The current debate over our national
financial picture can be a very confusing thing with opinions flying
all about like gnats at a picnic. One doesn’t know where to swat
first. The talking heads on TV have not been helpful. As a matter
of fact they have hurt the debate by emotionalizing and politicizing
the debate thereby preventing rational discussions over our options,
and our options are many. All the NEWS presents our immediate future
as very dire indeed but some options are available and it is
obviously going to require some compromise of our ideology.
We have options for revenue that are
left lying on the table because of an unwillingness to allow
government to be able to fund the services we demand. We have budget
cuts that are lying about waiting for people with enough courage to
take on special interests that benefit from them.
On the revenue side there are billions
left in what we call tax expenditures which are special benefits
placed in our tax code to encourage certain kinds of spending
behaviors or to encourage businesses to enter a certain market.
Examples of such are some benefits given to oil companies to
encourage drilling (as if they required encouragement). There is the
mortgage interest deduction that allows taxpayers to deduct the
amount spent on interest to buy or build a house. It is a good
provision that is intended to encourage middle class home ownership
but largely benefits those who buy second or third houses or who buy
extremely expensive houses. That could be limited to first homes and
then either eliminated for second homes or have the deduction
decreased. There is the deduction taken by business for providing
expensive health care coverage which has the effect of requiring the
American taxpayer to subsidize health insurance at an expensive rate.
Restrictions can be placed there. These are just a few that would
be relatively painless to the middle class but would provide some
additional revenue to deal with decaying infrastructure and investing
in technologies for the future.
On the budget cut side there are still
many economies to be garnered in the way we buy health care. As a
nation we spend three times as much per capita for 24th
place health care results. Medicare is prevented from negotiating
lower pricing for drugs while other countries pay much less for the
same medications. Hospitals are gross profit centers that prey on
consumers for bills that are larger than some people’s lifetime
incomes. Medicare provides health care for about 1/3 the cost of
private insurance and that presents a strong case for a national
health care service.
Also, on the budget side we have a
military that has grown exponentially over the last decade in which
we can find hundreds of billions in budget cuts without harming
national security. If we must spend that money then let’s spend it
turning swords into plowshares by encouraging defense contractors to
use military technology for civilian uses which would encourage new
industry. After each war up until the decade of the new century we
had cut military budgets by 20% to 30% after each conflict but now we
have increased military budgets in almost every year for the past 10
to 12 years. We have amazing new weapon systems but, to paraphrase
President Eisenhower, each dollar spent on them is a dollar taken
away from housing, schools, etc.
There is little disagreement that the
current debt is a result of wars and tax cuts that were not paid for.
The current deficit in our budget is due to the drastic decline of
revenues after the Wall Street fiasco led to depression and had the
effect of the tax cuts. There is also a tendency on the part of the
American public to want services but be less inclined to pay for
them. This leads to the most pressing problem that faces our
economic future and that is the exploding costs of Medicare.
Medicare has been a wonderful program
that has delivered medical care at a fraction of the cost of private
health care. Currently Medicare delivers medical services at a third
of the cost of private providers. This has the predictable effect of
not being popular among those who make money out of the provision of
health care services. As with any private enterprise health care is
a growth industry. One of the main tenets of capitalism is that your
market share must either increase or become more profitable in the
services rendered. They have been very good at that and that is
evidenced by the costs of tests, treatments and other services. This
does not mean that Medicare is unsustainable; it only means that we
must find the ways to increase its efficiency.
Proposed solutions are all over the
board mainly focused on cutting Medicare expenditures.
Medicare is the driving force in
budget deficits but that does not mean we should abandon it. Health
care costs are going to be paid for by someone. It is just a matter
of how much money is going to be paid. The solution is not to
curtail Medicare but rather to curtail medical costs. We can do that
by delivering care smarter and by allowing Medicare to negotiate
lower costs for services and drugs. Already Medicare is able to
negotiate lower costs to participating providers. If you have looked
at your Medicare statements you know that. Now Medicare must be able
to negotiate the prices for drugs.
Next, it may seem counter-intuitive but
the answer is to increase access to Medicare. Once you understand
that everyone is going to be in the market for health care and that
someone is going to pay the bill it begins to make sense to try to
deliver it as economically as possible. There is just no other
viable answer that does not allow people to sicken and die for lack
of being able to afford health care. I know that this may cause some
people’s heads to spin around but try to not just think of what it
will cost but what it will cost if we don’t.
It really isn't that hard. All that is
required is rational thought rather than pejorative mumbo-jumbo.
My take on the current so called budget
crisis. It is really a crisis of inability to overcome the fear of
not being re-elected.
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