By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.
On Tuesday, the Senate sent to President Obama the long-awaited and much-discussed Medicare “doc fix.” Each of the past 17 years, Medicare payments to physicians have been scheduled to be cut automatically under something called the sustainable growth rate formula, and each of those years, Congress has suspended those cuts for one year. It’s been a charade, but one with real consequences because Medicare payments to doctors are low, and some doctors routinely threaten to stop treating those patients. Those who still do would like more certainty than these one-year fixes provide.
Now there will be no more last-minute reversals of the pretend spending cuts. The problem, as is usually the case, is that Congress did not offset the costs of the doc fix, either with spending cuts or higher taxes. According to the Congressional Budget Office, the legislation will add $141 billion to the national debt through 2025 – money that almost certainly would have been added anyway, just one year at a time.
Arkansas Sens. John Boozman and Tom Cotton voted for the doc fix, which passed 92-8. Earlier, they voted for an amendment that would have required Congress to offset the bill’s costs. That amendment failed, 58-42.
So we’re still burdening future generations with more debt, but at least we’re being more honest and transparent about it. Unfortunately, that qualifies as progress.
On the same day that the Senate passed the doc fix, New Jersey Gov. Chris Christie, a probable presidential candidate, proposed in a speech a number of meaningful reforms to Social Security, Medicare and Medicaid. Generally speaking, Medicare serves seniors, and Medicaid also serves seniors along with poor people and the disabled.
Christie’s proposals would affect Americans of all income classes. The retirement age would be raised to 69 very gradually (for Medicare, it would reach that age in 2064). Future senior citizens earning annual incomes above $200,000 from other sources no longer would receive Social Security benefits. Wealthier recipients would pay a higher percentage of Medicare premium costs than they do now. Christie would reform the qualification process for Social Security Disability Insurance, which has become a welfare program for younger recipients. Medicaid recipients above the poverty line would be required to pay co-pays rather than basically receive their health care for free.
Why is he talking about those popular programs? Because they are important contributors to the national debt, which has grown from less than $1 trillion in 1981 to more than $18 trillion today. According to the Committee for a Responsible Federal Budget, $24.11 of every $100 the federal government spends goes to Social Security, while $14.42 goes to Medicare and $8.60 goes to Medicaid. That’s $47.13 of every $100, an amount that will grow as the baby boomers age.
What’s important about Christie’s speech is not whether he’s offered the right answers, but that he’s talking about the subject at all. Social Security has long been called the “third rail” of American politics: Like the electrified third rail on a subway system, if you touch it, you die. Politicians would rather talk about lowering taxes and increasing spending now because the young and unborn who will pay for those decisions don’t yet vote.
Hopefully, Christie’s plan will at least start a real discussion. A government that is $18 trillion in debt and adding more every year must cut spending, increase tax revenues, or do some combination of both. Other potential presidential candidates – including the two with Arkansas ties, Hillary Clinton and Mike Huckabee – should offer their own concrete proposals, not poll-tested platitudes. Those who want to keep the status quo, or increase spending, or cut taxes should show how they will make the numbers work.
At least then we’d have an honest debate – not just about how big the government should be, but also about how today’s taxpayers pay for the government we already have.
If Christie can’t win that debate, then hopefully someone else can with their own plan that preserves an appropriate social safety net without adding to the debt. We can’t just keep passing government’s costs to our children and grandchildren – like the doc fix does, albeit transparently.