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Policy

Costs of Health Care Programs and Social Security Poised to Bust the Country

J.D. Tuccille | 7.18.2014 2:17 PM

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Peter Suderman reported the other day that the federal government's unsustainable spending spree continues apace, with debt expected to continue stacking up, "to a percentage of GDP seen only once before in U.S. history (just after World War II)," in the words of the Congressional Budget Office. The health care component of those expenses is getting the most attention, he noted.

Why is the health care component so talked about? Because health care and Social Security are projected to double in cost as a share of GDP. Let's quote the CBO again:

Federal spending for Social Security and the government's major health care programs—Medicare, Medicaid, the Children's Health Insurance Program, and subsidies for health insurance purchased through the exchanges created under the Affordable Care Act—would rise sharply, to a total of 14 percent of GDP by 2039, twice the 7 percent average seen over the past 40 years. That boost in spending is expected to occur because of the aging of the population, growth in per capita spending on health care, and an expansion of federal health care programs.

Interest payments will also more than double, from 2 percent of GDP to 4.5 percent. By contrast, "total spending on everything other than Social Security, the major health care programs, and net interest payments would decline to 7 percent of GDP by 2039—well below the 11 percent average of the past 40 years."

Spending
CBO

Which is to say that spending on Social Security, Medicare, and other health programs is expanding at a rate that the federal government can't begin to afford. Servicing the resulting debt is also becoming increasingly spendy.

Getting the federal government to live within its means doesn't involve trimming a little fat. It's going to require strictly reining-in and reducing its role.

The Rattler is a weekly newsletter from J.D. Tuccille. If you care about government overreach and tangible threats to everyday liberty, this is for you.

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NEXT: Ohio Lawmakers Move to Ban Powdered Alcohol

J.D. Tuccille is a contributing editor at Reason.

PolicyBudget DeficitObamacareDeficitsHealth CareSocial Security
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  1. BiMonSciFiCon   11 years ago

    Vox told me this is a good thing. Except when it's not. Then we need Obamacare. Except when Obamacare raises spending. Then it's a good thing.

    It makes sense if you are one of The Brightest Minds, the Greatest Thinkers over at Vox.

    1. Sevo   11 years ago

      Yep, craig was here yesterday explaining how increased insurance company profits show that O-care is a success!
      Why, before O-care, those evil insurance companies were making profits, but now, those wonderful public spirited organizations are just making profits!
      Pretty sure craig is dizzy all the time, but if not, that spinning sure would do it.

      1. XM   11 years ago

        Increased profit resulting from freakishly high premiums and customers having forced to upgrade to more expensive plans. And people were actually forced to buy insurance.

        Insurance companies can also cut down on cost by limiting your choices of doctors and hospitals. But these are tales of success in the ACA world.

  2. creech   11 years ago

    Sure we can afford it if the mean Teathuglican kochsuckers would just get out of the way! SS, Medicare, rebuilding infrastructure knocked down by careless contractors, letting teeming masses into the country and providing cradle to grave succor, building democracy around the world while tripling our military strength, free condoms and health care for all, turning local LEOs into the 3rd Armored Division, and ten thousand other unfulfilled needs is all within our grasp if only
    the right Top. Men. are in charge.

  3. Suthenboy   11 years ago

    There isn't going to be any trimming, any reducing, any cutting. The craven political class is going to ride the gravy train until it runs off the rails, and it will run off the rails.

    1. Lord Humungus   11 years ago

      whee!

    2. Cytotoxic   11 years ago

      Once interest rates tick up, it will be slashed. Happened in Canada, it'll happen in America-once you lose reserve currency status.

  4. Dances-with-Trolls   11 years ago

    Getting the federal government to live within its means doesn't involve trimming a little fat. It's going to require strictly reining-in and reducing its role.

    For which there will be political and public will sometime after a catastrophic or near-catastrophic financial collapse. It's just not going to happen without it. It will stop when the government is unable to borrow, beg, or steal it's way out and the citizens get stuck with the horrific results of the fiscal behavior that lead it to that point. When we are all Detroit maybe people will be willing to imagine a different way. A little bit after it is a little to late. The way it usually works with people.

  5. Lady Bertrum   11 years ago

    My advice is to stock up now on your oxycontin, metformin, amoxicillian, and zoloft because when you need it it won't be available.

    1. jesse.in.mb   11 years ago

      Hoarder!

      1. Jordan   11 years ago

        Hodor!

        1. Sudden   11 years ago

          Holodomor

      2. Lady Bertrum   11 years ago

        We can never have too much oxy on hand.

        1. jesse.in.mb   11 years ago

          I see you studied at the Limbaugh school of pharmacology.

          1. Lady Bertrum   11 years ago

            It is one of the five food groups.

    2. Scruffy Nerfherder   11 years ago

      Who needs Zoloft when you've got moonshine?

      1. Pl?ya Manhattan.   11 years ago

        I don't have moonshine. Do you participate in the "Sharing Economy"?

      2. sarcasmic   11 years ago

        Or weed.

    3. Pl?ya Manhattan.   11 years ago

      Amoxicillin is worthless now. Augmentin or GTFO.

    4. Pl?ya Manhattan.   11 years ago

      Also, no stimulants in your medicine cabinet?

      You're doing it wrong.

      1. Lady Bertrum   11 years ago

        no stimulants in your medicine cabinet?

        I'm open to suggestions.

        I haven't used an anti-biotic since my sons were toddlers and had ear infections.

        1. Pl?ya Manhattan.   11 years ago

          You can get ProVigil without a written script (Schedule IV, I believe); a doctor can phone it in. Increased wakefulness, enhanced cognitive function, and improved working memory.

          Adderall is Schedule II, and requires a written script, no refills allowed. My taxes wouldn't get done without it.

          1. Lady Bertrum   11 years ago

            Sounds like a necessary addition to my list.

      2. Sudden   11 years ago

        One needs both depressants and stimulants.

        I generally think the cure for the blues is Italian reds and Colombian whites.

        1. Lady Bertrum   11 years ago

          My actual drug of choice is wine - boxed wine. I'm not fancy.

          1. Pl?ya Manhattan.   11 years ago

            If you take the aluminum bladder out of the box, it can fit into a backpack quite nicely. Perfect for beach days.

          2. Sudden   11 years ago

            Were the Piedmont Nebbiolo varietals cheaper, wine would be my drug of choice. I had a 2007 Barbaresco two weeks ago that was the best glass (and bottle) of wine I'd ever had.

            But sadly, those things run above my budget (that one was a wedding gift I was supposed to save for my five year anniversary, and upon rediscovery in my wine fridge, seemed like it should be drank post haste).

            Nay, when the economocalpyse strikes, I'll move to Oregon and pursue my life long goal of becoming a hops farmer.

    5. Ivan Pike   11 years ago

      metformin

      ??? - diabetes meds?

      1. Pl?ya Manhattan.   11 years ago

        It'll be like currency when the economy collapses.

        1. Ivan Pike   11 years ago

          It'll be like currency when the economy collapses.

          What is it used for other than diabetes? Seems strange to me, but then I had to look up the drugs to see what they were anyway.

          1. jesse.in.mb   11 years ago

            Nada. There are just a lot of diabetics. BP meds will also be needed. Red yeast rice extract is a serviceable mix of statins to treat cholesterol. I believe its nearly identical to atorvastatin or lovastatin (can't recall which though).

          2. Pl?ya Manhattan.   11 years ago

            People will pay anything for a drug they need to stay alive. I'm thinking maybe this should be part of my investment portfolio.

      2. Lady Bertrum   11 years ago

        By 2020 110% of the American population will be diabetic, so preparation and stuff.

        I'm not. I don't eat sugar. I aspire to be sugarfree.

        1. Pl?ya Manhattan.   11 years ago

          It's easy to be Sugarfree. Just accidentally get shot in the pancreas.

          1. Lady Bertrum   11 years ago

            If I get shot will I then be able to produce novellas that include entirely too much Doom and too much Cock?

            1. jesse.in.mb   11 years ago

              too much Cock

              I understand each of these words, but arranged thusly they make no sense.

              1. Lady Bertrum   11 years ago

                So, just like oxycontin?

                1. jesse.in.mb   11 years ago

                  Exactly, Lady B, exactly...

  6. DFG   11 years ago

    "Getting the federal government to live within its means doesn't involve trimming a little fat. It's going to require strictly reining-in and reducing its role."

    The meeting for all those who believe this will actually happen is scheduled for the phone booth at the end of the hall.

  7. Knarf Yenrab!   11 years ago

    That's not going to happen. The politician's master plan of staying in office as long as possible precludes any cuts to special interests, which means that when the can refuses to budge another inch, he's going to be the first one shouting about greed and deregulation.

    Interest payments will also more than double, from 2 percent of GDP to 4.5 percent.

    Interesting. Did the CBO check its magic 8-ball for the interest rates of the future?

    1. PapayaSF   11 years ago

      They have nowhere to go but up.

    2. Sudden   11 years ago

      We apparently had the same thought.

      As I stated after your comment, I'd bet dollars to donuts that this analysis assumes current rates with only gradual increases never reaching historical averages and assumes a far more robust economic growth (and resultant revenue and ergo lower debt levels) than can reasonably be expected given the increasing share of the economy that is the fedgov.

      1. Knarf Yenrab!   11 years ago

        And since interest rates have been the ad hoc-est of ad hoc since Greenspan ran the show, I have to imagine that the CBO economists know that this is the wildest of wild guesses for the same reasons that using statistical projections to predict the winner of the 2017 World Series would be absurdly overreaching.

  8. Sudden   11 years ago

    Not to mention that I think the debt service portion of that graph is assuming a) interest rates remaining where they are well below historical norms and b) far more robust economic growth (they generally assume 3% annual growth) than can reasonably be expected given the federal leviathan leeching ever more capital from the productive sector.

  9. Horatio   11 years ago

    Umm, I thought we established that this isn't a problem RIGHT NOW, so why the scare-mongering?

    1. Rasilio   11 years ago

      Because did you notice the time scale on that graph?

      2039 is just 23 years from now by which point health care, social security, and interest will consume 20% of GDP even though the government has never been able to reliable collect more than 19% in taxes which means annual deficits never again running below 8% of GDP and debt reaching somewhere around 400% of GDP by 2045.

      The really scary part is that is an impossibly rosy scenario which posits no net increases in spending on any other program, that interest rates stay at near or below 0%, and the economy grows smoothly at greater than 3% a year. Realistically we are looking at a total collapse of the dollar no later than 2025 and that collapse becoming inevitable by 2018 (assuming it is not already unavoidable which it may be because it is pretty clear we are nearing the top of yet another inflationary bubble and will see another severe recession within the next 24 months at most).

      1. Sudden   11 years ago

        Could not have said it any better myself.

        My currency collapse prediction was always the mid 2020's.

  10. PapayaSF   11 years ago

    Progressives tell me that all of this can easily be fixed by cutting the military and raising taxes on the rich. And if that doesn't work, cut the military and raise taxes on the rich.

    1. Knarf Yenrab!   11 years ago

      The bad news: if you have a job, you're rich.

    2. ant1sthenes   11 years ago

      Sounds like the next tax avoidance strategy for the rich is "use your wealth to hire unemployed vets and equip them with surplus weaponry sold off by the government to support the welfare state, then conquer the US"

  11. Doghouse Reilly   11 years ago

    Don't expect this to change if everyone's favorite Fauxcahontas gets elected:

    Elizabeth Warren's "11 Commandments of Progressivism"

    Fuck it, if TEAM RED doesn't field a suitable liberty-minded candidate, I'll vote for Warren in the hopes that it sends the country over the cliff faster. Might as well take the poison all at once.

    1. Sudden   11 years ago

      I seriously think we're gonna get a Rand v. Warren matchup, so you'll be able to vote for someone other than Warren.

      Sadly, Warren will win.

      1. Cytotoxic   11 years ago

        No and no.

      2. Pl?ya Manhattan.   11 years ago

        You have some, uh, perverse incentives.

        1. jesse.in.mb   11 years ago

          It occurs to me the bet is win-win for him too. If he loses the bet we live in a universe where Warren didn't get the nom. I count that a pretty big benefit.

          1. Sudden   11 years ago

            Sadly, I fully expect to win that $20 from you.

            And by the end of her second term (because not only will she win the election, she'll get re-elected), there is a good chance that $20 will be worth less than $0.02.

        2. Sudden   11 years ago

          $20 IS NOT PERVERSE!

          1. jesse.in.mb   11 years ago

            That's not what you said at lunch last week. While stone cold sober.

            1. Sudden   11 years ago

              I believe I said I look forward to collecting my twenty dollars (implication being I'll win the bet) and my penetrative sodomy (implication being that is the figurative, figurative, consequence of a Warren presidency.

              When she wins, I'm gonna say fuck it and go on the dole.

              1. jesse.in.mb   11 years ago

                You can't see it, but I'm making my skeptical face.

      3. jesse.in.mb   11 years ago

        No. You are wrong. Even Slate thinks she can't get the nom against Hillary, but should run to force Hillary to the left.

        Because that would make America more wonderful.

        There is zero chance of a President Warren.

        1. Sudden   11 years ago

          I'm sure there were plenty who said in 2006 that there is zero chance of a President Obama.

          And here we are.

          Jesse, the one thing you must learn in this world is to never underestimate the stupidity of your fellow man.

          1. jesse.in.mb   11 years ago

            I'm sure there were plenty who said in 2006 that there is zero chance of a President Obama.

            This is possibly true, but I know enough people who like her but don't want her in power that I hope it's not going to repeat itself.

            1. Sudden   11 years ago

              I really hope you're right. Elizabeth Warren might be the worst possible thing that could happen to this country. Her election would essentially etch the transition to Weimerica into stone.

              Hell, I hope Hillary gets the nomination because she may be the only Dem I actually don't see winning the election vs. a GOP candidate.

          2. Doghouse Reilly   11 years ago

            ... never underestimate the stupidity of your fellow man.

            Which is why I'm worried. Subsidize student loans to capture the Millenial vote, prop up SS/Medicare/Medicaid to capture the Boomer vote, and promise free money to everyone in between.

            How do you run and win on a principled stand for liberty when you're up against against "free stuff for everyone!"?

            1. Knarf Yenrab!   11 years ago

              How do you run and win on a principled stand for liberty when you're up against against "free stuff for everyone!"?

              You don't. The lesson conservatives, libertarians, and socialists should all learn from Obama is that you lie your ass off, then do what you want once you get elected, all the while lying your ass off every time a journalist is within 100 yards.

              1. ant1sthenes   11 years ago

                That only works if journalists want to play along.

      4. Knarf Yenrab!   11 years ago

        Recalling her 2012 convention speech, Warren is undoubtedly a passionate and engaging populist.

        She also has the unmistakable air of crazy about her, honest to god pound-shoe-on-desk crazy. The tv era has given us a steady stream of smooth talkers, and Warren isn't that. Biden has a better chance, and that's saying something.

        1. Knarf Yenrab!   11 years ago

          (smooth talker isn't the best description of W, but most all of the presidents since Nixon have been the neighborly sort of personality)

  12. Tony   11 years ago

    You don't care about debt or you'd advocate hiking taxes. The end.

    1. The Heresiarch   11 years ago

      Ooh! Ooh! I can play this game. "You don't care about debt or you'd advocate cutting spending. The end." What prize do I win?

    2. The Last American Hero   11 years ago

      Sorry pal, but look at tax revenues as a percent of GDP since WWII. You don't get more than 18 percent or so. That time frame covers booms, busts, wars, peacetime, HIGH TAX RATES and low tax rates. Raising the rates has the effect of doing jack for increasing tax collections.

      And since Fedgov spends a buck forty for every dollar they collect, how does this help?

    3. ant1sthenes   11 years ago

      If we hiked taxes, they would just increase spending and blow it all on stupid shit, so we'd be sacrificing economic growth (since the taxes would probably hit capital instead of consumption) for basically nothing.

  13. concerned cynic   11 years ago

    Somebody is going to pay more taxes, and I predict that the Medicare tax is going to be increased from 2.9% to 4% for everyone.
    The Federal govt. will eventually own and operate a chain of hospitals offering "free" but ugly healthcare. This is what Medicare and Medicaid and Federally subsidised health insurance will pay for. Better health will be available, but will require fully private insurance or paying out of pocket.

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