According to David Brooks, in the days following the release of Representative Ryan’s plan to essentially end Medicare and Medicaid to help finance more tax breaks to the wealthy:
“the Democrats are on defense because they are unwilling to ask voters to confront the implications of their choices.”
I can’t claim to have done a comprehensive survey, but all the Democrats I know think that they were handed the political gift of lifetime, as Representative Ryan has explicitly proposed doing exactly what Democrats have accused Republicans of wanting to do for decades: eliminate health care programs that are essential for middle class workers in order to give more money to their wealthy contributors.
Things may be different on Mr. Brooks’ planet, but here in Washington there is no shortage of politicians willing to denounce a plan that would require most seniors to spend most of their income on health care, if they want an insurance package equivalent to the one provided by Medicare. The more obvious shortage is of Republicans who are openly willing to embrace the Ryan plan and say, “yes, we are the party that wants to eliminate Medicare and give more tax breaks to the richest people in the country.”
Brooks again ignores the most obvious point that health care is not a sidebar in this story, it is the story. If the United States paid the same amount per person for its health care as do people in other wealthy countries, then we would be looking at huge budget surpluses not deficits.
He also tries to pass off to NYT readers nonsense from his Tea Party friends:
“The president’s health reform plan relies on a centralized board of technocrats to restrict choices. The Ryan plan relies on a premium support model that would allow individuals to exercise greater control over what sorts of procedures they would not be covered for.”
Can we get out the extra large ridicule box for this one? There is nothing, as in zero, in President Obama’s health care plan that prevents any individual from getting any health care procedure that he or she wants to pay for. The “centralized board of technocrats” he mentions would determine the procedures that Medicare would pay for, not the procedures that individuals could receive.
Obviously this will be a very serious restriction for people who cannot pay for expensive procedures on their own, but Ryan’s plan does not change this situation one iota. It gives people a choice of insurance companies, each of which will rely on a board of technocrats to restrict choices.
Using the Tea Party terminology, if President Obama’s plan is viewed as creating death panels, then Mr. Ryan’s plan gives seniors a choice of death panels and, according to the Congressional Budget Office, we pay trillions more for this choice.
Addendum:
Some folks have asked me about the generational equity concerns raised by Brooks who tells readers that:
“two 56-years-olds with average earnings will pay about $140,000 in dedicated Medicare taxes over their lifetimes. They will receive about $430,000 in benefits. This is an immoral imposition on future generations.”
There are two important points here. First, most of that $430,000 is over-payments to drug companies, hospitals, doctors and other health care providers. If these two 56-years-olds were buying their health care in Canada, Germany, or any other country with comparable health care outcomes, they would pay less than half as much for their care. Should my older brother feel that he has done me an injustice because the government gets overcharged for his health care? Maybe on Planet Brooks, but that’s not an easy one to see here on Earth.
The other point that Brooks seems to have missed is that people are getting richer through time. The lifetime earnings for two average 26-year-olds will be more than $1.3 million greater on average than the average lifetime earnings for today’s 56-year-olds. If the 26-year-old gets to pocket this much more cash, simply by virtue of being born later, is there any reason for the 56-year-old to feel they have committed an injustice because they got a better deal on their Medicare?
Now, there is a serious issue of inequality that must be considered. As a result of the fact that a larger share of income is being distributed to those at the top, most 26-year-olds may see little of this $1.3 million gain in earnings. But this is an issue of intra-generational inequality, not inter-generational inequality. On this dimension, Representative Ryan’s plan is a huge leap in the wrong direction.
According to David Brooks, in the days following the release of Representative Ryan’s plan to essentially end Medicare and Medicaid to help finance more tax breaks to the wealthy:
“the Democrats are on defense because they are unwilling to ask voters to confront the implications of their choices.”
I can’t claim to have done a comprehensive survey, but all the Democrats I know think that they were handed the political gift of lifetime, as Representative Ryan has explicitly proposed doing exactly what Democrats have accused Republicans of wanting to do for decades: eliminate health care programs that are essential for middle class workers in order to give more money to their wealthy contributors.
Things may be different on Mr. Brooks’ planet, but here in Washington there is no shortage of politicians willing to denounce a plan that would require most seniors to spend most of their income on health care, if they want an insurance package equivalent to the one provided by Medicare. The more obvious shortage is of Republicans who are openly willing to embrace the Ryan plan and say, “yes, we are the party that wants to eliminate Medicare and give more tax breaks to the richest people in the country.”
Brooks again ignores the most obvious point that health care is not a sidebar in this story, it is the story. If the United States paid the same amount per person for its health care as do people in other wealthy countries, then we would be looking at huge budget surpluses not deficits.
He also tries to pass off to NYT readers nonsense from his Tea Party friends:
“The president’s health reform plan relies on a centralized board of technocrats to restrict choices. The Ryan plan relies on a premium support model that would allow individuals to exercise greater control over what sorts of procedures they would not be covered for.”
Can we get out the extra large ridicule box for this one? There is nothing, as in zero, in President Obama’s health care plan that prevents any individual from getting any health care procedure that he or she wants to pay for. The “centralized board of technocrats” he mentions would determine the procedures that Medicare would pay for, not the procedures that individuals could receive.
Obviously this will be a very serious restriction for people who cannot pay for expensive procedures on their own, but Ryan’s plan does not change this situation one iota. It gives people a choice of insurance companies, each of which will rely on a board of technocrats to restrict choices.
Using the Tea Party terminology, if President Obama’s plan is viewed as creating death panels, then Mr. Ryan’s plan gives seniors a choice of death panels and, according to the Congressional Budget Office, we pay trillions more for this choice.
Addendum:
Some folks have asked me about the generational equity concerns raised by Brooks who tells readers that:
“two 56-years-olds with average earnings will pay about $140,000 in dedicated Medicare taxes over their lifetimes. They will receive about $430,000 in benefits. This is an immoral imposition on future generations.”
There are two important points here. First, most of that $430,000 is over-payments to drug companies, hospitals, doctors and other health care providers. If these two 56-years-olds were buying their health care in Canada, Germany, or any other country with comparable health care outcomes, they would pay less than half as much for their care. Should my older brother feel that he has done me an injustice because the government gets overcharged for his health care? Maybe on Planet Brooks, but that’s not an easy one to see here on Earth.
The other point that Brooks seems to have missed is that people are getting richer through time. The lifetime earnings for two average 26-year-olds will be more than $1.3 million greater on average than the average lifetime earnings for today’s 56-year-olds. If the 26-year-old gets to pocket this much more cash, simply by virtue of being born later, is there any reason for the 56-year-old to feel they have committed an injustice because they got a better deal on their Medicare?
Now, there is a serious issue of inequality that must be considered. As a result of the fact that a larger share of income is being distributed to those at the top, most 26-year-olds may see little of this $1.3 million gain in earnings. But this is an issue of intra-generational inequality, not inter-generational inequality. On this dimension, Representative Ryan’s plan is a huge leap in the wrong direction.
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We all know the line about history repeating itself. The first time is tragedy, but at this point we are well past farce. Ezra Klein calls attention, via Paul Krugman, to the fact Charles Krauthammer is impressed by Paul Ryan’s use of 37 footnotes in his budget plan.
With the prospect of a government shutdown facing the country it’s hard not to think of Dick Morris, the architect of President Clinton’s triangulation strategy between the Republicans majority in Congress and the Democratic minority in Congress. Clinton had to break his ties to Morris when he was caught with a prostitute, with whom he apparently engaged in strange activities with her feet.
But the footnotes are far less important that Krauthammer’s substantive errors which he kindly numbered for readers. His error number 1 is a criticism of Ryan’s critics for claiming that Ryan’s cuts would hurt the poor. Krauthammer’s trump card is the foolishness of the liberals who complained about Clinton’s welfare reform, singling out Peter Edelman who resigned from the administration in protest over the policy. We are told that:
“Within five years child poverty had declined by more than 2.5 million — one of the reasons the 1996 welfare reform is considered one of the social policy successes of our time.”
The decline in child poverty was real, but it is more typically attributed to the unemployment rate dropping to 4.0 percent in the late 90s boom. More recently, the child poverty rate has risen back to its mid-90s level, meaning that we have made no progress in eliminating child poverty over the last 15 years. One of the reasons that Edelman and others objected to welfare reform is that the new TANF program that replaced the old welfare system would not guarantee that resources would expand during a recession when they were most needed. On this score, it looks like Edelman was exactly right.
In error number 2, Krauthammer complains about the people who have attacked Ryan’s Medicare plan as privatization. He tells us that:
“instead of paying the health provider directly (fee-for-service), Medicare would give seniors about $15,000 of ‘premium support,’ letting the recipient choose among a menu of approved health insurance plans.”
In fact the premium support is set at $8,000 per person in 2022. That translates into $6,100 a year in today’s dollars. According to the Congressional Budget Office (CBO), this will be enough to pay less than 40 percent of the cost of a Medicare equivalent benefit in 2022. The assessment of CBO, based on the experiment with Medicare Advantage (we have tried this before) and an examination of the private health insurance market, is that Ryan’s plan will raise, not lower, Medicare costs.
Krauthammer touts the lower than expected cost of Medicare Part D. The main reason that this program cost less than expected is that drug prices in general have risen less rapidly than had been projected. This in turn is due to the fact that many blockbuster drugs have gone off patent, leading to lower prices now that they face generic competition. The industry has produced few important new drugs in the last few years thereby reducing the upward pressure on costs.
Finally we have Krauthammer’s error number 3:
“The final charge — cutting taxes for the rich — is the most scurrilous. That would be the same as calling the Ronald Reagan-Bill Bradley 1986 tax reform ‘cutting taxes for the rich.’ In fact, it was designed for revenue neutrality. It cut rates — and for everyone — by eliminating loopholes, including corrupt exemptions and economically counterproductive tax expenditures, to yield what is generally considered by left and right an extraordinarily successful piece of economic legislation.”
No, actually it is not designed to be revenue neutral. It is designed to cut taxes on the wealthy. Ryan has not produced a set of loopholes whose elimination would offset the cost of his tax cuts. He just wrote in numbers. When the Tax Policy Center of the Urban Institute and Brooking Institution examined Ryan’s tax plan, they found that it came up $2.9 trillion short over the course of the decade. Ryan did not describe a specific set of loopholes to close that they could score, but they would have to be quite large to fill this gap.
I suppose after reading through Ryan’s plan, if you can’t find much good to say about it, you can always talk about the footnotes.
We all know the line about history repeating itself. The first time is tragedy, but at this point we are well past farce. Ezra Klein calls attention, via Paul Krugman, to the fact Charles Krauthammer is impressed by Paul Ryan’s use of 37 footnotes in his budget plan.
With the prospect of a government shutdown facing the country it’s hard not to think of Dick Morris, the architect of President Clinton’s triangulation strategy between the Republicans majority in Congress and the Democratic minority in Congress. Clinton had to break his ties to Morris when he was caught with a prostitute, with whom he apparently engaged in strange activities with her feet.
But the footnotes are far less important that Krauthammer’s substantive errors which he kindly numbered for readers. His error number 1 is a criticism of Ryan’s critics for claiming that Ryan’s cuts would hurt the poor. Krauthammer’s trump card is the foolishness of the liberals who complained about Clinton’s welfare reform, singling out Peter Edelman who resigned from the administration in protest over the policy. We are told that:
“Within five years child poverty had declined by more than 2.5 million — one of the reasons the 1996 welfare reform is considered one of the social policy successes of our time.”
The decline in child poverty was real, but it is more typically attributed to the unemployment rate dropping to 4.0 percent in the late 90s boom. More recently, the child poverty rate has risen back to its mid-90s level, meaning that we have made no progress in eliminating child poverty over the last 15 years. One of the reasons that Edelman and others objected to welfare reform is that the new TANF program that replaced the old welfare system would not guarantee that resources would expand during a recession when they were most needed. On this score, it looks like Edelman was exactly right.
In error number 2, Krauthammer complains about the people who have attacked Ryan’s Medicare plan as privatization. He tells us that:
“instead of paying the health provider directly (fee-for-service), Medicare would give seniors about $15,000 of ‘premium support,’ letting the recipient choose among a menu of approved health insurance plans.”
In fact the premium support is set at $8,000 per person in 2022. That translates into $6,100 a year in today’s dollars. According to the Congressional Budget Office (CBO), this will be enough to pay less than 40 percent of the cost of a Medicare equivalent benefit in 2022. The assessment of CBO, based on the experiment with Medicare Advantage (we have tried this before) and an examination of the private health insurance market, is that Ryan’s plan will raise, not lower, Medicare costs.
Krauthammer touts the lower than expected cost of Medicare Part D. The main reason that this program cost less than expected is that drug prices in general have risen less rapidly than had been projected. This in turn is due to the fact that many blockbuster drugs have gone off patent, leading to lower prices now that they face generic competition. The industry has produced few important new drugs in the last few years thereby reducing the upward pressure on costs.
Finally we have Krauthammer’s error number 3:
“The final charge — cutting taxes for the rich — is the most scurrilous. That would be the same as calling the Ronald Reagan-Bill Bradley 1986 tax reform ‘cutting taxes for the rich.’ In fact, it was designed for revenue neutrality. It cut rates — and for everyone — by eliminating loopholes, including corrupt exemptions and economically counterproductive tax expenditures, to yield what is generally considered by left and right an extraordinarily successful piece of economic legislation.”
No, actually it is not designed to be revenue neutral. It is designed to cut taxes on the wealthy. Ryan has not produced a set of loopholes whose elimination would offset the cost of his tax cuts. He just wrote in numbers. When the Tax Policy Center of the Urban Institute and Brooking Institution examined Ryan’s tax plan, they found that it came up $2.9 trillion short over the course of the decade. Ryan did not describe a specific set of loopholes to close that they could score, but they would have to be quite large to fill this gap.
I suppose after reading through Ryan’s plan, if you can’t find much good to say about it, you can always talk about the footnotes.
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My home town paper, the Chicago Tribune, wants us all to take House Budget Committee Chairman Paul Ryan’s budget proposals very seriously. Remarkably the paper, which recently went through a leveraged buyout that puts ordinary tax scams to shame, tells readers to “trust us.”
Even if it weren’t for the stench of the paper’s leveraged buyout it would be hard to trust an editorial that never once mentions health care costs and uses the cheap trick of lumping Social Security in with Medicare and Medicaid as unaffordable “entitlements.” Of course everyone involved in the budget debate knows that the real story of the federal government’s long-term deficit problem is health care. If we paid the same amount for health care per person as other wealthy countries we would be looking at huge budget surpluses, not deficits.
Remarkably health care costs never get mentioned in the piece. According to the Congressional Budget Office, Ryan’s plan would actually increase what we pay for health care, giving tens of trillions of dollars over the coming decades to the health care industry. And, contrary to the Tribune’s assertion, it would likely put many elderly and sick into poverty by dismantling Medicare and Medicaid.
The editorial also neglected to mention the tax cuts that Representative Ryan wants to give the wealthy. Under current law, folks like Goldman Sachs CEO Lloyd Blankfein would be paying a marginal tax rate of 39.6 percent on income above $500,000. Instead, Mr. Ryan would have them pay a tax rate of just 25 percent. (He would also cut Goldman Sach’s corporate taxes as well.) This means that if Mr. Blankfein earned $20 million of income subject to the ordinary tax rate, Mr. Ryan would be giving him a tax break that is worth almost $3 million a year.
So, if you’re keeping score, Representative Ryan’s plan would give the wealthy hundreds of billions a year in tax cuts, it would give the health insurance industry and health care providers hundreds of billions of dollars of additional revenue each year, and it would deny tens of millions of retirees and sick people any guarantee of decent health care. And the Chicago Tribune tells us that this is “what real leaders do.”
My home town paper, the Chicago Tribune, wants us all to take House Budget Committee Chairman Paul Ryan’s budget proposals very seriously. Remarkably the paper, which recently went through a leveraged buyout that puts ordinary tax scams to shame, tells readers to “trust us.”
Even if it weren’t for the stench of the paper’s leveraged buyout it would be hard to trust an editorial that never once mentions health care costs and uses the cheap trick of lumping Social Security in with Medicare and Medicaid as unaffordable “entitlements.” Of course everyone involved in the budget debate knows that the real story of the federal government’s long-term deficit problem is health care. If we paid the same amount for health care per person as other wealthy countries we would be looking at huge budget surpluses, not deficits.
Remarkably health care costs never get mentioned in the piece. According to the Congressional Budget Office, Ryan’s plan would actually increase what we pay for health care, giving tens of trillions of dollars over the coming decades to the health care industry. And, contrary to the Tribune’s assertion, it would likely put many elderly and sick into poverty by dismantling Medicare and Medicaid.
The editorial also neglected to mention the tax cuts that Representative Ryan wants to give the wealthy. Under current law, folks like Goldman Sachs CEO Lloyd Blankfein would be paying a marginal tax rate of 39.6 percent on income above $500,000. Instead, Mr. Ryan would have them pay a tax rate of just 25 percent. (He would also cut Goldman Sach’s corporate taxes as well.) This means that if Mr. Blankfein earned $20 million of income subject to the ordinary tax rate, Mr. Ryan would be giving him a tax break that is worth almost $3 million a year.
So, if you’re keeping score, Representative Ryan’s plan would give the wealthy hundreds of billions a year in tax cuts, it would give the health insurance industry and health care providers hundreds of billions of dollars of additional revenue each year, and it would deny tens of millions of retirees and sick people any guarantee of decent health care. And the Chicago Tribune tells us that this is “what real leaders do.”
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Folks in Greece are being taught Keynesian economics by people who don’t believe in it. It seems that when you strangle your economy, budget deficits rise. Greece’s shrinking economy is leading to larger deficits (less growth means lower taxes and more transfer payments for things like unemployment insurance) and a rise in its debt to GDP ratio (when GDP falls, the debt to GDP ratio rises).
The news is that the austerity being imposed by the EU and the IMF is making Greece’s debt situation worse, not better, just as all of us Keynesian types predicted. While the Greek experience should be a warning against going down the austerity path in the United States, due to the incompetence of the U.S. media it will be taken as a further warning of the need to act on the budget deficit quickly.
This is sort of like pointing to the medical problems of a person suffering from anorexia as evidence of the urgent need to lose weight. That makes no sense, unless you are involved in the national debate over economic policy.
Folks in Greece are being taught Keynesian economics by people who don’t believe in it. It seems that when you strangle your economy, budget deficits rise. Greece’s shrinking economy is leading to larger deficits (less growth means lower taxes and more transfer payments for things like unemployment insurance) and a rise in its debt to GDP ratio (when GDP falls, the debt to GDP ratio rises).
The news is that the austerity being imposed by the EU and the IMF is making Greece’s debt situation worse, not better, just as all of us Keynesian types predicted. While the Greek experience should be a warning against going down the austerity path in the United States, due to the incompetence of the U.S. media it will be taken as a further warning of the need to act on the budget deficit quickly.
This is sort of like pointing to the medical problems of a person suffering from anorexia as evidence of the urgent need to lose weight. That makes no sense, unless you are involved in the national debate over economic policy.
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The NYT had a good piece that reported on the sharp rise in the number of people getting government disability payments over the last two decades. While this is partly due to the aging of the baby boom cohort into the peak years of disability, some of the increase also reflects changes in the economy.
The piece also points out that the disability portion of the Social Security program is much more poorly funded than the much larger retirement and survivor programs. The projected 75-year shortfall in the disability program is more than 16 percent of its income, where it is just over 10 percent of the income of the larger retirement and survivors program.
The NYT had a good piece that reported on the sharp rise in the number of people getting government disability payments over the last two decades. While this is partly due to the aging of the baby boom cohort into the peak years of disability, some of the increase also reflects changes in the economy.
The piece also points out that the disability portion of the Social Security program is much more poorly funded than the much larger retirement and survivor programs. The projected 75-year shortfall in the disability program is more than 16 percent of its income, where it is just over 10 percent of the income of the larger retirement and survivors program.
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Economists usually think that firms increase hiring when they see more demand for labor, but we have a new story coming from John Lott Jr, courtesy of Fox. Mr Lott argues that firms will hire more workers because the government is laying off workers.
Lott tells readers that:
“Democrats respond that government spending can’t be cut because it would eliminate jobs. Just the proposed $61 billion cuts by House Republicans in the current budget is said to “amount to a loss of 700,000 jobs.” The claim only counts the jobs funded by the government and assumes that this spending isn’t offset by the loss of private sector jobs. The notion is that if the government doesn’t spend the money, it never really exists.”
Actually many of these lost jobs are not funded by the government. (The federal government only employs a bit over 2 million workers directly. It will not lose one-third of its work force as a result of these cuts.) Most of the lost jobs would be from reduced spending on private sector goods and services by the government or from reduced spending by workers who had formerly been employed by government agencies.
It is difficult to see how the government cutbacks would be offset by increased private sector hiring. If the economy were closer to full employment then we might expect to see interest rates fall in response to a cutback in government spending. This could spur increased consumption and investment, which would then lead to more hiring.
However in the current environment it is difficult to believe that these cutbacks would lead to any noticeable reduction in interest rates, nor that the reduction in interest rates would lead to any noticeable increase in spending. In other words, in the current circumstances it is likely that government cutbacks simply lead to a reduction in demand and employment as seems to be the case in the United Kingdom at present. (The OECD just lowered its growth projection for the UK this year to 1.0 percent. The UK adopted a Republican-type austerity program last summer.)
Economists usually think that firms increase hiring when they see more demand for labor, but we have a new story coming from John Lott Jr, courtesy of Fox. Mr Lott argues that firms will hire more workers because the government is laying off workers.
Lott tells readers that:
“Democrats respond that government spending can’t be cut because it would eliminate jobs. Just the proposed $61 billion cuts by House Republicans in the current budget is said to “amount to a loss of 700,000 jobs.” The claim only counts the jobs funded by the government and assumes that this spending isn’t offset by the loss of private sector jobs. The notion is that if the government doesn’t spend the money, it never really exists.”
Actually many of these lost jobs are not funded by the government. (The federal government only employs a bit over 2 million workers directly. It will not lose one-third of its work force as a result of these cuts.) Most of the lost jobs would be from reduced spending on private sector goods and services by the government or from reduced spending by workers who had formerly been employed by government agencies.
It is difficult to see how the government cutbacks would be offset by increased private sector hiring. If the economy were closer to full employment then we might expect to see interest rates fall in response to a cutback in government spending. This could spur increased consumption and investment, which would then lead to more hiring.
However in the current environment it is difficult to believe that these cutbacks would lead to any noticeable reduction in interest rates, nor that the reduction in interest rates would lead to any noticeable increase in spending. In other words, in the current circumstances it is likely that government cutbacks simply lead to a reduction in demand and employment as seems to be the case in the United Kingdom at present. (The OECD just lowered its growth projection for the UK this year to 1.0 percent. The UK adopted a Republican-type austerity program last summer.)
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That is what headlines would look like if the United States had an independent press. After all, this is one of the main takeaways of the Congressional Budget Office’s (CBO) analysis of the plan proposed by Representative Paul Ryan, the Republican chairman of the House Budget Committee. Representative Ryan would replace the current Medicare program with a voucher for people who turn age 65 in 2022 and later. This voucher would be worth $8,000 for someone turning age 65 in that year. It would rise in step with the consumer price index and also as people age. (Health care expenses are higher for people age 75 than age 65.)
According to the CBO analysis the benefit would cover 32 percent of the cost of a health insurance package equivalent to the current Medicare benefit (Figure 1). This means that the beneficiary would pay 68 percent of the cost of this package. Using the CBO assumption of 2.5 percent annual inflation, the voucher would have grown to $9,750 by 2030. This means that a Medicare type plan for someone age 65 would be $30,460 under Representative Ryan’s plan, leaving seniors with a bill of $20,700. (This does not count various out of pocket medical expenditures not covered by Medicare.)
According to the Social Security trustees, the benefit for a medium wage earner who first starts collecting benefits at age 65 in 2030 would be $32,200. (This adjusts the benefit projected by the Social Security trustees [$19,652 in 2010 dollars] for the 2.5 percent annual inflation rate assumed by CBO.) For close to 70 percent of seniors, Social Security is more than half of their retirement income. Most seniors will get a benefit that is less than the medium earners benefit described here since their average earnings are less than that of a medium earner and they start collecting Social Security benefits before age 65.
Furthermore, the portion of income going to health care costs will increase through time according to the CBO analysis. This is due both to aging of individuals and to increasing health care costs through time. As noted insurance for older beneficiaries will cost more than insurance for younger beneficiaries, but Representative Ryan’s voucher would still only pay the same amount for their care. This means that if the average 80-year-old cost twice as much to insure as the average 65-year-old, then the premium that would come out of a seniors’ pocket would be twice as large. This implies that if the program had been in effect for 15 years in 2030 then the average senior would be paying $41,400 for a Medicare equivalent insurance package in 2030, 25 percent more than the medium earner’s benefit in that year.
The other reason that Representative Ryan’s plan will lead to rising health care costs for seniors through time is that the voucher payment does not keep pace with health care cost inflation. As costs continue to rise relative to the voucher, seniors will be required to pay a larger portion of their health care costs themselves. It is worth noting that 2030 is only 8 years after the voucher program kicks in.
That is what headlines would look like if the United States had an independent press. After all, this is one of the main takeaways of the Congressional Budget Office’s (CBO) analysis of the plan proposed by Representative Paul Ryan, the Republican chairman of the House Budget Committee. Representative Ryan would replace the current Medicare program with a voucher for people who turn age 65 in 2022 and later. This voucher would be worth $8,000 for someone turning age 65 in that year. It would rise in step with the consumer price index and also as people age. (Health care expenses are higher for people age 75 than age 65.)
According to the CBO analysis the benefit would cover 32 percent of the cost of a health insurance package equivalent to the current Medicare benefit (Figure 1). This means that the beneficiary would pay 68 percent of the cost of this package. Using the CBO assumption of 2.5 percent annual inflation, the voucher would have grown to $9,750 by 2030. This means that a Medicare type plan for someone age 65 would be $30,460 under Representative Ryan’s plan, leaving seniors with a bill of $20,700. (This does not count various out of pocket medical expenditures not covered by Medicare.)
According to the Social Security trustees, the benefit for a medium wage earner who first starts collecting benefits at age 65 in 2030 would be $32,200. (This adjusts the benefit projected by the Social Security trustees [$19,652 in 2010 dollars] for the 2.5 percent annual inflation rate assumed by CBO.) For close to 70 percent of seniors, Social Security is more than half of their retirement income. Most seniors will get a benefit that is less than the medium earners benefit described here since their average earnings are less than that of a medium earner and they start collecting Social Security benefits before age 65.
Furthermore, the portion of income going to health care costs will increase through time according to the CBO analysis. This is due both to aging of individuals and to increasing health care costs through time. As noted insurance for older beneficiaries will cost more than insurance for younger beneficiaries, but Representative Ryan’s voucher would still only pay the same amount for their care. This means that if the average 80-year-old cost twice as much to insure as the average 65-year-old, then the premium that would come out of a seniors’ pocket would be twice as large. This implies that if the program had been in effect for 15 years in 2030 then the average senior would be paying $41,400 for a Medicare equivalent insurance package in 2030, 25 percent more than the medium earner’s benefit in that year.
The other reason that Representative Ryan’s plan will lead to rising health care costs for seniors through time is that the voucher payment does not keep pace with health care cost inflation. As costs continue to rise relative to the voucher, seniors will be required to pay a larger portion of their health care costs themselves. It is worth noting that 2030 is only 8 years after the voucher program kicks in.
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There are few things that get David Brooks more excited than seeing a politician beat up on the elderly and because he has a column in the New York Times, we all get to share the thrill. As Brooks tells us, Representative Paul Ryan, the Republican chairman of the House Budget Committee, has a long list of budget reforms and most importantly is prepared to go after Medicare. Ryan would replace the current Medicare program with a voucher system. This would end the commitment of Medicare to provide decent health care to the elderly and disabled. If private sector health care costs grow as projected the vast majority of seniors would soon find themselves unable to afford health care under Mr. Ryan’s plan.
Brooks’ excitement for Ryan extends beyond his willingness to cut Medicare benefits for retired workers. He tells us that Ryan would even, “reform the tax code along the Simpson-Bowles lines, but without the tax increases.” What a guy, Ryan is even prepared to reduce taxes as he ends the security that Medicare provides for retired workers.
I’ll confess to having gotten caught up in the excitement, but getting back to the facts that Brooks gets wrong, he tells readers that:
“The current welfare state is simply unsustainable and anybody who is serious, on left or right, has to have a new vision of the social contract.”
Actually this is not true, as everybody who serious on the left or right knows. The U.S. health care system is unsustainable. If per person health care costs were the same as those in Germany, Canada or any other wealthy country, then the United States would be looking at long-term budget surpluses, not deficits. If the health care system is not fixed it will have a devastating impact on the economy regardless of what we do with public sector health care programs like Medicare and Medicaid.
Of course fixing the health care system requires going after powerful interest groups like the pharmaceutical and insurance industries and the doctors’ lobbies. Attacking these powerful groups is less likely to draw praise from media pundits like Brooks. They don’t get quite as excited when politicians attack the wealthy and powerful as when they attack ordinary workers.
Brooks is also excited by the fact that “the ex-chairmen of the Council of Economic Advisers and 64 prominent budget experts” signed letters stressing the urgency of reducing the budget deficit. While no one would want to question the credentials of these experts, they may want to question their competence.
Not one member of this group warned of the $8 trillion housing bubble, the collapse of which led to the worst downturn since the Great Depression. This downturn is likely to cost the economy close to $3 trillion in lost output and add a comparable amount to the nation’s debt. In fact, if these budget hawks had a better understanding of the economy, they would have been focusing their concerns on the housing bubble instead of the deficit in the years from 2002-2006.
Their focus on the deficit distracted the public’s attention from the economy’s most pressing problem. Because of their prominence, these experts were able to draw media attention from those who were actually warning of the housing bubble. The result was the economic collapse that we are now experiencing and much larger deficits than the ones that had concerned them in the years prior to the collapse. There is no evidence that this group’s understanding of the economy has improved in the last 4 years.
There are few things that get David Brooks more excited than seeing a politician beat up on the elderly and because he has a column in the New York Times, we all get to share the thrill. As Brooks tells us, Representative Paul Ryan, the Republican chairman of the House Budget Committee, has a long list of budget reforms and most importantly is prepared to go after Medicare. Ryan would replace the current Medicare program with a voucher system. This would end the commitment of Medicare to provide decent health care to the elderly and disabled. If private sector health care costs grow as projected the vast majority of seniors would soon find themselves unable to afford health care under Mr. Ryan’s plan.
Brooks’ excitement for Ryan extends beyond his willingness to cut Medicare benefits for retired workers. He tells us that Ryan would even, “reform the tax code along the Simpson-Bowles lines, but without the tax increases.” What a guy, Ryan is even prepared to reduce taxes as he ends the security that Medicare provides for retired workers.
I’ll confess to having gotten caught up in the excitement, but getting back to the facts that Brooks gets wrong, he tells readers that:
“The current welfare state is simply unsustainable and anybody who is serious, on left or right, has to have a new vision of the social contract.”
Actually this is not true, as everybody who serious on the left or right knows. The U.S. health care system is unsustainable. If per person health care costs were the same as those in Germany, Canada or any other wealthy country, then the United States would be looking at long-term budget surpluses, not deficits. If the health care system is not fixed it will have a devastating impact on the economy regardless of what we do with public sector health care programs like Medicare and Medicaid.
Of course fixing the health care system requires going after powerful interest groups like the pharmaceutical and insurance industries and the doctors’ lobbies. Attacking these powerful groups is less likely to draw praise from media pundits like Brooks. They don’t get quite as excited when politicians attack the wealthy and powerful as when they attack ordinary workers.
Brooks is also excited by the fact that “the ex-chairmen of the Council of Economic Advisers and 64 prominent budget experts” signed letters stressing the urgency of reducing the budget deficit. While no one would want to question the credentials of these experts, they may want to question their competence.
Not one member of this group warned of the $8 trillion housing bubble, the collapse of which led to the worst downturn since the Great Depression. This downturn is likely to cost the economy close to $3 trillion in lost output and add a comparable amount to the nation’s debt. In fact, if these budget hawks had a better understanding of the economy, they would have been focusing their concerns on the housing bubble instead of the deficit in the years from 2002-2006.
Their focus on the deficit distracted the public’s attention from the economy’s most pressing problem. Because of their prominence, these experts were able to draw media attention from those who were actually warning of the housing bubble. The result was the economic collapse that we are now experiencing and much larger deficits than the ones that had concerned them in the years prior to the collapse. There is no evidence that this group’s understanding of the economy has improved in the last 4 years.
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That is what the NYT told readers this morning. Of course the NYT has no ability to determine what needs politicians actually see, if in fact they do see anything. Politicians get elected by appealing to powerful interest groups who can supply them the money and support needed to win elections. They are not required to have visions of the country or the economy. What they present to the public as their vision is what they say, it may have nothing to do with what they actually believe.
The correct way to have reported this information would have been to tell readers that many Republicans “say” they see a need to revamp Social Security. It may have also been worth reminding readers that the Social Security trustees project that the program could pay all scheduled benefits for more than a quarter century and that after this date it would still be able to pay close to 80 percent of scheduled benefits, even if nothing is ever done to change the program. The benefit that is payable after 2037 would always be considerably larger than the benefits that retirees receive on average today.
That is what the NYT told readers this morning. Of course the NYT has no ability to determine what needs politicians actually see, if in fact they do see anything. Politicians get elected by appealing to powerful interest groups who can supply them the money and support needed to win elections. They are not required to have visions of the country or the economy. What they present to the public as their vision is what they say, it may have nothing to do with what they actually believe.
The correct way to have reported this information would have been to tell readers that many Republicans “say” they see a need to revamp Social Security. It may have also been worth reminding readers that the Social Security trustees project that the program could pay all scheduled benefits for more than a quarter century and that after this date it would still be able to pay close to 80 percent of scheduled benefits, even if nothing is ever done to change the program. The benefit that is payable after 2037 would always be considerably larger than the benefits that retirees receive on average today.
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Okay, we haven’t seen this headline yet, but given current fashions in Washington policy circles it can only be a matter of time. Today the New York Times ran a column on Social Security by Alicia Munnell, the Director of the Center for Retirement Research at Boston College and a former member of President Clinton’s Council of Economic Advisors.
This column made the claim that Social Security does contribute to the deficit, telling readers that:
“scheduled Social Security benefits and current payroll taxes are included in long-term deficit projections by the Congressional Budget Office, the Office of Management and Budget and the Government Accountability Office. These projections matter: policymakers, investors and the bond markets use them to gauge the nation’s fiscal health. Since a shortfall in Social Security is embedded in these projections, eliminating that shortfall would substantially improve the long-term budget outlook and the nation’s creditworthiness.”
This is an interesting observation. These projections are supposed to reflect current law. Under the law, as Munnell points out, Social Security is prohibited from spending anything beyond the money in its trust fund. This means that if these baseline projections show deficits from the program spending at levels beyond what can be supported by the trust fund, then they are not making projections based on what Social Security can legally spend.
The more obvious complaint would seem to be with the nature of the projections than with the Social Security program. In effect, the projections assume that Congress will opt to maintain the level of scheduled benefits without doing anything to increase revenues. While this is a possibility, that seems a rather strong assumption to include in a baseline projection.
The column also includes another serious stretch. It tells readers that people are taking Social Security at the earliest possible age of eligibility because they are worried that the program will not be there for them if they wait until a later age. The article links to a USA Today article which supports this view by noting that the percentage of people who began taking benefits at age 62 rose sharply in 2009.
The most obvious reason that the share of people age 62 who took benefits rose in 2009 is that the unemployment jumped by 5 percentage points from its 2008 level. There were undoubtedly many workers age 62 who unexpectedly lost their job and saw little prospect of finding a new one. Therefore they decided to start collecting their Social Security benefits.
There has been a lack of confidence in the Social Security system for decades. And there has been much more serious talk of reform at other times, notably the late 90s and 2005 when President Bush proposed to privatize the program. Concern about the future of the program is not a plausible explanation for the jump in people collecting early benefits in 2009, nor is it likely a major factor in the decision of workers to take early benefits more generally.
(Thanks to Eric Kingson, the co-director of Social Security Works, for calling this one to my attention.)
Okay, we haven’t seen this headline yet, but given current fashions in Washington policy circles it can only be a matter of time. Today the New York Times ran a column on Social Security by Alicia Munnell, the Director of the Center for Retirement Research at Boston College and a former member of President Clinton’s Council of Economic Advisors.
This column made the claim that Social Security does contribute to the deficit, telling readers that:
“scheduled Social Security benefits and current payroll taxes are included in long-term deficit projections by the Congressional Budget Office, the Office of Management and Budget and the Government Accountability Office. These projections matter: policymakers, investors and the bond markets use them to gauge the nation’s fiscal health. Since a shortfall in Social Security is embedded in these projections, eliminating that shortfall would substantially improve the long-term budget outlook and the nation’s creditworthiness.”
This is an interesting observation. These projections are supposed to reflect current law. Under the law, as Munnell points out, Social Security is prohibited from spending anything beyond the money in its trust fund. This means that if these baseline projections show deficits from the program spending at levels beyond what can be supported by the trust fund, then they are not making projections based on what Social Security can legally spend.
The more obvious complaint would seem to be with the nature of the projections than with the Social Security program. In effect, the projections assume that Congress will opt to maintain the level of scheduled benefits without doing anything to increase revenues. While this is a possibility, that seems a rather strong assumption to include in a baseline projection.
The column also includes another serious stretch. It tells readers that people are taking Social Security at the earliest possible age of eligibility because they are worried that the program will not be there for them if they wait until a later age. The article links to a USA Today article which supports this view by noting that the percentage of people who began taking benefits at age 62 rose sharply in 2009.
The most obvious reason that the share of people age 62 who took benefits rose in 2009 is that the unemployment jumped by 5 percentage points from its 2008 level. There were undoubtedly many workers age 62 who unexpectedly lost their job and saw little prospect of finding a new one. Therefore they decided to start collecting their Social Security benefits.
There has been a lack of confidence in the Social Security system for decades. And there has been much more serious talk of reform at other times, notably the late 90s and 2005 when President Bush proposed to privatize the program. Concern about the future of the program is not a plausible explanation for the jump in people collecting early benefits in 2009, nor is it likely a major factor in the decision of workers to take early benefits more generally.
(Thanks to Eric Kingson, the co-director of Social Security Works, for calling this one to my attention.)
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