except Mom, and it still should be a right at that). Health care is not a right because to get it, you have to take it from someone else, or give them something in exchange for giving it to you. Since taking it impinges on THEIR rights, HC is not a right that you may have.
And John, one of us is not understanding the fundamental flaw in socialized medicine, which is that if the government refuses you care, for whatever reason, it is against the law for you to pay for it yourself, or for a doctor to accept cash!
Care is not in infinite supply. We can let government ration it arbitrarily and capriciously, or we can ration by a free market. If you want to talk about limiting government's role to a simple "premium support" role as an intermediate step, OK. We have to get government healthcare out of the budget quickly or nothing else will help. forbes
So are you now say that Peter”s possessions are now more important than Paul’s life.
You and St Peter are going to have an interesting discussion at the pearly gates. :-)
I am saying that St. Peter expects me to willingly look after Paul. I get absolutely zero treasures in Heaven if government forces me to do it. And what these socialists don't realize is that THEY get no credit for forcing Peter to pay Paul, only if THEY look after Paul themselves.
Ahhh... I'll leave that discussion to you and St Peter...
To me it sounds like you are placing the money of some who have plenty above the health and well being of others...
"Life is a right because you can have it without anyone else "giving" it to you (except Mom, and it still should be a right at that). Health care is not a right because to get it, you have to take it from someone else, or give them something in exchange for giving it to you. Since taking it impinges on THEIR rights, HC is not a right that you may have."
Quite the contrary. You are placing government in charge of who benefits from Peter's labor-- Peter or Paul, who did nothing to earn it. THEN you also want government to decide whether Paul gets the health care he needs, or not, or whether we are going to pour all of Somebody Else's Money into bureaucracy and futility. If you don't thank that last can happen, I'll tell you about Newfoundland sometime.
Who are we to questions God's Will? :-)
Meh...I prefer Catholic Social Teaching over whatever Prosperity Gospel nonsense it is that you're espousing, jerry.
Do you mean the Catholic Social Teaching that preaches women shall not use birth control or have access to first term abortions?
Maybe they just wanted more kids in the flock...
2401-2449 of the Catechism
Moose
Are we talking about religion or government? I thought we were not supposed to entangle the two? What I may freely donate as a Christian obligation is completely different than what I am commanded to do by government. One is charity, the other is tyranny.
And again to my point: government involvement in health care is the single largest and fastest-growing contributor to deficits. If your concern is truly deficits, that is where we must focus reform efforts. If your concern is some "feel-good" utopian approach that has government giving "free," high-quality health care to everybody, you do not care about the federal budget at all.
Moose,
I don't have time to read them now, but they seem interesting.
Jerry,
You seem to have forgotten that the USA spends the most per capita and our results are not great in many ways.
So the reality is that if we want to control healthcare spending... We need to control healthcare spending... :-)
"What I may freely donate as a Christian obligation is completely different than what I am commanded to do by government. One is charity, the other is tyranny."
That is not in conformity with the Catechism of the Catholic Church.
Moose
Moose, exactly so. I am not Catholic, so I am not bound by whatever it is. I AM, most unfortunately, bound by what government decrees in many areas, and having them tell me that I must pay for somebody else's health insurance but I am NOT allowed to pay for my own, as I see fit, is a bridge too far. There is no religious precept that commands GOVERNMENT to "care for the poor." Not even on my behalf.
John, I will make the claim again, that if we got government OUT of health care, costs would be halved with little or no reduction in quality, and a corresponding improvement in coverage because people would find "affordable health care."
Jerry,
The use of the word "tyranny" in our democratic country is humorous... Apparently anytime one is in the minority they can scream tyranny...
1 : oppressive power ·every form of tyranny over the mind of man
—Thomas Jefferson especially : oppressive power exerted by government ·the tyranny of a police state
2 a : a government in which absolute power is vested in a single ruler; especially : one characteristic of an ancient Greek city-state
b : the office, authority, and administration of a tyrant
3 : a rigorous condition imposed by some outside agency or force ·living under the tyranny of the clock —Dixon Wecter
4 : an oppressive, harsh, or unjust act : a tyrannical act ·workers who had suffered tyrannies
You can fight the data all you want... But the healthiest countries in the world have universal healthcare that is managed by the government.
How to lie with statistics. Source please, and I will insist they be apples to apples comparisons. One wonders why world potentates come HERE for their care? We claim a very high rate of death by gunshot, much higher than anywhere in the world. Would universal health care reduce that statistic?
If there is "tyranny of the clock" can there not be tyranny in other limited areas, like by "death panels"? The word was not chosen for humor, but intended to show the serious nature of giving government control of our right to life.
Here are some interesting links...
Costs
Outcomes
Wealthy people come here because we have great healthcare if you can afford it...
Unfortunately a whole lot of American citizens can not afford to see those high end Doctors in those high end facilities.
So you are willing to give control of your life to:
- bad luck (ie you develop a serious chronic condition and go broke)
- some unidentified charity org with little financial means
- some charitable healthcare organization
However you do not trust your fellow citizens to vote for a good system...
Very confusing.
As for Death Panels
'There is no religious precept that commands GOVERNMENT to "care for the poor."'
You're wrong.
"Love for the poor is incompatible with immoderate love of riches or their selfish use
St. John Chrysostom vigorously recalls this: "Not to enable the poor to share in our goods is to steal from them and deprive them of life. The goods we possess are not ours, but theirs."239 "The demands of justice must be satisfied first of all; that which is already due in justice is not to be offered as a gift of charity
A just wage is the legitimate fruit of work. To refuse or withhold it can be a grave injustice.221 In determining fair pay both the needs and the contributions of each person must be taken into account. "Remuneration for work should guarantee man the opportunity to provide a dignified livelihood for himself and his family on the material, social, cultural and spiritual level, taking into account the role and the productivity of each, the state of the business, and the common good."222 Agreement between the parties is not sufficient to justify morally the amount to be received in wages.
Those responsible for business enterprises are responsible to society for the economic and ecological effects of their operations.218 They have an obligation to consider the good of persons and not only the increase of profits.
Economic life is not meant solely to multiply goods produced and increase profit or power; it is ordered first of all to the service of persons, of the whole man, and of the entire human community. Economic activity, conducted according to its own proper methods, is to be exercised within the limits of the moral order, in keeping with social justice so as to correspond to God's plan for man.
The Church has rejected the totalitarian and atheistic ideologies associated in modem times with "communism" or "socialism." She has likewise refused to accept, in the practice of "capitalism," individualism and the absolute primacy of the law of the marketplace over human labor.207 Regulating the economy solely by centralized planning perverts the basis of social bonds; regulating it solely by the law of the marketplace fails social justice, for "there are many human needs which cannot be satisfied by the market."208 Reasonable regulation of the marketplace and economic initiatives, in keeping with a just hierarchy of values and a view to the common good, is to be commended.
Goods of production - material or immaterial - such as land, factories, practical or artistic skills, oblige their possessors to employ them in ways that will benefit the greatest number. Those who hold goods for use and consumption should use them with moderation, reserving the better part for guests, for the sick and the poor."
Moose
"However you do not trust your fellow citizens to vote for a good system..." -- John
Absolutely not true. I trust every citizen to be able to vote, for themselves, that spending which most benefits them at every given moment. If they want to buy health insurance, or health care for themselves, or for others, that is absolutely (or should be) their free choice to do so, and that "system" will be far superior to what any bureaucracy can possibly devise.
And Moose: "Goods of production - material or immaterial -... oblige their possessors to employ them in ways that will benefit the greatest number." And allowing people to maximize their "INCOME" allows them to provide more jobs and more goods and services-- the greatest good for the greatest number-- by each person maximizing their industry in "enlightened self-interest." 206-208 seem to say it pretty well, depending on what you see as "reasonable regulation of the marketplace."
As for death panels, Politifact's lie of the year award is itself the lie of the year. Common sense tells you that, as Thomas Sowell is quoted as saying, government will not pay every cost for every person-- they cannot. Therefore they will ration care on some basis, and some people will therefore die for lack of care. QED. You don't have to call them death panels, but the result is inevitably the same.
"And allowing people to maximize their "INCOME" allows them to provide more jobs and more goods and services..."
"Reserving the better part for guests, for the sick and the poor."
Moose
Jerry,
I realize you are okay with letting people who make poor life choices die as part of their natural consequences. Sometimes I am also.
But most of the time I realize that Medicare, Medicaid and ACA are necessities if we want to care adequately for the stupid, lazy and unlucky.
I'll leave judging your choice to put money and personal control above the lives of the unfortunate to St Peter / God... Not my problem.
I am not sure why I would care what TS thinks... Many other countries are doing what he claims to be impossible.
"But most of the time I realize that Medicare, Medicaid and ACA are necessities if we want to care adequately for the stupid, lazy and unlucky."
Simply not true. We may need something for people who, largely through no fault of their own or are only on the path to self-sufficiency but not "there" yet, but these massive, one-size-fits-all government programs are NOT what we need.
"The [obamacare] law’s skyrocketing subsidies have kept subsidized insurance enrollment fairly steady — although more than 50 percent below what was once expected. But Americans who make too much to receive subsidies have begun to opt out of the insurance market en masse. An independent analysis found that the entire unsubsidized individual insurance market shrank by more than 40 percent from the first quarter of 2016 to the first quarter of 2018. In other words, Obamacare has forced unsubsidized Americans to choose between unaffordable insurance and no insurance at all.
This is unacceptable. It is one reason the Trump administration recently expanded an affordable insurance option the previous administration had all but discarded, providing new choices for these forgotten men and women.
Americans will once again be able to buy what is known as short-term, limited-duration insurance for up to a year, assuming their state allows it. These plans are free from most Obamacare regulations, allowing them to cost between 50 and 80 percent less."
"Reserving the better part for guests, for the sick and the poor."
Moose, you obviously have trouble distinguishing between God and government. God may encourage me as you suggest. Government may FORCE me to do so. Which is better for my soul? There is no such thing as "involuntary charity."
Source?
Food for Thought
It’s not ‘involuntary charity’, it’s justice. You seem to not want to talk about the part where withholding wealth while the poor suffer is theft.
Moose
John-- Washington Post yesterday.
Moose, what is "justice" about taking, by force of law, from one person to give to another? "Robin Hood government" is not just immoral and amoral, it's ineffective public policy. "Withholding wealth is theft" is BACKWARDS. Taking wealth is the classic definition, and the motivation does not matter. Not to mention that if you need it and ASK me for it, I am likely to give it to you, if I can, out of true charity. Unless I'm a liberal, and then I insist government take it from somebody else.
See new post
That is your belief, just please don't confuse it with basic Christian principles.
Moose
It is my belief that "thou shalt not steal" is pretty fundamental. Having government do it for you does not make it any less sinful. Who did Christ charge with care of the poor? Was it government?
Personally I think this commandment is more relevant.
Exodus 20:3-5 King James Version (KJV)
3 Thou shalt have no other gods before me.
4 Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth.
5 Thou shalt not bow down thyself to them, nor serve them: for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me
I find that many conservative money lovers have replaced God with the almighty dollar...
And let's not forget "Render to Caeser"
I love the Bible... There are several answers for every question...
"It is my belief that "thou shalt not steal" is pretty fundamental. Having government do it for you does not make it any less sinful. Who did Christ charge with care of the poor? Was it government?"
It's quite fundamental. If you have excess, and someone is in need, your excess is theft from the person in need.
The government is nothing but the collective work of the people. Private charity never was and never will be enough...unless everyone were charitable. Your solution would mean 1) people dying from need, or 2) forcing everyone to be charitable so that no one is left in need. But even then, it is not truly charity if you have excess. It is simply justice.
Moose
"But even then, it is not truly charity if you have excess." Thank you, Lewis Carrol. Who are YOU to decide what is excess? Who are you to decide how much "charity" is needed? And if I do NOT have excess, even by your standard, from what am I expected to give? We give from abundance. There is no justice in taking from anyone the fruits of their labors, and I don't care who you are or what you intend. Thou shalt not steal. Stealing is an injustice.
This is an interesting read.
Jesus, The Bible and Food stamps
"What I can say for sure is that we are in absolutely no danger of social programs making the work of churches irrelevant."
And he was doing so well, up to that point. It isn't the work of government, according to Jesus, to care for the poor, therefore this statement is in error. All the rest of the piece I cannot find fault with.
I note again our Constitution requires government to "PROVIDE for the common defense, PROMOTE the GENERAL welfare..." The framers never intended government to PROVIDE individuals with welfare.
Well thankfully you have little control over the care of the unlucky and stupid in our democratic society. :-)
Actually, I have a great deal of control over my personal charitable efforts-- both money and time. I would have a lot more if government quit depriving me of the means to do more, and then spending it not just inefficaciously but often counterproductively.
But that is not what I said... I said...
"Well thankfully you have little control over the care of the unlucky and stupid in our democratic society. :-)"
I agree that the government could do it better, however there is a big benefit of operating it through a secular management system with the authority to tax. They have funds and they don't discriminate regarding who gets them.
They don't discriminate? So the stupid and irresponsible pay no penalty for being stupid and irresponsible, while the wise and responsible stand in line behind them? That is a BENEFIT to what you propose?
How about allowing people to CHOOSE where to spend and what to spend it on, as we (thankfully still) do with all other consumer goods and services? Costs would go down greatly, more people could afford it, and quality would improve. Why do anything different? Do you think having government run all the grocery stores would be a good idea?
Of course some people on the religious right are happy to discriminate against people who "sin" or are "different"... Look at our years of LGBTQ discussions... Look at the centuries of "good Christian people" owning and/or treating Black Americans terribly.
Thankfully the national government learned and improved...
By the way, stores work because people exchange things of value to each party.
Caring for the stupid, unlucky and irresponsible is something totally different.
Now I wish the government systems would improve, but eliminating them would be disastrous for many.
"Thankfully the national government learned and improved... " Really? Or did they simply fail to live up to their own good intentions, relying too much on their supposed great wisdom, where a few bureaucrats are smarter than the collective wisdom of millions of individuals deciding on billions of choices for themselves?
"By the way, stores work because people exchange things of value to each party." So?
Aren't doctors and hospitals just "health care stores"? What is the distinction in your mind?
"Now I wish the government systems would improve, but eliminating them would be disastrous for many." It took decades for the government to screw up our healthcare system, and it will take many years to undo that damage and restore a lightly regulated free-market. But getting back to the topic, We have no choice, since government funding of healthcare is the single biggest contributor to the deficit and to the increase in it.
We ended slavery and the legal protections for racism. We gave women rights that they initially did not have. Most states protect LGBTQ citizens. I would certainly say that our secular government of the people learned and improved. Imagine how backwards we would still be if the religious right was still in charge.
Yes, however when millions of people can not afford to buy services at the healthcare store, those customers are left out in the cold.
However I was actually talking about charity not being able to function on the capitalistic model. There are too many Ebenezer Scrooges in our "me first" society.
Actually I would argue that technology screwed up our healthcare system. In 1960 there was little one could do to evaluate and fix a person, so costs were low... Not so today... And no one wants themselves to die if they may live...
You have cause and effect backwards. Look at the cost of an MRI in the US today vs. the cost under any of the nationalized health systems. So long as competition is allowed costs get and stay low. Monopolies raise prices and lower quality and availability, and government monopolies are the worst because no government is willing to bust them up (anti-trust) like they do private monopolies.
Millions of people can not afford coverage because of Obamacare! When they could before! How is that better?!?
Charity doesn't work because government has arrogated onto itself to do "charity," and it doesn't know how. I've worked with private charities whose purpose is to help people who "fall through the cracks" of the government system.
Again, with government control and funding of so much of the health care system driving our budget deficit, why is that not the place to look for reform and cost reductions? The budget deficit could be eliminated if government got out of the health care business and, in a few years (of transition), private systems would supplant that with something far better and cheaper. It's these silly ideas that if government doesn't do it it doesn't get done, and that government knows best about everything. Color me a skeptic on both counts.
Oh, and all that "progress"? You call $21 Trillion of debt and $200 Trillion of unfunded mandates progress?
Do some research
More millions could not afford health insurance before ACA, or they could not even get a policy. It is hard to feel for people with great incomes whining about insurance rates... Remember that poor folks are subsidized with ACA.
Charity was failing, therefore government had to fill the void.
I agree we do have a spending problem and a low tax problem. That is why we should consider adopting the policies of countries that have great healthcare outcomes for much less money. Instead you want to go back to the systems that put us in the situation.
Remember that just because poor folks are subsidized that the total cost of health care does not change, merely who pays. And the fact that costs for those NOT subsidized has gone up greatly tells me that ACA is WORSE, cost-wise, then the status quo ante, and that means that without the subsidies, FEWER people can afford the insurance. It's already happened. "If you like your policy, you can keep your policy." = Lie of the Year, remember?
And there is no evidence that charity was even involved. We are talking about the /insurance/ market, not health care, an area already largely provided or controlled by government. And the statement "therefore government had to fill the void" is pure nonsense. Why? If people are hungry, is government obligated to "two chickens in every pot"?
And we do not need, and ought not want, to emulate the systems in other countries, when by the simple expedient of getting government OUT of our health care we could have better care at half the cost.
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