Entitlement Reform? Not Their Cup of Tea

Tea Party candidates are backing off from serious spending cuts

Anyone who has not been living under a pumpkin lately knows that the single, biggest threat to this country’s economic future is its gimongous (hey, if Sarah Palin gets to invent words, why not me!) entitlement state. The massive unfunded liabilities of Medicare and Social Security are a noose around this country’s economic neck that tightens every passing day that nothing is done. Given this backdrop, the Tea Party movement’s raging about out-of-control federal spending and the need for fiscal discipline might seem like just what the doctor ordered, right?

Wrong. Actually, the handling of this issue by the Tea Party and its anointed candidates might have arguably set the cause of entitlement reform backward—not forward—in this election.

First some gory details about entitlement spending: As the 78 million baby boomers begin retiring over the next few years, under business-as-usual scenarios, spending on their Social Security and health care will more than double by 2050 to about 18 percent of the GDP. By 2052, Uncle Sam’s three entitlement programs—Social Security, Medicare, and Medicaid—will consume all federal tax revenues, leaving nothing for government’s core, constitutional functions. America will have to either mortgage its entire economy by 2042 or raise federal income taxes by 81 percent in order to pay for the $107 trillion in health care and pensions it has promised seniors. Add to all this the 30 million uninsured Americans whom ObamaCare has put on Uncle Sam’s insurance card and you have the makings of the fiscal equivalent of Nightmare on Elm Street.

The country’s fiscal prognosis is so scary that even some members of Obama’s economic team are showing signs of waking up and taking note. Take, for example, the president’s Stimulator-in-Chief, Treasury Secretary Tim Geithner. Geithner has yet to encounter an economic woe anywhere in the world that a good dose of stimulus can’t cure, its fiscal side effects be damned. He is to the cause of global stimulus and bailouts what Bush was to the cause of global democracy. But America’s deficit—thanks to stimulus and entitlement spending—is reaching such unsustainable heights that even Geithner recently applauded the Tea Party movement on NBC’s Meet the Press for raising public awareness about the problem, noting that this would be “helpful when we move to try to make the hard choices to get them (deficits) down again”—a veiled reference to cutting retirement benefits or raising taxes to pay for the entitlements.

But Geithner is way too optimistic—and wrong.

For starters, polls by the New York Times and Bloomberg have found that although a vast majority of Tea Party supporters favor smaller government, they don’t want cuts in their Medicare or Social Security, a contradiction perfectly captured in a sign at a Tea Party rally: “Keep the Guvmint out of my Medicare.” Indeed, the Bloomberg poll discovered that even though Tea Partiers dislike ObamaCare, they want Medicare to offer more drug benefits and the government to force insurance companies to cover pre-existing conditions. The upshot is that while the rhetoric on entitlements has become bolder during this election, the discussion about reform has become tamer.

In fact, setting aside the lapsed witch of Delaware, Christie O’ Donnell, in the most visible Senate races where Tea Party or Tea Party-anointed candidates are running, only two have stuck to their crosses on entitlement reform. One is Joe Miller of Alaska, a man so unfamiliar with the First Amendment that he conducted a citizen’s arrest of a reporter for asking tough questions. The other is Sharron Angle of Nevada, a genuine bright spot in an otherwise bleak Tea Party landscape, who admirably admonished Harry Reid to “man up” and admit that Social Security had a problem.

Literally all of the others are equivocating if not completely backing off from their original plans to give at least partial ownership of Medicare and Social Security to individuals themselves—the only realistic way of limiting the government’s liabilities without completely screwing over future seniors or taxpayers or the economy. In a painfully embarrassing exchange with Fox News host Chris Wallace, California’s Carly Fiorina found every which way to wiggle out of answering how she plans to control federal spending without entitlement reform, even accusing Wallace of asking her a—heaven forbid!—“political” question. Meanwhile, Florida’s Marco Rubio and Connecticut’s Linda McMahon have both been turned from macho to mush by this issue.

But Kentucky’s Rand Paul, who is running as an uncompromising apostle of limited government and free markets, has pulled the most distressing switcheroo of them all. A doctor himself, he denounced Medicare as socialized medicine. Yet he has balked at the idea of cutting physician salaries, even though American physicians make twice as much as doctors in OECD countries. Why? Because their cartel, the American Medical Association, both restricts the supply of physicians through insanely restrictive licensure requirements and controls the Medicare board that determines physician compensation, as the Wall Street Journal reported this week. Yet, Paul now maintains: “Physicians should be allowed to make a comfortable living.” (But he is just being fair—not pleading for his special interest of course!) Likewise, after calling Social Security a Ponzi scheme, Paul is now talking less about reforming it and more about protecting it for those now reaching retirement age.

To be sure, much of this backsliding is in response to attacks by Democratic opponents who are undoubtedly worse and shamelessly demagoguing the issue. Still, the fact of the matter is that instead of pulling Democrats in the direction of reform, the Tea Party candidates themselves are moving in the direction of the status quo. This wouldn’t happen if these candidates could count on a strong and large constituency for reform within their own movement. Elections are a discovery process through which candidates find out what their base really wants. And what many of the Tea Party candidates have found is that when push comes to shove, their backers want to protect their entitlements as much as the next guy. In fact, much of the fury of the Tea Partiers against government stimulus and bailouts might have less to do with any principled belief in the limits of government and more to do with fear of what this will do to their own entitlements.

If that’s the case, then it is safe to assume that the cause of serious entitlement reform is DOA in the next Congress—regardless of whether Tea Party candidates win or lose on Tuesday.

Shikha Dalmia is a senior analyst at Reason Foundation and a Forbes columnist. This article originally appeared at Forbes.

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  • Alan Vanneman||

    I'm giving this one two thumbs up only because I haven't got three! Yeah, yeah, I've made fun of Reason Senior Analyst Shikha Dalmia in the past and may do so again, but this one is FANTASTIC! Double points for the well-place elbow in the solar plexus of the AMA!

  • ||

    STFU Venneman before Dalmia gets another restraining order against you.

  • Richard Head||

    STFU yourself and concentrate on kicking the ball, Lucy is holding it nice and steady for you.

  • ||

    Ouch

  • twins jerseys||

    Ouch? What?

  • ||

    . One is Joe Miller of Alaska, a man so unfamiliar with the First Amendment that he conducted a citizen’s arrest of a reporter for asking tough questions.

    http://news.yahoo.com/s/theweek/20101019/cm_theweek/208340

    You don't help yourself by lying. Seriously, that is just complete bullshit. Right or wrong whatever happened up there is not quite that way. Fuck off Shikha, if you can't write an article without nasty, untrue snark, why should anyone listen to you even if your points are valid?

  • ||

    I have to agree with John about your throwaway Joe Miller line. He wasn't even present when the reporter was detained - he had already left. Additionally, the security personnel that detained the reporter did so for two reasons:
    1. the reporter was attempting to physically accost Mr. Miller. "asking tough questions" is misleadingly understated.
    2. The security firm providing the personnel have a policy of detaining security threats, and they determined that the reporter's aggressive behavior fit the bill.

    Further, the local police said that the security personnel did the right thing. You might also remember that Joe Miller was forced to hire the security firm by the facilities he was using at the time.

    Pretty sloppy, and completely beside the point of your piece.

  • MNG||

    Ben says Miller "wasn't even present when the reporter was detained - he had already left" and "the security personnel that detained the reporter did so for two reasons:
    1. the reporter was attempting to physically accost Mr. Miller"

    WTF? He had left but was being accosted?

    Also, doesn't the renter of the facility deny Miller was "forced to hire the security firm?"

    And do you have a citation for the claim that the police said the right thing was done? I read that noone was charged on either side but that police ordered the reporter released when they arrived.

  • DLM||

    Also, doesn't the renter of the facility deny Miller was "forced to hire the security firm?"

    His opponents certainly do.

  • ||

    Few of her points are ever valid. Why start now?

  • IceTrey||

    Not to mention the First Amendment applies only to the government, not individual citizens.

  • ||

    Wrong. That 'reporter' was held and arrested for getting violent when people were asking him to leave.

  • ||

    I agree with Paul. We should have more doctors. But what is wrong with doctors making what the market will bear? What do you mean "Yet he has balked at the idea of cutting physician salaries". Since when does the Senate have the power to do that?

    Weak tea.

  • ||

    I wanted a clarification on that too.

    What do you mean "cutting physician's salaries?" You mean congress passing a "wage cap" on physician salaries? If that's the case, it's hardly surprising Paul would be against that. Everyone at this publication should presumably be against that.

    Does it mean cutting the money they get from Medicare? If so does that mean they can stop seeing as many Medicare patients to cut their losses? If not, I can see why he'd be against that too.

  • ||

    Holy guacamole! Hey, Voros!

  • ||

    Hey Rob.

  • NoVAHockey||

    Probably talking about the SGR and the scheduled 21% (23%?) cut to Medicare physician payment rates that will go into effect unless Congress acts. and they will.

  • ||

    If that is the case, Paul is right and Dalmai is full of shit. That is just a price control. Doctors cost what they cost. If you cut their pay they will just stop seeing patients with medicare. A lot of them have already done that.

    This is a terrible weak article. No wonder Venneman likes it so much.

  • ||

    "Weak"?

    Doctors cost what they cost.


    And he mentioned why they "cost what they cost" (the AMA's stranglehold on new physicians, among other things).

  • Contrarian P||

    Among a lot of other things. Most of which have nothing at all to do with the AMA.

  • NoVAHockey||

    Double checked -- it's a 23 percent on Dec. 1 and another 6.5 percent on Jan. 1.

    WaPO has a story on it.

    http://www.washingtonpost.com/.....04425.html

  • Some Guy||

    If you cut their pay they will just stop seeing patients with medicare. A lot of them have already done that.

    Sounds like a feature, not a bug.

  • Mo||

    Ideally states, in conjunction with the AMA, wouldn't limit the number of seats in medical schools and limit the supply of doctors. Doctors don't operate in the free market. Medical accreditation is worse than the legal profession's.

  • ||

    True. But saying you should end the AMA's monopoly is different than saying the government should "lower physician's salaries". Dalmai is pulling a bait and switch.

  • Mo||

    Uh, Shika did bring up the cartel.

    Yet he has balked at the idea of cutting physician salaries, even though American physicians make twice as much as doctors in OECD countries. Why? Because their cartel, the American Medical Association, both restricts the supply of physicians through insanely restrictive licensure requirements and controls the Medicare board that determines physician compensation, as the Wall Street Journal reported this week.
  • ||

    That is the bait. The switch is then her next talking about how Paul refuses to "cut physicians salaries". The second piece is about medicare rates. The first point is about the AMA. One has nothing to do with the other. But Dalamia puts them together like they do and implies that Paul supports the AMA monopoly when in fact he wasn't saying anything about the AMA.

    It is crappy writing and logic. And the kind of thing a decent editor would put a boot up her ass over. But Reason apparently doesn't employ editors.

  • Mo||

    Did you read the WSJ link about Medicare reimbursement rates? It's an anonymous panel of doctors that pick what doctors make of Medicare reimbursements that's fraught with all sorts of abuses* and conflicts of interest. It's obvious that Medicare is hugely profitable because the vast majority, 85%, of doctors and hospitals accept it. That's a lot more than will accept my private insurance. Groups that drop it are smaller practices and those that aren't associated with hospitals, not to mention fake medicine.

    http://www.healthcarefinancene.....d-medicare

    * Specific examples include pricing in hospital time for outpatient procedures.

  • ||

    Medicare rates are actually quite a bit less than private insurance.

  • ||

    "It's obvious that Medicare is hugely profitable because the vast majority, 85%, of doctors and hospitals accept it."

    I think they accept it because it's _safe_ money, not more money. You don't have to worry about calling them up and hearing "the number you have reached..."

    In any event the article wasn't particularly clear on what Pauls' position was on what issue, so it seems awfully hard to criticize him for it.

  • ||

    Then fuck them, safe money comes at a price. If MDs don't like the rates, drop the shit.

  • Realist||

    I agree. And if would be union workers don't like what a company offers them in wages go to another company....don't join a union!

  • ||

    My anecdotal experience with my parents is that a whole lot of doctors don't take medicare. But that is anecdote.

    Beyond that, maybe the rates are too high. In which case Paul is wrong. But the article doesn't address that. Instead, it just says Paul doesn't support cutting the rates and then talks about the AMA. I don't know what Paul thinks of the AMA. And the article doesn't tell us.

  • ||

    Tops for medicaid are nephrology/dialysis, which covers patients in chronic renal failure. Bottom is occupational medicine--no shit, they aren't working. That's why they need medicaid.

  • Contrarian P||

    Must be why Medicare reimbursements suck. If the physicians were all on the take, wouldn't they at least try to make Medicare reimbursement keep pace with private insurance? Pretty lousy conspiracy theory.

  • TwoFingers||

    The conspiracy is that private insurance reimbursements follow Medicare's lead.

    Contrary to Dalmia, physicians have only limited control over Medicare reimbursements. They get to cut the slices of the pie, but not determine how big the pie itself is.

  • ||

    I take Medicare because my hospital essentially requires me to. They take Medicare and if I want to practice here, I do too. I could always leave, but there are very few hospitals who do not consider it part of their "mission" to take these patients. The government has hospitals sized to serve these patients and, were Medicare to end overnight, 30% of hospital business would disappear. Private insurers index their payment off the medicare rates. So a private insurer may pay, say, 165% of Medicare rate. They subsidize the Medicare patients.

    Personally, if I were competing with some guy from India who would do my medical job for 1/10th what I do it for, I would just leave medicine and go back into engineering, or business. Perhaps that is what the free market demands, but you will get what you pay for quality-wise. Taking only the top candidates does tends to winnow people who would suck at the job.

  • ||

    Why do you assume 30% of hospital business would disappear? Just because you cut out the middleman who takes money from the kids and grandkids and gives it to Grandma, the aforementioned younger generation isn't necessarily going to go out and spend it all on jawbreakers and gum drops. Maybe they'd voluntarily help Grandma anyway, the way they used to for the thousands of years before Medicare and the way they do in third-world countries with no senior entitlements.

  • NoVAHockey||

    The real problem with the AMA is the Relative Value Scale Update Committee (RUC). The RUC makes annual recommendations to CMS on what each physician code should cost. CMS then reviews and signs off on it.

    http://online.wsj.com/article/.....72102.html

  • NoVAHockey||

    I'll RTFA first next time.

  • El Duderino||

    If there is any artificial limit placed on how much a doctor can earn, then it is wrong.

    Doctors have huge bills for school, insurance, and all sorts of other costs that are associated with a practice. Now, if you want doctors to make less, then be prepared to have fewer doctors (fewer than we have right now). If you want doctors to demand less money, then the only way to do that is to make the cost of becoming and being a doctor less and this includes the time commitment. There is a shortage of good doctors and nurses in this country and the work is not easy when hours get long.

    Reducing the price of health care means reducing waste, making it affordable to get a degree in medicine, and eliminating the need for liability insurance. None of these things are easy tasks, but here is what I would do.

    1. Loser pays for malpractice lawsuits.

    2. Allow anyone to practice medicine. They must disclose their credentials to their patients, but if there is a med student that knows how to take care of my bum knee, why shouldn't I be able to go to them instead of having to go to a doctor who has an MD if the student is just as capable. I realize this may be risky, but I think it should be up to the patient to decide how much risk they are willing to take when it comes to their own health.

    3. Can we once and for all computerize medical records and simplify medical coding? I mean Jesus Harold Christ, it is 2010 and my doctor still carries around a fucking manila folder.

    4. Tell the government to get the fuck away from regulating health insurance. Health insurance is NOT A RIGHT. If you dont like the fact that your insurance company is upset about your pre-existing condition, then you can go ahead and not take their coverage. Health insurance is for HEALTHY people, that is why it is called HEALTH insurance. If insurance was for sick people, it would be called SICK insurance. Health insurance would not be available on a long term basis if it was meant to take care of sick people. It is just for people who are healthy IN CASE they become sick. My point here is that there is far too much regulation in insurance and this makes the paperwork overwhelming due to its complexity and DOCTORS spend all their TIME fucking around with insurance forms.

    Anyway, thats my 2 cents, but it seems, as usual, my opinion doesnt really matter because Obama gets what Obama wants. Spoiled fucking Commie.

  • Anonymous||

    where Tea Party or Tea Party-anointed candidates are running

    I don't know what this means; isn't that the same thing?

    It's not a political party, so wouldn't a "Tea Party candidate" have to be one who is approved by that group?

    uncompromising apostle of limited government and free markets

    Again with the religious imagery. Joe, is that you? Or maybe you were a city planner in a former life...

  • ||

    It should be noted that Democrats get around these types of questions by simply not mentioning that there's any entitlement problem at all.

  • Liberal Elitist||

    It's called the Social Contract and it's magic.

    The people receiving entitlements paid for their parents' entitlements, the people working today pay for current retirees, and when you retire future workers will pay your entitlements.

    See?

    It's that simple.

    Now sit down and STFU!

  • Liberal Elitist pt 2||

    Oh yeah, we also need to more brown people to have more babies to fulfill that whole social contract thing.

    Shhhhh- don't tell anyone.

  • ||

    When Forbes started publishing this kind of crap I dropped my subscription.

  • ||

    DRINK!

  • Tea Party Candidate||

    I pledge to cut all parts of government except the parts that affect you!

  • Richard Head||

    don't forget fraud, waste, & earmarks!

  • Brian R||

    Isn't that pretty much every political candidate since the invention of elected officials?

  • creech||

    Politicians are not going to lead on any issues where there isn't at least a significant minority of the public in favor of something. LP candidates can martyr themselves because no one really expects them to win: the soapbox to speak truth is the prime reason for the LP's existence.

    On S.S. & medicare, I suggest the libertarian movement - Reason, Cato, etc. - launch an educational campaign advocating pragmatic reforms in the direction of more liberty that a majority of the public can come to support.

  • sarcasmic||

    I've come to believe that people are being conditioned against liberty.

    Liberty is hard.

    It means making choices and being responsible for the consequences.

    It's so much easier to just let government do those things for you.

    Why take risks when you can get promises from government?

    After all, we are government and government is us.

    We can trust government. Can't we?

  • rts||

    Freedom means responsibility, that is why most men fear it. -- George Bernard Shaw.

    (Yes, I know, ironic coming from a socialist)

  • ||

    "Elections are a discovery process through which candidates find out what their base really wants."

    And what they are finding is that people want to keep all of "their" stuff, while depriving others of their stuff.

    Or as Bastiat put it, the state is that great fiction in which all attempt to live at the expense of everyone else.

  • ||

    http://www.slate.com/id/2272766/

    Jacob Weisburg wrote virtually the same article in Slate, only looking at it as a positive. Since Weisburg is lucky to have an IQ above 90 and thus has never had an original idea, apparently this is the conventional wisdom the lefty media is going with. Too bad Reason can't come up with something a little smarter.

  • ||

    What a politician says before an election has absolutely nothing to do with how they will act once in office. My great hope is the Tea Party candidates hate Washington enough not to want to stay there forever.

  • steve||

    Christie in NJ seems to bucking that trend...

  • DLM||

    My great hope is the Tea Party candidates hate Washington enough not to want to stay there forever.

    This may be true for about half of them. The other half will gladly allow themselves to be coopted by the PTB.

  • kc||

    yeah, and we'll throw their asses out in 2 years.

  • Carl||

    im thinking rand paul will pull a switcheroo again once he is elected and it will be a switcheroo to policies similar to his fathers. i hope im right because if not then i will have absolutely come to the conclusion it is all corrupt. i see rand paul as the control in this whole tea party experiment.

  • ||

    I'm curious about the role of the AMA licensing in medical legal liability cases. In the case where an AMA licensed doctor is successfully sued, could the AMA also get hit by this if it lowered its licensing standards?

  • ||

    No.

  • Mo||

    The problem isn't just the licensing standards, the problem is the limitation put in in the number of med school seats.

  • ||

    I keep pointing this out, but the AMA doesn't license anybody. The states do. And the states don't get sued for malpractice--the responsibility is the professional and his or her conduct.

  • ||

    Subtitle: folks like free shit.

  • Correction||

    folks like "free" shit

  • ||

    Just so.

  • Mr. FIFY||

    There ain't no such thing as a free shit.

  • Gilbert Martin||

    "Actually, the handling of this issue by the Tea Party and its anointed candidates might have arguably set the cause of entitlement reform backward—not forward—in this election."

    Compared to what?

    You don't think the liberal democrats would ever actually do anything about it do you?

    Other than propose more soak "the rich" schemes.

  • Chad||

    The rich have literally billions of dollars that they don't need.

    We could put it to much better use, like high speed rails. .

  • Mr. FIFY||

    Shit, Chad, why not take any largesse from anyone that "they don't need"? Why limit yourself to just "the rich"?

    Shit, you wealth-enviers never give up.

  • Old Mexican||

    Re: Chad,

    The rich have literally billions of dollars that they don't need.

    Oh? You asked them all?

    We could put it to much better use, like high speed rails[.]

    Or grafting narwal DNA with horse DNA, so that we can have unicors, Chad. That's even better use than on a Monorail - I mean, "high speed" rail.

  • Orzag, Romer, & Summers||

    The country’s fiscal prognosis is so scary that even some members of Obama’s economic team are showing signs of waking up and taking note.

    You got that right!

  • Anonymous||

    How long will Austan last?

  • ||

    "Yet he has balked at the idea of cutting physician salaries,"

    Medicare already pays less than cost for many things.

    Trying to cut down the payments further, will just result in less doctors treating medicare patients and/or more cost shiftining to insurance patients.

    It does NOT lower total medical costs.

  • ||

    I used to work scheduling home nursing visits, and apparently, home health care is one of the rare areas where Medicare pays better than insurance. It resulted in an interesting dynamic wherein the hospital we were affiliated with couldn't wait to discharge Medicare patients, and we couldn't wait to get them on our schedules. And of course no one was fond of Medicaid patients.

  • ||

    That's because private insurance companies don't want to pay for long term care, so they make it more attractive for patients to apply for Medicare/Medicaid to reduce their own liability for the chronically ill.

  • ||

    Are you serious, by paying less for HHAs, which patients never see in an invoice or anything, the insurance companies are encouraging people to apply for medicare/medicaid?

  • ||

    A portion of what social workers do is to get patients into insurance options that will cover them long-term, ie Medicare and Medicaid. Private insurance generally won't pay for home care long term; they cap it after a certain period of time. Medicare and Medicaid go on long term. Example: dialysis.

  • Cyto||

    home health care is one of the rare areas where Medicare pays better than insurance

    I have seen this as well. In fact, I have a friend who quit her job as a delivery nurse in the top hospital in the region to work full time in home healthcare. It pays more than twice as much, with overtime available. And it isn't like delivery nurse is at the bottom of the scale.

    I would have assumed that home healthcare was at the absolute bottom of the food chain. Apparently not.

  • MNG||

    Wait a minute, is that true? Whatever else Medicare is it is a big consumer in the market. By their size and cutting the price they are willing to buy at can't they exert a downward pressure on prices much the same way Wal-Mart has pushed prices lower in a realm of areas?

  • ||

    Not when you are paying below cost. It just gets shifted to the insurance companies. Who then jack up their rates.

    To truly get costs down, you will need to change the system.

  • MNG||

    How does that work? Why would the insurance companies take that? If Medicare offers below cost why would providers accept it? Aren't they free to not take it? I've always thought that while it is cheap it is like a lot of things in the market, it's a big, reliable client, and that often matters more than how much they are paying (think of airline companies who will contract at high prices with jet fuel providers but who do so because the providers promise years of providing in the contract, they pay for the stable source).

  • Contrarian P||

    No. In my profession (emergency medicine) we are required by law to see you if you show up, regardless of what insurance you have. I can't just decide not to take Medicare. Neither can hospitals. A private practice could, and many do.

  • Old Mexican||

    Re: MNG,

    Wait a minute, is that true [that trying to cut down the payments further, will just result in less doctors treating medicare patients and/or more cost shiftining to insurance patients]? Whatever else Medicare is it is a big consumer in the market.

    It's not a consumer. It's just an after-the-fact payer.

    By their size and cutting the price they are willing to buy at can't they exert a downward pressure on prices much the same way Wal-Mart has pushed prices lower in a realm of areas?

    Walmart negotiates the price before they issue purchase orders. Also, suppliers want t do business with Walmart. Medicare does not work that way. Never has, never will.

    The way Medicare works is exactly like an extorsionist. And extorsionists don't drive market prices down, they drive supply OUT.

  • ||

    For many years, I have assumed that SS will not be there when I retire, and have tried to plan accordingly. It is unsustainable. It must either be drastically cut or eliminated, previous "promises" notwithstanding.

    The SS taxes that I payed for the last few decades? For me, pissed away. But that's too bad. Time to suck it up, America...

  • ||

    I'm not exactly counting on SS for my retirement either, but there's a lot of information showing that, in fact, the program won't require either drastic cuts or elimination. I'd link to various cites, but I don't have any idea how to do so. Bob Somerby at the Daily Howler has done a good job of explaining the specifics. You might want to check it out to see a different viewpoint than your own.

    Also, with respect to the main post, is it really fair to call Social Security an "unfunded" liability, where payroll taxes specifically fund the payments?

  • ||

    I think current payroll taxes are enough to fund about 75% or so of current promises.

    By raising the retirmenent age a couple of years that number gets much less.

    Really fixing SS isn't that hard, it's Medicare that's the real kicker.

  • ||

    Unfortunately, I'm extremely pessimistic that "current promises" have been adequately defined, and even more so that "projections" of required revenue aren't being lowballed. Of course, that is based on my own personal history of publicly-funded projects. YMMV.

  • Chad||

    Kroneborge: We agree on something.

    SS is short by about 25% in the long term. It also stabilizes around 2040, as the boomers die off and our demographics stabilize.

    We simply have to choose which combination of a 25% benefit cut or 33% SS tax increase we want, and how to distribute the pain.

  • Rich||

    For many years, I have assumed that SS will not be there when I retire, and have tried to plan accordingly.

    Everybody I know has this approach, so [sarc] maybe America *doesn't* have to suck it up! [/sarc]

  • West Texas||

    Imagine the drain on the economy that this is. Not only are many people putting away extra money for their retirement (as they should be) and not counting on SS (as they shouldn't be), but at the same time the government is hoovering up another 15% of income.

    Yay for statism!

  • Old Mexican||

    But Kentucky’s Rand Paul, [...] has pulled the most distressing switcheroo of them all[...] he has balked at the idea of cutting physician salaries, even though American physicians make twice as much as doctors in OECD countries. Why? [Why what?] Because their cartel, the American Medical Association, both restricts the supply of physicians through insanely restrictive licensure requirements and controls the Medicare board that determines physician compensation, as the Wall Street Journal reported this week.

    Maybe Dalmia should clarify this paragraph, as it is not clear if the explanation above is to explain why doctors make more money in the US than doctors in other countries, or to explain Paul's "switcheroo," which would then make it a non sequitur.

    Yet, Paul now maintains: "Physicians should be allowed to make a comfortable living."

    As opposed to "they should NOT be allowed"? Or what did you mean with "Paul now maintains..."?

    Likewise, after calling Social Security a Ponzi scheme, Paul is now talking less about reforming it and more about protecting it for those now reaching retirement age.

    You mean, different from what his father proposed, that is, to protect SS for those about to retire, and ween out the rest from SS?

    Or what did you think he was talking about when he proposed reforming SSN? Stop giving retirees their money?

    Paul proposed weening out people from the system, not simply cutting off those that are about to retire as many have no other backup plan for their retirement.

  • ||

    what did you mean with "Paul now maintains..."?


    I don't find this confusing in the least. It means Paul opposes the physician fee-for-service cut that is supposed to be automatic but keeps getting vetoed by annual legislation.

    The part on Social Security is, agreed, unclear.

  • Old Mexican||

    Re: Rob McMillin,

    It means Paul opposes the physician fee-for-service cut that is supposed to be automatic but keeps getting vetoed by annual legislation.

    That may be true but that is not what Ms. Dalmia wrote: "Yet, Paul now maintains: 'Physicians should be allowed to make a comfortable living.'"

    The confusing part resides with the word "now," which implies that Paul's previous position had to be something contrary, as in "he maintained before that physicians should NOT be allowed to make a comfortable living, and NOW maintains that they should be allowed."

  • ||

    You think? It seems to me that in the latter he's walked away from the idea that physicians should have to take pay cuts.

  • Old Mexican||

    Re: Rob McMillin,

    It seems to me that in the latter he's walked away from the idea that physicians should have to take pay cuts.

    If he actually SAID that, then what Dalmia aludes to makes sense. That's a big IF.

  • Mash||

    Has John become a bot?
    The spelling has improved but the rants are getting more random.

  • ||

    They only seem random if you are too stupid to follow the argument. Sorry we can't pass out programs.

  • Mash||

    Your arguments rarely make any sense.
    Have you ever thought about reading a book on critical thinking or logic?
    It could really help you.

  • ||

    Because their cartel, the American Medical Association, both restricts the supply of physicians through insanely restrictive licensure requirements

    Medicare rates aside, this point shouldn't be too controversial. If some foreign trained doc wants to open up shop and charge less, more power to him and caveat emptor to his prospective patients. I don't need the AMA to tell me who can treat my cold, or prescribe simple stuff like birth control.

  • ||

    Problem is, in this country you don't get to be a licensed physician for easy stuff. If licensed, you can in theory do whatever you want. Foreign medical graduates are required to train here to ensure that they meet the standard for the specialty they select.

  • ||

    Because their cartel, the American Medical Association, both restricts the supply of physicians through insanely restrictive licensure requirements

    The AMA doesn't set licensure requirements. The states do.

  • Old Mexican||

    One is Joe Miller of Alaska, a man so unfamiliar with the First Amendment that he conducted a citizen’s arrest of a reporter for asking tough questions.

    "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

    Seems like someone else is unfamiliar with the 1st Amendment...

    Maybe the text was suddenly and hurriedly changed to include "thou shall not restraint and escort out any obnoxious, in-your-face reporter from the restroom stool thou are about to use."

  • ||

    Wrong
    The 'reporter' stalked him into hte bathroom, impeded Joe when he was leaving the building, and physically assaulted others at the event. This is not a violation of 1a or 4a or any other.

  • Old Mexican||

    Re: Sy,

    My point exactly.

  • ||

    Dalmia: terrible article. Angle Miller Lee and Paul and a few others REALLY DO care about entitlement reform and have at least demonstrated a modicum of courage in talking about the issue.

    Sometimes, it is the contrarians who are wrong. Sorry bro.

  • ||

    Let’s be honest. This problem is never going to be resolved until this shit hits the fan. Just be resigned to the fact that the US is heading for an economic apocalypse. It just better to prepare for it.

  • ||

    My reply below was meant for you.

  • Matrix||

    The only way to prepare for something like that is stocking up on commodities because money won't help.

  • ||

    Guns and lead. Got em both.

  • ||

    If you can make a compact with some other individuals/families. Look for some cheap rural land and stock pile it with rations, and seeds and invest in some basic masonry.

  • ||

    Gold and silver too, but the lead may be more valuable.

  • DLM||

    This problem is never going to be resolved until this shit hits the fan.

    Just my 2 cents, but I don't think it will ever really 'hit the fan'. It will go away (or more accurately get continuously kicked down the road) by inflating the dollars paid to retirees. By the time people realize it's a permanent situation, they'll be getting too little for it to matter and the baby boomers will mostly be dead. The point is, it won't hit the fan. It will kind of ooze into it.

  • It's always funny...||

    when John gets the vapors anytime Reason posts something critical of Republicans.

  • ||

    It is always funny to give the liberal tolls the vapors. I really do it better than anyone on here. It is nice to know I make you little fuckers in the "oh not this again" and the Edward franchise just a little more miserable each day.

  • spelling||

    Actually it probably does the opposite.
    The trolls are making fun of you.

  • ||

    That is what trolls do. They troll. The guy living in the dumpster behind the 7-11 probably makes fun of me to. His critiques are about as rational and mean as much.

  • DBN||

    You've been here since the 1990's, and post all day every day; at least, you're always posting when I check and the odds of that being a coincidence are pretty low. WTF is your deal? Are you disabled? Do you need a job?

  • MNG||

    "I really do it better than anyone on here."

    My the humility! This reminds me of joe's "declaring himself the winner of the debate" moment...

  • ||

    Agreed. My only concern is that it might not come quick enough. I'm at that age where it might hit in the middle of my 60s, and then I'll have to eat MRIs in my golden years.

  • waffles||

    MREs? because I don't magnetic resonance images have much nutritional value.

  • ||

    Meals Ready to Ingest.

  • ||

    I'd rather eat an MRI. Have you ever tried MREs? I think the old c-rations were better. Beans and weenies. Guaranteed to lose friends.

  • ||

    There are also Meals Ready to Inject.

  • ||

    I didn't mind them. Then again, when you're in the field for any length of time, you're ready to eat your boot.
    Also, if you look out and get the egg noodles with the beef crap, you can mix that shit together and throw in some tobasco sauce. mmmmm..
    but fuck the chili mac. gross.

  • ||

    Hey, with modern technology, you could be in pretty good shape at 60. Remember you dont need to be a master sniper or kung fu master, just be able to disable a man at a distance farther than he can attack you. Unless said man is a zombie, then you're fucked.

  • ||

    Cardio

  • Fluffy||

    Look, all you have to know about Rand Paul is this:

    Usually, when a GOP candidate talks about what he wants to cut, he's lying to make it sound like he wants to cut more programs than he actually is willing to vote to cut.

    In Paul's case, I'm pretty sure that he lies to make it sound like he wants to cut less than what he'd be willing to vote to cut.

    That works for me.

  • asdf||

    Agreed!

  • MlR||

    Indeed.

  • ||

    One of the reasons why I initially helped organize a tea party group in my area, but then disengaged: too few serious folks about going after the big expenditures (Entitlements and Defense). If you cut all the discretionary spending you'd have what, enough to pay the interest on the debt? Lost cause until people are willing to do without that which they don't want to be taxed for...

  • ||

    That is the problem. The ones doing the paying are not the ones benefiting. And the ones getting the benefits are not the ones paying the taxes, at least now. FDR and Johnson really set us up good didn't they?

  • MNG||

    I'm not sure there is much alternative for a program that aims to take care of the "needy." It's going to have to involve those paying not benefiting and those benefiting not paying at some level.

    Of course there's a lot to be said about who qualifies as needy.

  • ||

    That is a fair point. But SS and medicare created a system where people paid into them expecting a return. And now that return has turned out to be unaffordable. Worse still, they based their retirement decisions on the assurances those programs would be there. It is too late for them to plan again or go back to work and pay their own way.

    What do we do? Tell them "hey you fucked up. You trusted us"?

  • MNG||

    It is strange and messed up that it is so often sold as an actual retirement program instead of what it is, a mandatory "social insurance" program.

    I recognize the problem that we have way less people per old person to pay for said old person's programs now. How would I deal with it? That's a very difficult problem. I would start by means testing the hell out of benefits. But then you run into that "hey I saved that money and I want it!" mentality...

  • Old Mexican||

    Re: MNG,

    But then you run into that "hey I saved that money and I want it!" mentality...

    Whoever decides to tackle the problem can always fall back to the argument used to defend SS in front of the SCOTUS - as a TAX, and not as INSURANCE which is how FDR's regime sold it to the American people. As a TAX, it passed the SCOTUS' muster.

    If a TAX (which it is), the FedGov is really under NO real obligation to pay anybody anything.

    Of course this may lead to a pitchforks-and-torches situation, but what are you going to do?

  • DLM||

    But then you run into that "hey I saved that money and I want it!" mentality...

    That was the problem with spinning it as some kind of savings account instead of Social Security INSURANCE.

  • Janice||

    As a person who will retire (supposedly) in 10 years, I am concerned on how this would work. Would the government have to look at total worth or total income? Worth seems to be much more complicated. Does your home have to be included in worth, 401k, pension? (No I am not civil service - I happen to work for a company which offered pensions until last year. Now only the old timers keep it and everyone else gets much better 401k matching.)
    Now I have been a saver all my life. Even though the current salary is $50,000, my current net worth - including mortgage free home - is about $500,000. Would you cut my SSN benefits because I saved?

  • Fatty Bolger||

    IMO, cutting earmarks and the other crap will increase the odds of cutting entitlements as well. Poor mouthing while not cutting frills never plays well, even if it's true that cutting the frills won't get you all the way there.

  • The Other Kevin||

    Then we are truly screwed. One man's pork is another man's reason to keep voting for the same SOB year after year.

    Who (besides H&R readers) would vote against someone for getting funding for a new college building or community center in their town?

  • Tman||

    I don't understand why a mag like Reason would have such a knee-jerk reaction and bash a guy like Paul over entitlements and doctor salaries.

    I can't fathom how this helps in convincing others who are unsure about the merits of Free Markets in determining the best path to resolve these problems. Considering the fact that the left is not only ignoring the problem but actively making it worse it would seem there are much more worthy targets.

  • Icky, icky Tea-partiers! ||

    "I can't fathom how this helps in convincing others who are unsure about the merits of Free Markets in determining the best path to resolve these problems."

    Well there's your problem. You assumed that was the point of it.

  • Publius||

    Unaware of any recent back track on the issue, I gave Rand Paul and Marco Rubio a little more credit for willingness to reform social security: http://freemarkets-freeminds-f.....gspot.com/

  • Investment bankers||

    Money set aside for entitlements could be in much better hands... ours.

  • ||

    Why is Social Security referred to as a "entitlement"? The only thing "entitled" here is something I've been paying into for years. I simply want my money back with interest. That's it. I don't want anything other than that. Is that too much to ask for?

    The Gov't going to have to stop treating this like a ponzi scheme, stop collecting Social Security from the young and sell off whatever assets it has to pay back those of us who've "invested" into this wack-job of a retirement plan.

  • The Other Kevin||

    That sounds great, but the problem is the money you "invested" will run out long before you die. So are you ok with going to the mailbox one day at age 75 (or whatever) and finding no more SS checks?

    If you want people to keep getting a check until death, it HAS to be a Ponzi scheme.

  • Tman||

    That sounds great, but the problem is the money you "invested" will run out long before you die.

    But that's the problem. SS isn't a guarantee either. And all signs point to SS running out as well.

    The fact is this-A couple who worked from 1965 to 2009 would have beat the government payout by 75%.

    Yep. So why can't I opt not to have say, half of my SS money placed in something else, in lieu of equal return from said account?

  • shrike ||

    You're entitled to it because (if you paid FICA taxes) you bought it.

    The big three - SS, Medicare, and Defense will never see serious cuts from the GOP/Tea Party. It would be political suicide - a stake in the heart of their primary constituency - old, entitlement-dependent Guiliani/Cheney style paranoid idiots.

  • Tman||

    The big three - SS, Medicare, and Defense will never see serious cuts from the GOP/Tea Party.

    As opposed to our current other option, Team Blue, who are currently piling new disasters on top of the current ones. I would rather have the ones in power that are at least TALKING about it, even if they turn out to be lying shitheels again.

  • Mr. FIFY||

    And shrike knows what Team Blue really wants... because he hangs out with them, while professing to be an admirer of Hayek.

  • DLM||

    Why is Social Security referred to as a "entitlement"?

    Keep going. What's the rest of it? Social Security ___________ ?

  • Some Guy||

    Why is Social Security referred to as a "entitlement"? The only thing "entitled" here is something I've been paying into for years. I simply want my money back with interest. That's it. I don't want anything other than that. Is that too much to ask for?

    Your generation robbed the "trust fund" to pay for whatever you felt like for the last 30+ years. You already got your money back in the form of not paying taxes for your reckless spending binges, instead blowing your "savings." I hope that clears everything up.

  • shrike ||

    Right, and they swooned for the Bushpigs who enacted the Medicare Pharma Welfare Plan which cost MORE than the Obama stimulus, Bushes TARP, and Obamacare COMBINED by 2030.

    Not to mention the Iraq Fiasco.

    Bush set the bar so that no one will ever contest him in wasted spending.

  • Tman||

    the Medicare Pharma Welfare Plan which cost MORE than the Obama stimulus, Bushes TARP, and Obamacare COMBINED by 2030.

    [citation needed]...like, a good one.

  • shrike ||

    Add it yourself.

    Medicare Part D has an escalating $50 billion/yr cost now. That is one trillion by 2030 if costs and participants remain constant (which they won't) + old costs of $400 billion.

    TARP will have a net loss of $50 billion, stimulus $900 billion (1/3 tax cuts) and the CBO projects Obamacare at a $47 billion net gain by then (due to new taxes)

    We're talking deficit impact and Bush never bothered to pay for a fucking thing.

  • Tman||

    You must not be very good at math.

    Medicare Part D has an escalating $50 billion/yr cost now. That is one trillion by 2030 if costs and participants remain constant (which they won't) + old costs of $400 billion.

    So what, about $1.5 trillion by 2030? According to Bloomberg, TARP I by Bush "has earned $25.2 billion on its investment of $309 billion in banks and insurance companies, an 8.2 percent return over two years, according to data compiled by Bloomberg."

    TARP II, the other $400 billion went to Obama projects like buying GM and the clunkers program. We will never see that money again. Unless you believe GM will sell a few million Volts, which hey, anything is possible.

    As for Obamacare, CATO says the Cost Could Top $6 Trillion.

    The CBO estimate you listed is a fantasy.

    How can you ignore things like this?How can you ignore things like this, and argue that Obama is spending less?

  • Janice||

    You left out Bush's tax cuts, which were also unfunded.

  • TwoFingers||

    Tax cuts aren't unfunded.

    Unfunded = the spending that was based on those (now absent) tax revenues.

  • Some Guy||

    Unfunded = the spending that was based on those (now absent) tax revenues.

    One could say that not cutting spending while removing those revenues amounts to the same thing.

  • cynical||

    Alternatively, one could argue that cutting taxes without lowering spending simply makes some additional portion of spending unfunded. It makes a little more sense.

  • Mr. FIFY||

    Which is why tax cuts + spending cuts = must-do.

    Of course, wealth-envy fucktards will never want to cut spending OR taxes.

    Right, shrike?

  • ||

    Good conversation and I can empathize with some of it, but...it's not my fault the money will "run out". The Federal Government collected this money from me because I had no choice (i.e. at the point of a gun), then promised me that it'd be there when I was ready to retire. It's my fucking money. I want it back. And I want it back with reasonable interest. No more, no less.

  • ||

    Entitlement Reform, Step 1:

    All federal "entitlement" programs (Soc Sec, Medicare, whatever) will be funded currently (that is, no "surplus" to be raided by the general fund, and no draw on the general fund) out of income (that is, no hidden tax on employers).

    That way, everybody can see exactly how much they entitlement programs are costing them. Until that happens, nobody will be very motivated to cut them back.

    To really get the full effect, get rid of withholding for these programs, and make everyone write a check quarterly or annually. IRS employees would be paid a percentage of past due amounts that they collect, to really amp up the hatred.

  • ||

    ""All federal "entitlement" programs (Soc Sec, Medicare, whatever) will be funded currently (that is, no "surplus" to be raided by the general fund, and no draw on the general fund) out of income (that is, no hidden tax on employers).""

    But you don't really expect those who benefit from raiding the surplus to actually pass that?

  • ||

    Tea Party folks need aserious dose of reality tea. I'm 64 and will probably keep working until 70, but I am certainly willing to take a reduction in SS if it spares my grandkids having to pay taxes in the 50 - 60 percent range.

    Just who are we taking care of, ourselves or our kids and grandkids? Are we really going to be the first generation to hand off a lessor quality of life to the next because we ARE SO DAMN SELFISH?

  • DLM||

    I am certainly willing to take a reduction in SS if it spares my grandkids having to pay taxes in the 50 - 60 percent range.

    I suggest you prepare your grandkids for moving to another country, just as a fallback.

  • J||

    As someone relatively young and unattached, I've realized there's no where to go. Suggestions?

  • ||

    Belize?

  • Some Guy||

    Tea Party candidates are backing off from serious spending cuts

    "Backing off" implies they were ever actually talking about them to begin with.

  • shrike ||

    The Tea Party is just a Medicare/SS Political Action Committee.

  • sevo||

    Could be. As opposed to brain-deads such as yourself who are the Entitlement Expansion PAC.
    Both suck.

  • Mr. FIFY||

    Ol' shrike pretends to be a fan of Hayek, but he talks like Bernie Sanders.

  • Peter Jensen||

    "Tea Party candidates are backing off from serious spending cuts"

    Surprise.

  • ||

    NOT KNOWING THE ANSWER, PROBABLY AS MOST LEGISLATORS DON'T, LET ME ASK ANYWAY.

    HOW MUCH OF TAXPAYER MONEY IS SPENT OUTSIDE OF THE USA IN TOTALLY FRUITLESS ENDEAVORS?

    IF SOMEONE IN AUTHORITY CAN ANSWER THAT, WE PROBABLY HAVE ENOUGH LEFTOVER CASH TO PROVIDE 1ST CLASS HEALTHCARE TO ALL OF OUR CITIZENS.....CRADEL TO GRAVE AND STILL WHUP THE WORLDS ENEMIES ASS TO BOOT.
    WHAT ELSE DO WE NEED?

    HOW ABOUT A DOLLAR FIGURE???????

  • sevo||

    YOU COULD UNLOCK YOUR CAPS, DO A SIMPLE SEARCH and find that defense is not the major cost:
    http://www.cbpp.org/cms/index......mp;id=1258

  • ||

    This is what you get when Reason opens its borders.

  • wulfy||

    3 words:
    Balanced Budget Amendment

  • Max||

    Rand Paul may be a hypocrite, but he's not a fucking racist piece of shit like his old man. Rand would have voted for the Civil Rights act.

  • Contrarian P||

    Of course he will never been in a position to do so, so how would you ever know?

  • sevo||

    Nor is he an ass-sucking, shit-eating ignoramus like max, right ass-sucking, shit-eating max?

  • Brian R||

    I believe he disagreed with one of the (9?) titles of the Civil Rights Act. But don't let facts get in the way of your trolling.

  • Mr. FIFY||

    Max, you need to meet some REAL racists. Ron Paul doesn't even come close.

    Not that I'd actually recommend meeting real racists... they're ugly people. But you do need to rethink how you use the term "racist". Buy a fucking dictionary.

  • ||

    Let us first dispense with the word "entitlement" and replace it with its proper term "charity". It is a fact many people draw far more from the varied systems than they contributed and are taking out of the system at rate higher than a currently declining pool of contributors will ever withdraw, if at all. We have no choice but accept some systems must eliminated or drastically scaled back in order to save them in some form.

  • Brian R||

    I get your point, but I think "charity" is the wrong word too. Charity is something freely given. The taxes you pay the government are required, and taken by force if necessary. Since none of the money the government has was freely given to it, the government cannot engage in charity.

    We could use more charity and less government wealth transfer.

  • ||

    What a bunck of mooks you all are, you want spending controled but want the AMA to be able to let doctors make more than their worth!

    ever heard the saying" You Can't Have Your Cake And Eat It To".

    What a bunch of retarded Chimps!

  • sevo||

    Dave Y|11.1.10 @ 8:49PM|#
    "What a bunck of mooks you all are, you want spending controled but want the AMA to be able to let doctors make more than their worth!"

    Who wants what? Careful with that strawman; they are inflammable and could cause harm to those who embrace them.

  • ||

    OK, so I engaged in a little exercise in self flagellation today. I compared how much I'm going to get from SS if I live 20 years past retirement (about $550K) compared to how much my SS contributions would be worth had I been investing them in a 401(k) account for 43 years. Using a very modest 5% return, I came up with nearly a 70% better return. And if everyone did that (required to?) imagine how many trillions of dollars would have been been available to the capital markets that have not been otherwise.

  • ||

    Which is what Bush wanted to do, and got excoriated for it. Sensible, practical, and politically radioactive.

  • ||

    For all their anti-establishment bluster, these Tea Party Republicans are just that, Republicans. Few if any of them adhere to the Libertarian priciples the original Tea Party movement was founded on.

  • Draco||

    People think there is an "entitlement problem" because they make the mistake of reifying the numbers and formulae. The only thing real here is the real goods and services produced by the people who make up the economy. That's all that can ever be doled out (not counting stuff that was produced before and stored away, of course, but that doesn't really affect the argument), regardless of the formula used to dole it out.

    So, yes, you can't dole out more than is being produced in the economy in any given year. So, yes, "entitlement" formulae will need to be changed if they lead to a scenario where more is planned to be doled out than produced. Eventually, we will change the formulae. Please stop the hysteria. We won't really dole out 10 or 100 or 1000 or 10^32 times what the economy actually produces in a given year, even if that's what your projection of existing numbers and formulae lead you to predict, because that's impossible.

    What we can do, of course, and what we are more and more in danger of doing, is concoct a system where the relatively young productive class are not suitably motivated to produce a surplus of real goods and services which can be doled out to retirees. That is the real problem. And it isn't helped by presenting those young and productive people with disincentives to produce more.

    And, once again, social security is not a Ponzi scheme, nor is it a retirement plan on which a "rate of return" can be calculated. Click the link for more.

    Finally, stop insulting John. He is one of the consistently best commentators on the H&R boards. I don't always agree with him, but I always enjoy his posts.

  • Brian R||

    you can't dole out more than is being produced in the economy in any given year

    That's only true in a completely closed system. In the actual US economy, we borrow a ton of money from China, which allows us to buy more goods than the US economy produces. That's what the national debt is - the sum of our excess consumption over the decades.

  • ||

    Obamacare is supposed to be partly funded by $500 billion cut in Medicare. Thus government is messing with the promise of Medicare. That we ever trusted government with this is unbelievable. The fact that they did it again with Obamacare is shameful. Rubio has proposed increasing the age of retirement. He has not turned to mush on that. You failed to explain your point. The times ahead will be very tough. Many have depended on this Medicare/Social security as large chunks taken from their paychecks --but not for their own future account but for current recipients because those in government can't keep their hands out of the cookie jar. Could this have been the sentiment behind the sign? Isn't that reasonable, Mr. Reason magazine reporter... But you are so much smarter than us. Please do tell me everything that is reasonable, because a tea-party supporter like me needs to just wait and follow an "intellectual" like you (sarcasm intended). As a physician who ended my education/training ordeal with six figure debt, that augmented when purchasing a home --which felt like the thing to do already at 28 years old, married and eager to start a family. I moved away from my family so that my husband and I could afford to save and pay off debt, which we have been doing. Medicare and Medicaid pay shit. But physicians are scared to not take these insurances because so many people are now stuck with these entitlements. Going for the out-of-pocket market is hard because it is a small market and scary when the debt is high. But I am well on my way to paying off my debt, with my extremist frugal ways that I have developed over the years --living on a quarter of my income (my husband also and my son has grown up with it). And when it is all paid off, I will then likely choose to not take any government insurance. It is a pain in the ass. If Medicare and Medicaid cut doctor reimbursement any further, secretaries will be let go, next nurses will be let go, and next Medicare will be dropped from more and more offices. Many times now, when I see a Medicaid pt who is very sick and requires a lot of intervention, it is a monetary loss for the office. Many docs still see Medicaid pts out of compassion, not profit. If you think that I am rich working 80 hours per week and making personal sacrifices too long to even explain here --including waiting until age 35 to have kids and seeing one die in the ICU at age 3 weeks due to being born premature-- then buddy I have to tell you that it is the snarky internet reporters that are way overpaid. Get a clue. In spite of my issues, I did buy a house that was half the cost that most suggested and have paid it off in full --after only 5 years. Once my student loan is paid, I will reconsider wether I even want to be a physician or work only part time. The sacrifices I have made I think are not worth it. Everywhere I look I find jerks who think they are entitled to get my services for free or other jerks who think I make too much money and still other morons who envy me as if I was born not from poor immigrants but with a silver spoon in mouth... So at the very least I will say bye-bye to Medicare and Medicaid as so many docs in my community have already done. Medicare will self-implode even if politicians don't touch it. Doctors will abandon it. It is not a cash-cow for anyone.

  • ||

    Under my government you'd have paid that student loan off before you'd be eligible for any mortgare.

  • Chad||

    did buy a house that was half the cost that most suggested and have paid it off in full --after only 5 years

    Hmmm, how many lawyers, scientists, professors, etc do I know that paid off a home in five years?

    Zero.

    And trust me, I know a lot of such people.

    Thanks for refuting your own point that you aren't overpaid. In fact, you very demonstratably are. You make more than members of similar professions (yes, even after accounting for your loans and insurance), and you make more than your international peers.

    You are just pissy that the Medicare "cuts" are cuts to your bottom line. You c primarily an give up the beemer and switch to a Chevy like everyone else.

  • Mr. FIFY||

    Chad, when are you going to learn? Wealth. Envy. Solves. Nothing. Period.

    Oh, it makes you FEEL better, but it doesn't fix one goddamned thing. Not one.

  • ||

    And I agree that social security is a ponzi scheme... or a pyramid that is about to collapse. It is money that goes in and right out to pet projects of politicians dejour. If that money could instead be invested privately, people would have wealth at time of retirement, not crap. With old people living longer and young people having less children, there is not enough to sustain it... not to mention the many young people who are successfully obtaining disability. Too many think that they don't have to work for any condition they might have. Total BS that this gets approved. As a physician I see this crap everyday. And the diagnosis of FIBROMYALGIA -a total invention that government has given disability for, as well as depression. Could you imagine being 30 with an able body and a BS diagnosis on disability?! How is this even possible?

  • Rock Action ||

    If I understand this article, there is a problem with the Tea Party candidates in this election cycle. The few national politicians that are credited with riding the wave of Tea Party sentiment (sentiments derided by the mainstream and left-wing media as loony, angry, injurious, and politically and culturally sophomoric) have not explicitly adopted the libertarian position of cuts and restrictions in entitlement programs (a position declared by most members of the mainstream and left-wing media as a litmus test deciding one's cultural lunacy, potential for social malfeasance, and political sophistication) in order to get elected?

    How logically inconsistent of them not to commit political suicide in today's environment. In all seriousness, give me a national candidate outside of a redder than red state that can even survive rumors of a position advocating "privatization" of these benefits, or even a means-testing requirement to receive them. Joe Miller did this in Alaska, and he keeps sliding...

    Please. And Medicare reimbursement rates and ducking questions are the prime example of this backsliding? Oh man, talk about some absolutist religiosity we've got going here.

    "I am for drastic cuts in Social Security and Medicare"

    5%, thank you very much, you are now slightly more effective than a Libertarian Party candidate - or Carl Paladino. There's a whore at the door for ya.

  • Peter Jensen||

    In other words the voters, including most "don't touch my Medicare" tea partiers, aren't serious about cost cutting.

  • Chad||

    If even right-wing idiot nutjobs aren't serious about cutting anything that matters (and they certainly aren't), what does that tell you?

    THAT YOU CAN'T FIX OUR PROBLEMS WITH CUTS ALONE.

    GET THE BLEEPING HELL OVER IT.

  • Old Mexican||

    Re: Chad,

    If even right-wing idiot nutjobs aren't serious about cutting anything that matters (and they certainly aren't), what does that tell you?

    That they are all parasitic rent-seekers just like the left-wing idiot nutjobs who don't want to cut anything either?


    THAT YOU CAN'T FIX OUR PROBLEMS WITH CUTS ALONE.

    Well, I can certainly fix MY problem with cuts alone - I need to cut my hair, because it's getting to be a problem.

  • Mr. FIFY||

    Note that Chad - as usual - insinuates that RAISING TAXES FIXES EVERYTHING.

  • El Duderino||

    When you cant afford to pay your rent do you:

    A: Demand a raise.
    B: Cut your other expenses.

    If you say "A" then what makes you think that your employer has more money to give you, or is even willing to give it to you.

  • El Duderino||

    Okay. I understand the point here, but I do not completely agree with it.

    Americans are addicted to entitlements. Not just unions, poor people or the perpetually out of work college liberals, but ALL AMERICANS.

    The fact that we are even having a serious discussion about cutting major entitlements like Social Security or Medicare is a somewhat new thing for most mainstream Americans and we have the Tea Party to thank for that, but like any addiction, we must first admit we have a problem before we can do anything to fix it.

    Right now, as of this election, America is standing up and saying "Hello, My name is America, and I have a . . ." The words "entitlement problem" are going to come out, but not until after a few weepy tears.

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    "But Kentucky’s Rand Paul, who is running as an uncompromising apostle of limited government and free markets, has pulled the most distressing switcheroo of them all. A doctor himself, he denounced Medicare as socialized medicine. Yet he has balked at the idea of cutting physician salaries, even though American physicians make twice as much as doctors in OECD countries."

    -- I heard him put this in context. Physician reimbursements have already been cut drastically, and he's got other places to cut government health care spending. I'll wait to see his overall plan for health care before judging him on this one point.

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