Beat the Press

Beat the press por Dean Baker

Beat the Press is Dean Baker's commentary on economic reporting. He is a Senior Economist at the Center for Economic and Policy Research (CEPR). To never miss a post, subscribe to a weekly email roundup of Beat the Press. Please also consider supporting the blog on Patreon.

Dentists are apparently among the group of workers who lack the skills necessary to compete in the modern economy, who then turn to the government to protect their jobs and wages. This is in effect the story told in this Washington Post news article about the power of the American Dental Association (ADA).

The piece focuses on the ADA’s efforts to block other professionals from doing work that is now done by dentists. While the piece doesn’t mention this fact, the ADA also blocks foreign-trained dentists from practicing in the United States. Dentists cannot practice in the United States unless they have a degree from a U.S. dental school. (Since 2011, graduates of Canadian dental schools have also been allowed to practice here.)

As a result of this protectionism, the pay of dentists averages $200,000 a year, roughly twice as much as their pay in other wealthy countries. This costs the country $20 billion a year (roughly equal to the TANF budget) in higher dental expenses.

It’s striking that the protectionism for dentists gets so little attention relative to much less costly forms of protectionism, like tariffs for steel, cars, or other items. Perhaps it has something to do with the people reporting on the topic identifying with the beneficiaries. I discuss this in chapter 7 of Rigged: How Globalization and the Rules of the Modern Economy Have Been Structured to Make the Rich Richer (it’s free).

Dentists are apparently among the group of workers who lack the skills necessary to compete in the modern economy, who then turn to the government to protect their jobs and wages. This is in effect the story told in this Washington Post news article about the power of the American Dental Association (ADA).

The piece focuses on the ADA’s efforts to block other professionals from doing work that is now done by dentists. While the piece doesn’t mention this fact, the ADA also blocks foreign-trained dentists from practicing in the United States. Dentists cannot practice in the United States unless they have a degree from a U.S. dental school. (Since 2011, graduates of Canadian dental schools have also been allowed to practice here.)

As a result of this protectionism, the pay of dentists averages $200,000 a year, roughly twice as much as their pay in other wealthy countries. This costs the country $20 billion a year (roughly equal to the TANF budget) in higher dental expenses.

It’s striking that the protectionism for dentists gets so little attention relative to much less costly forms of protectionism, like tariffs for steel, cars, or other items. Perhaps it has something to do with the people reporting on the topic identifying with the beneficiaries. I discuss this in chapter 7 of Rigged: How Globalization and the Rules of the Modern Economy Have Been Structured to Make the Rich Richer (it’s free).

That’s the question millions are asking after reading an NYT article on the state of the U.S. aluminum industry. The article notes that an increasing share of aluminum is imported, mostly from Iceland and other countries with low-cost electricity. (The industry uses huge amounts of electricity.) However, it also points out that China is getting a growing share of the market and the industry claims that the Chinese firms are subsidized by the government. The industry and steelworkers union are arguing for offsetting tariffs.

The piece then presents a comment from an executive at the Molson Coors Brewing:

“If there are duties on aluminum coming to this country, it will obviously get passed on to us and the customer … Our prices will go up.”

The piece doesn’t give any sense of how much beer prices to consumers would rise from the tariffs being considered. While it would take a bit of homework to calculate the prospective increase from a tariff, suppose that tariffs on Chinese aluminum raised the price of aluminum by 10 percent. This is almost certainly too high a figure, since Chinese aluminum only accounts for 5 percent of U.S. consumption, according to the article.

Suppose that the cost of the aluminum accounts for 10 percent of the price of a can of beer in the store. This is also almost certainly far too high since the current cost of aluminum is less than a dollar a pound. If you can get twenty cans out of a pound of aluminum that would make the cost per can less than five cents.

In this scenario, tariffs would raise the price of a can of beer by 1.0 percent. It’s a safe bet that the beer drinking public would rather not pay 1.0 percent more for their beer, but most would probably not be terrified by this prospect.

That’s the question millions are asking after reading an NYT article on the state of the U.S. aluminum industry. The article notes that an increasing share of aluminum is imported, mostly from Iceland and other countries with low-cost electricity. (The industry uses huge amounts of electricity.) However, it also points out that China is getting a growing share of the market and the industry claims that the Chinese firms are subsidized by the government. The industry and steelworkers union are arguing for offsetting tariffs.

The piece then presents a comment from an executive at the Molson Coors Brewing:

“If there are duties on aluminum coming to this country, it will obviously get passed on to us and the customer … Our prices will go up.”

The piece doesn’t give any sense of how much beer prices to consumers would rise from the tariffs being considered. While it would take a bit of homework to calculate the prospective increase from a tariff, suppose that tariffs on Chinese aluminum raised the price of aluminum by 10 percent. This is almost certainly too high a figure, since Chinese aluminum only accounts for 5 percent of U.S. consumption, according to the article.

Suppose that the cost of the aluminum accounts for 10 percent of the price of a can of beer in the store. This is also almost certainly far too high since the current cost of aluminum is less than a dollar a pound. If you can get twenty cans out of a pound of aluminum that would make the cost per can less than five cents.

In this scenario, tariffs would raise the price of a can of beer by 1.0 percent. It’s a safe bet that the beer drinking public would rather not pay 1.0 percent more for their beer, but most would probably not be terrified by this prospect.

In her column on “Five Myths About Health Insurance,” health economics professor Alexis Pozen pushes a common myth. As part of myth number five, Pozen tells readers;

“Although firms may boast about offering generous health-care benefits, the costs of coverage are largely borne by employees, in the form of lower wages than a competitive market would otherwise support. That helps explain why inflation-adjusted wages have remained flat, even while productivity has increased — it’s all going to cover rising health-care costs.”

While there is some truth to this story in prior decades (only some, since payments for insurance largely came at the expense of pensions), benefit growth has actually trailed wage growth in the recovery, as shown below.

fredgraph12

Since benefits have not kept pace with wage growth over the last five years, we should be expecting wages to rise somewhat faster than productivity since we are seeing a shift in compensation from benefits to wages.

In her column on “Five Myths About Health Insurance,” health economics professor Alexis Pozen pushes a common myth. As part of myth number five, Pozen tells readers;

“Although firms may boast about offering generous health-care benefits, the costs of coverage are largely borne by employees, in the form of lower wages than a competitive market would otherwise support. That helps explain why inflation-adjusted wages have remained flat, even while productivity has increased — it’s all going to cover rising health-care costs.”

While there is some truth to this story in prior decades (only some, since payments for insurance largely came at the expense of pensions), benefit growth has actually trailed wage growth in the recovery, as shown below.

fredgraph12

Since benefits have not kept pace with wage growth over the last five years, we should be expecting wages to rise somewhat faster than productivity since we are seeing a shift in compensation from benefits to wages.

There has probably never been a National Bureau of Economic Research working paper that produced as much glee in the media as last week's report showing that Seattle's minimum wage law may have led to a net loss in wages for low wage workers. According to the analysis, there was a reduction in average hours worked among those in the low wage labor market that more than offset the gain in wages. The result was a net loss in wages for exactly the group of people the law was intended to benefit. This finding was quickly picked up in every major news outlet. While some, notably the New York Times, reported the finding with appropriate cautions, others (e.g. here, here, here, here, and here) were nearly gleeful at the idea that workers in Seattle were losing their jobs. Most of the reporting ignored the fact that the same week a team of researchers from Berkeley produced an analysis using a very similar methodology that found no statistically significant impact on employment. There are important differences in the studies. The Berkeley study follows much prior research and only looks at the restaurant industry, a major employer of low wage workers. The University of Washington NBER paper looked at all workers getting paid less than $19 an hour. It also had two additional quarters of data. However, the Washington study also excluded the roughly 40 percent of the workforce that worked at multi-site employers (think Starbucks and McDonald's). In other words, it it not obvious that the Washington study is the "better" analysis. The Berkeley team has produced much of the cutting edge research on the minimum wage over the last fifteen years. I doubt that many of the reporters touting the Washington study would be able to explain why it is a better analysis of the impact of Seattle's minimum wage hikes.
There has probably never been a National Bureau of Economic Research working paper that produced as much glee in the media as last week's report showing that Seattle's minimum wage law may have led to a net loss in wages for low wage workers. According to the analysis, there was a reduction in average hours worked among those in the low wage labor market that more than offset the gain in wages. The result was a net loss in wages for exactly the group of people the law was intended to benefit. This finding was quickly picked up in every major news outlet. While some, notably the New York Times, reported the finding with appropriate cautions, others (e.g. here, here, here, here, and here) were nearly gleeful at the idea that workers in Seattle were losing their jobs. Most of the reporting ignored the fact that the same week a team of researchers from Berkeley produced an analysis using a very similar methodology that found no statistically significant impact on employment. There are important differences in the studies. The Berkeley study follows much prior research and only looks at the restaurant industry, a major employer of low wage workers. The University of Washington NBER paper looked at all workers getting paid less than $19 an hour. It also had two additional quarters of data. However, the Washington study also excluded the roughly 40 percent of the workforce that worked at multi-site employers (think Starbucks and McDonald's). In other words, it it not obvious that the Washington study is the "better" analysis. The Berkeley team has produced much of the cutting edge research on the minimum wage over the last fifteen years. I doubt that many of the reporters touting the Washington study would be able to explain why it is a better analysis of the impact of Seattle's minimum wage hikes.

I’m not sure which it is since I never met the guy, but it really is tiresome to see people try to pass off as a serious argument on health care something that anyone with any knowledge on the topic knows to be false. In a column touting the virtues of health savings accounts, so that we can all do comparison shopping for our colonoscopies, Stephens pronounced Obamacare a failure.

He notes the high rate increases in the last two years for insurance plans offered on the exchanges (ignoring the fact that the costs were originally below projections, so that premiums are now roughly in line with the projections from before the plan was passed). He then tells readers:

“Same deal for employer-sponsored plans. ‘While Sen. Obama promised during his campaign in 2008 that the average family would see health insurance premiums drop by $2,500 per year, the average family premium for employer-sponsored coverage has risen by $3,671,’ noted Maureen Buff and Timothy Terrell in the Journal of American Physicians and Surgeons. That was back in 2014, and premiums continue to rise.”

Okay Obama’s $2,500 drop in premium number was relative to a growing baseline. This was completely obvious at the time and was apparent to anyone who spend two seconds looking at the projections. Health care costs had been rising 6 to 7 percent annually for decades. Obama was not saying that his plan would reverse this pattern and actually cause costs to decline. He was talking about costs relative to the baseline projection of growth. (Costs actually have dropped relative to baseline projections even more than Obama projected, although it is debatable how much the Affordable Care Act is responsible.)

Everyone following the debate fully understood that Obama was making his claim relative to a baseline of rising cost growth, since it would have been completely absurd for him to claim he would actually cause premiums to fall in nominal terms. If Stephens is unaware of this fact, his level of ignorance on health care is truly astounding. Alternatively he could just be lying, deliberately misrepresenting Obama’s promises to score a cheap political point.

Either way, it doesn’t speak well for Stephens. I know the NYT has an affirmative action policy for conservatives, but this is ridiculous.

I’m not sure which it is since I never met the guy, but it really is tiresome to see people try to pass off as a serious argument on health care something that anyone with any knowledge on the topic knows to be false. In a column touting the virtues of health savings accounts, so that we can all do comparison shopping for our colonoscopies, Stephens pronounced Obamacare a failure.

He notes the high rate increases in the last two years for insurance plans offered on the exchanges (ignoring the fact that the costs were originally below projections, so that premiums are now roughly in line with the projections from before the plan was passed). He then tells readers:

“Same deal for employer-sponsored plans. ‘While Sen. Obama promised during his campaign in 2008 that the average family would see health insurance premiums drop by $2,500 per year, the average family premium for employer-sponsored coverage has risen by $3,671,’ noted Maureen Buff and Timothy Terrell in the Journal of American Physicians and Surgeons. That was back in 2014, and premiums continue to rise.”

Okay Obama’s $2,500 drop in premium number was relative to a growing baseline. This was completely obvious at the time and was apparent to anyone who spend two seconds looking at the projections. Health care costs had been rising 6 to 7 percent annually for decades. Obama was not saying that his plan would reverse this pattern and actually cause costs to decline. He was talking about costs relative to the baseline projection of growth. (Costs actually have dropped relative to baseline projections even more than Obama projected, although it is debatable how much the Affordable Care Act is responsible.)

Everyone following the debate fully understood that Obama was making his claim relative to a baseline of rising cost growth, since it would have been completely absurd for him to claim he would actually cause premiums to fall in nominal terms. If Stephens is unaware of this fact, his level of ignorance on health care is truly astounding. Alternatively he could just be lying, deliberately misrepresenting Obama’s promises to score a cheap political point.

Either way, it doesn’t speak well for Stephens. I know the NYT has an affirmative action policy for conservatives, but this is ridiculous.

Just kidding, we know that newspapers don’t make a point of running stories on incompetent bosses. Instead we have Obama administration car czar Steve Rattner telling us in a NYT column that manufacturers are not hiring because they can’t get qualified workers. His evidence is data from the Bureau of Labor Statistics’ Job Openings and Labor Turnover Survey which shows a rise in job openings reported in manufacturing, but little increase in hires. Rattner says that this is because firms can’t find qualified workers.

The problem with this explanation is that employers are not acting like they have a shortage of workers. As Rattner himself points out, the real hourly wage in manufacturing has risen by just 0.8 percent over the last decade. (This is cumulative, not an annual rate.) If firms really were trying to hire people but couldn’t find qualified workers then they would be offering higher wages to attract workers from their competitors. We don’t see this happening.

The other way that employers would respond to a lack of qualified workers is by working their existing workforce more hours. This doesn’t seem to be happening either as the graph below shows.

 Average Weekly Hours: Manufacturing Workers

Man hours

Source: Bureau of Labor Statistics.

While average hours are high, they are no higher than they were in 2013 and down from the peaks hit in 2014, periods when the labor market was considerably weaker by all measures. This picture is not consistent with an industry desperate for qualified workers.

Another item that needs correcting in Rattner’s piece is the claim that college-educated workers are doing well in the current economy. His column includes a chart that shows the wages of college-educated workers (including those with advanced degrees) have increased by 10.7 percent since 1979. (This is actually a growth rate of just 0.3 percent annually — not very impressive.) Since 2000, the median wage of workers with just a college degree has fallen by 1.5 percent. So, even college grads have not shared in the gains from growth in this century.

Just kidding, we know that newspapers don’t make a point of running stories on incompetent bosses. Instead we have Obama administration car czar Steve Rattner telling us in a NYT column that manufacturers are not hiring because they can’t get qualified workers. His evidence is data from the Bureau of Labor Statistics’ Job Openings and Labor Turnover Survey which shows a rise in job openings reported in manufacturing, but little increase in hires. Rattner says that this is because firms can’t find qualified workers.

The problem with this explanation is that employers are not acting like they have a shortage of workers. As Rattner himself points out, the real hourly wage in manufacturing has risen by just 0.8 percent over the last decade. (This is cumulative, not an annual rate.) If firms really were trying to hire people but couldn’t find qualified workers then they would be offering higher wages to attract workers from their competitors. We don’t see this happening.

The other way that employers would respond to a lack of qualified workers is by working their existing workforce more hours. This doesn’t seem to be happening either as the graph below shows.

 Average Weekly Hours: Manufacturing Workers

Man hours

Source: Bureau of Labor Statistics.

While average hours are high, they are no higher than they were in 2013 and down from the peaks hit in 2014, periods when the labor market was considerably weaker by all measures. This picture is not consistent with an industry desperate for qualified workers.

Another item that needs correcting in Rattner’s piece is the claim that college-educated workers are doing well in the current economy. His column includes a chart that shows the wages of college-educated workers (including those with advanced degrees) have increased by 10.7 percent since 1979. (This is actually a growth rate of just 0.3 percent annually — not very impressive.) Since 2000, the median wage of workers with just a college degree has fallen by 1.5 percent. So, even college grads have not shared in the gains from growth in this century.

That seems to be the case in an article on the recent drop in fertility rates that warns:

“If the trend (lower fertility) continues — and experts disagree on whether it will — the country could face economic and cultural turmoil.”

That is more than a bit hard to see. If we do see a sustained drop in the fertility rate it will mean that eventually we will have higher rates of retirees to workers, assume no offsetting increase in immigration or an increase in labor force participation by either the prime-age population (ages 25 to 54) or older potential workers.

However, the economic implications of this rise in the ratio of retirees to workers are very modest. According to the Social Security Trustees Report, the impact of a sustained fall in the fertility rate would increase Social Security’s projected shortfall over the next 75 years by an amount equal to 0.36 percent of payroll over this period. This is equal roughly 0.12 percent of projected GDP. There are other costs, such as Medicare, that would also increase with a larger ratio of retirees to workers; however, this would be offset in part by reduced spending on education and health care for the young.

By comparison, the increase in military spending associated with the wars in Iraq and Afghanistan was close to 2.0 percentage points of GDP. While these wars have prompted some opposition and protest, it has not led to economic turmoil. It is difficult to see why an increase in spending that is perhaps one-tenth as large would be expected to cause economic turmoil.

It is also worth noting that plausible changes in productivity growth swamp the impact of even large changes in fertility rates. If the country, had sustained the rate of productivity growth it experienced from 1995 to 2005 (also from 1947 to 1973) over the last twelve years, it would have the equivalent effect on workers’ take-home pay as reducing the Social Security tax by 10 percentage points. If the rate of productivity can be boosted by just 0.1 percentage point, it would swamp the long-term impact of a lower fertility rate on workers’ living standards. And, this is before even taking into the account the benefits of reduced stress on infrastructure and the environment.

In short, we should worry if people don’t have children because they don’t think they can afford them. We need not worry about running out of people.

That seems to be the case in an article on the recent drop in fertility rates that warns:

“If the trend (lower fertility) continues — and experts disagree on whether it will — the country could face economic and cultural turmoil.”

That is more than a bit hard to see. If we do see a sustained drop in the fertility rate it will mean that eventually we will have higher rates of retirees to workers, assume no offsetting increase in immigration or an increase in labor force participation by either the prime-age population (ages 25 to 54) or older potential workers.

However, the economic implications of this rise in the ratio of retirees to workers are very modest. According to the Social Security Trustees Report, the impact of a sustained fall in the fertility rate would increase Social Security’s projected shortfall over the next 75 years by an amount equal to 0.36 percent of payroll over this period. This is equal roughly 0.12 percent of projected GDP. There are other costs, such as Medicare, that would also increase with a larger ratio of retirees to workers; however, this would be offset in part by reduced spending on education and health care for the young.

By comparison, the increase in military spending associated with the wars in Iraq and Afghanistan was close to 2.0 percentage points of GDP. While these wars have prompted some opposition and protest, it has not led to economic turmoil. It is difficult to see why an increase in spending that is perhaps one-tenth as large would be expected to cause economic turmoil.

It is also worth noting that plausible changes in productivity growth swamp the impact of even large changes in fertility rates. If the country, had sustained the rate of productivity growth it experienced from 1995 to 2005 (also from 1947 to 1973) over the last twelve years, it would have the equivalent effect on workers’ take-home pay as reducing the Social Security tax by 10 percentage points. If the rate of productivity can be boosted by just 0.1 percentage point, it would swamp the long-term impact of a lower fertility rate on workers’ living standards. And, this is before even taking into the account the benefits of reduced stress on infrastructure and the environment.

In short, we should worry if people don’t have children because they don’t think they can afford them. We need not worry about running out of people.

I suppose that is their natural state. After all, they completely missed the housing bubble and then somehow expected the economy would bounce right back even though there was nothing to replace the demand generated by the bubble. Anyhow, at least according to this NYT article, they are very confused about the course of technology.

There are two big issues that the piece implies the bankers are missing. First, contrary to the concern of massive job displacement by robots, productivity growth has actually been very slow in recent years. It has averaged just over 1.0 percent annually over the last decade. This compares to a 3.0 percent annual rate in the long post-war Golden Age from 1947 to 1973 and again from 1995 to 2005.

It is also worth noting that these periods of rapid job displacement due to technology were also periods of low unemployment and rapid wage growth. (The 2001 recession, following the collapse of the stock bubble, put an end to the late 1990s wage growth.) There is no reason to blame weak wage growth and high unemployment on rapid productivity growth. If there is a weak labor market the problem is with macroeconomic policy that is leading to insufficient demand. (Bizarrely, this piece never once mentions trade deficits, which are a major drain on demand.)

The other big issue missing here is attributing distribution effects to technology. The ownership of technology is determined by policy, specifically rules on patents and copyrights, it is not determined by the technology. If we are seeing an upward redistribution associated with trends in technology, it would indicate that patents and copyrights are too long and too strong.

That would be a strong argument for making these forms of protection shorter and weaker (policy has been going in the other direction). There is no indication this topic even came up at the meetings. This suggests the central bankers are once again very confused about the economy. 

I suppose that is their natural state. After all, they completely missed the housing bubble and then somehow expected the economy would bounce right back even though there was nothing to replace the demand generated by the bubble. Anyhow, at least according to this NYT article, they are very confused about the course of technology.

There are two big issues that the piece implies the bankers are missing. First, contrary to the concern of massive job displacement by robots, productivity growth has actually been very slow in recent years. It has averaged just over 1.0 percent annually over the last decade. This compares to a 3.0 percent annual rate in the long post-war Golden Age from 1947 to 1973 and again from 1995 to 2005.

It is also worth noting that these periods of rapid job displacement due to technology were also periods of low unemployment and rapid wage growth. (The 2001 recession, following the collapse of the stock bubble, put an end to the late 1990s wage growth.) There is no reason to blame weak wage growth and high unemployment on rapid productivity growth. If there is a weak labor market the problem is with macroeconomic policy that is leading to insufficient demand. (Bizarrely, this piece never once mentions trade deficits, which are a major drain on demand.)

The other big issue missing here is attributing distribution effects to technology. The ownership of technology is determined by policy, specifically rules on patents and copyrights, it is not determined by the technology. If we are seeing an upward redistribution associated with trends in technology, it would indicate that patents and copyrights are too long and too strong.

That would be a strong argument for making these forms of protection shorter and weaker (policy has been going in the other direction). There is no indication this topic even came up at the meetings. This suggests the central bankers are once again very confused about the economy. 

Thomas Friedman Whines About His Lost TPP

Thomas Friedman, who is legendary for his boldly stated wrong assertions, got into the game again making absurd claims about the Trans-Pacific Partnership (TPP) and the great loss the U.S. suffers from it going down. Friedman tells readers: "It was not only the largest free-trade agreement in history, it was the best ever for U.S. workers, closing loopholes Nafta had left open. TPP included restrictions on foreign state-owned enterprises that dumped subsidized products into our markets, intellectual property protections for rising U.S. technologies — like free access for all cloud computing services — but also anti-human-trafficking provisions that prohibited turning guest workers into slave labor, a ban on trafficking in endangered wildlife parts, a requirement that signatories permit their workers to form independent trade unions to collectively bargain and the elimination of all child labor practices — all to level the playing field with American workers." This is of course wrong. First, and most importantly, all the provisions on items like human trafficking, child labor, and trading in endangered wildlife depended on action by the administration. In other words, if the TPP had been approved by Congress last year we would be dependent on the Trump administration to enforce these parts of the agreement. Even the most egregious violations could go completely unsanctioned, if the Trump administration opted not to press them. Given the past history with both Democratic and Republican administrations, this would be a very safe bet. In contrast, the provisions on items like violations of the patent and copyright provisions or the investment rules can be directly enforced by the companies affected. The TPP created a special extra-judicial process, the investor-state dispute settlement system, which would determine if an investor's rights under the agreement had been violated.
Thomas Friedman, who is legendary for his boldly stated wrong assertions, got into the game again making absurd claims about the Trans-Pacific Partnership (TPP) and the great loss the U.S. suffers from it going down. Friedman tells readers: "It was not only the largest free-trade agreement in history, it was the best ever for U.S. workers, closing loopholes Nafta had left open. TPP included restrictions on foreign state-owned enterprises that dumped subsidized products into our markets, intellectual property protections for rising U.S. technologies — like free access for all cloud computing services — but also anti-human-trafficking provisions that prohibited turning guest workers into slave labor, a ban on trafficking in endangered wildlife parts, a requirement that signatories permit their workers to form independent trade unions to collectively bargain and the elimination of all child labor practices — all to level the playing field with American workers." This is of course wrong. First, and most importantly, all the provisions on items like human trafficking, child labor, and trading in endangered wildlife depended on action by the administration. In other words, if the TPP had been approved by Congress last year we would be dependent on the Trump administration to enforce these parts of the agreement. Even the most egregious violations could go completely unsanctioned, if the Trump administration opted not to press them. Given the past history with both Democratic and Republican administrations, this would be a very safe bet. In contrast, the provisions on items like violations of the patent and copyright provisions or the investment rules can be directly enforced by the companies affected. The TPP created a special extra-judicial process, the investor-state dispute settlement system, which would determine if an investor's rights under the agreement had been violated.

Realizing the unpopularity of their health care plan, the Republicans are now playing games with the word “cut,” to deny that their proposal would lead to large cuts in Medicaid spending over the next decade and beyond. The NYT ran a piece that ostensibly was intended to clarify the issue, but likely left readers more confused than they had been previously. The piece tells readers:

“At issue is whether the funding changes should be compared to the increases that would occur under current law, the Affordable Care Act, or whether the focus should be on the modest annual increases that would happen under the Republican bill.

“The White House says that Republicans are being victimized by a broken budgeting system that unfairly casts their fiscal restraint as callous cutting.”

The baseline for spending against which the Republican proposal is being measured is a baseline that assumes current levels of services and eligibility requirements are left in place. This can perhaps best be explained by a comparison with Social Security.

Under the law, workers are entitled to Social Security benefits based on their work history and their age. With a growing population of people receiving Social Security benefits and new retirees typically collecting higher benefits than earlier retirees (due to higher average wages), and an inflation adjustment for those already receiving Social Security, benefit payments rise each year.

By standard budgetary practice, if the Republicans were to reduce the benefit schedule or not give the annual cost of living adjustment, it would be called a “cut” in benefits even if total Social Security payments stayed the same or rose somewhat. It is a cut because people would be getting less than is promised under the current law.

In the case of Medicaid, the Congressional Budget Office (CBO) uses the best information available to project the eligible population and also the cost of providing services to this population. This is the baseline that the Republicans are working from with their health care plan. They are proposing to spend roughly $800 billion less over the 10-year budget horizon than the baseline spending level projected by CBO. This is equal to approximately 17.0 percent of projected spending over this period and 25.6 percent of spending in 2026, the last year for which CBO made projections for the Republican plan. (The reduction from baseline is even larger after the end of the 10-year horizon.)

This means that unless the Republicans have some way to reduce the cost of services that they have not told anyone about (e.g. paying drug companies and medical equipment companies less for their products or doctors less for their services), Medicaid will not be able to provide the services offered under current law. Given the size of the reductions relative to the baseline, by year 10 this will likely mean hugely reducing the number of people getting coverage and quite likely throwing people out of nursing homes.

This is the meaning of “cuts.” This is, in fact, a rather simple point and not a question of semantics. The Republicans do not have a plan for Medicaid to provide the level of services promised under current law, they are proposing to radically reduce the level of services. This is not ambiguous, just like it is not ambiguous that President Obama was not born in Kenya.

Realizing the unpopularity of their health care plan, the Republicans are now playing games with the word “cut,” to deny that their proposal would lead to large cuts in Medicaid spending over the next decade and beyond. The NYT ran a piece that ostensibly was intended to clarify the issue, but likely left readers more confused than they had been previously. The piece tells readers:

“At issue is whether the funding changes should be compared to the increases that would occur under current law, the Affordable Care Act, or whether the focus should be on the modest annual increases that would happen under the Republican bill.

“The White House says that Republicans are being victimized by a broken budgeting system that unfairly casts their fiscal restraint as callous cutting.”

The baseline for spending against which the Republican proposal is being measured is a baseline that assumes current levels of services and eligibility requirements are left in place. This can perhaps best be explained by a comparison with Social Security.

Under the law, workers are entitled to Social Security benefits based on their work history and their age. With a growing population of people receiving Social Security benefits and new retirees typically collecting higher benefits than earlier retirees (due to higher average wages), and an inflation adjustment for those already receiving Social Security, benefit payments rise each year.

By standard budgetary practice, if the Republicans were to reduce the benefit schedule or not give the annual cost of living adjustment, it would be called a “cut” in benefits even if total Social Security payments stayed the same or rose somewhat. It is a cut because people would be getting less than is promised under the current law.

In the case of Medicaid, the Congressional Budget Office (CBO) uses the best information available to project the eligible population and also the cost of providing services to this population. This is the baseline that the Republicans are working from with their health care plan. They are proposing to spend roughly $800 billion less over the 10-year budget horizon than the baseline spending level projected by CBO. This is equal to approximately 17.0 percent of projected spending over this period and 25.6 percent of spending in 2026, the last year for which CBO made projections for the Republican plan. (The reduction from baseline is even larger after the end of the 10-year horizon.)

This means that unless the Republicans have some way to reduce the cost of services that they have not told anyone about (e.g. paying drug companies and medical equipment companies less for their products or doctors less for their services), Medicaid will not be able to provide the services offered under current law. Given the size of the reductions relative to the baseline, by year 10 this will likely mean hugely reducing the number of people getting coverage and quite likely throwing people out of nursing homes.

This is the meaning of “cuts.” This is, in fact, a rather simple point and not a question of semantics. The Republicans do not have a plan for Medicaid to provide the level of services promised under current law, they are proposing to radically reduce the level of services. This is not ambiguous, just like it is not ambiguous that President Obama was not born in Kenya.

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