TW: I have posted before about the senior voting bloc. It is large, it votes and it is growing. The Republicans have found political gold in claiming Obamacrats are seeking to slow medical spending on seniors. We are. But then we must slow the rate of increase on medical spending across all demographics or else medical spending will grow from the 8% of GDP of the 1970's to the 16% of the naughties to 30%+ by the 2030s.
Conservative columnist Douthat asks whether the Republicans are opening a pandora's box by pandering so baldly to the 65+ yr voters.
From Ross Douthat at NYT:
"...If the Democratic Party’s attempt at health care reform perishes, senior citizens will have done it in, not talk-radio listeners and Glenn Beck acolytes. It’s the skepticism of over-65 Americans that’s dragging support for reform southward. And it’s their opposition to cost-cutting that makes finding the money to pay for it so difficult.
That’s because they’re the ones whose benefits are on the chopping block. At present, Medicare gives its recipients all the benefits of socialized medicine, with few of the drawbacks. Once you hit 65, the system pays and pays, without regard for efficiency or cost-effectiveness.
...Republicans find themselves tiptoeing into an unfamiliar role — as champions of old-age entitlements.
....You can understand why Republicans, after decades of being demagogued for proposing even modest entitlement reforms, would relish the chance to turn the tables. But this is a perilous strategy for the right.
Medicare’s price tag, if trends continue, will make a mockery of the idea of limited government. For conservatives, no fiscal cause is more important than curbing this exponential growth. And by fighting health care reform with tactics ripped from Democratic playbooks, and enlisting anxious seniors as foot soldiers, conservatives are setting themselves up to win the battle and lose the longer war.
...But for now, their strategy means the country suddenly has two political parties devoted to Mediscaring seniors — which in turn seems likely to make the program more untouchable than ever.
And if you think reform is tough today, just wait. We’re already practically a gerontocracy: Americans over 50 cast over 40 percent of the votes in the 2008 elections, and half the votes in the ’06 midterms. As the population ages — by 2030, there will be more Americans over 65 than under 18 — the power of the elderly and nearly elderly may become almost absolute.
In this future, somebody will need to stand for the principle that Medicare can’t pay every bill and bless every procedure. Somebody will need to defend the younger generation’s promise (and its pocketbooks). Somebody will need to say “no” to retirees.
That’s supposed to be the Republicans’ job. They should stick to doing it."
http://www.nytimes.com/2009/08/17/opinion/17douthat.html?_r=1&scp=1&sq=ross%20douthat%20grandma&st=cse
Showing posts with label Entitlement reform. Show all posts
Showing posts with label Entitlement reform. Show all posts
Sunday, August 30, 2009
Monday, August 24, 2009
Sorry Those Social Security COLAs Should Stay Flat
TW: We are experiencing deflation. Therefore, social security recipients are scheduled to receive no cost of living adjustment in their benefit for 2009 and perhaps 2010. This fact is starting to percolate into public view. I would bet you a bunch of COLAs that Congress (with POTUS support) will ignore the model and vote some sort of COLA increase. That would be wrong and grossly unfair to the rest of the country.
SS recipients booked a 5.8% COLA this past January to reflect the incipient inflation that ultimately reversed course rapidly into deflation. No one complained about that one. More importantly for those working, very few folks received anywhere near a 5.8% increase. In many cases folks were and are taking pay cuts.
The headline to the Huffington piece itself was misleading "Millions of older people face shrinking Social Security checks next year", their checks cannot shrink by law. They will face slightly higher co-pays on certain Medicare treatments, just like all of other Americans will face increases on certain goods. Also like other Americans in a deflationary environment they will enjoy lower costs on other goods.
Times are tough, the pain should be shared as equally as possible. Yet I suspect Congress in a bi-partisan manner will approve a COLA, why? Because seniors vote in big numbers. This would be wrong. This epitomizes why our fiscal future has been and continues to be under very serious stress.
From Huffington Post:
"Millions of older people face shrinking Social Security checks next year, the first time in a generation that payments would not rise. The trustees who oversee Social Security are projecting there won't be a cost of living adjustment (COLA) for the next two years. That hasn't happened since automatic increases were adopted in 1975.
By law, Social Security benefits cannot go down. Nevertheless, monthly payments would drop for millions of people in the Medicare prescription drug program because the premiums, which often are deducted from Social Security payments, are scheduled to go up slightly.
...Advocates say older people still face higher prices because they spend a disproportionate amount of their income on health care, where costs rise faster than inflation. Many also have suffered from declining home values and shrinking stock portfolios just as they are relying on those assets for income.
"For many elderly, they don't feel that inflation is low because their expenses are still going up," said David Certner, legislative policy director for AARP. "Anyone who has savings and investments has seen some serious losses."
...All beneficiaries received a 5.8 percent increase in January, the largest since 1982.
More than 32 million people are in the Medicare prescription drug program. Average monthly premiums are set to go from $28 this year to $30 next year, though they vary by plan. About 6 million people in the program have premiums deducted from their monthly Social Security payments, according to the Social Security Administration."
http://www.huffingtonpost.com/2009/08/23/millions-face-shrinking-s_n_266404.html
SS recipients booked a 5.8% COLA this past January to reflect the incipient inflation that ultimately reversed course rapidly into deflation. No one complained about that one. More importantly for those working, very few folks received anywhere near a 5.8% increase. In many cases folks were and are taking pay cuts.
The headline to the Huffington piece itself was misleading "Millions of older people face shrinking Social Security checks next year", their checks cannot shrink by law. They will face slightly higher co-pays on certain Medicare treatments, just like all of other Americans will face increases on certain goods. Also like other Americans in a deflationary environment they will enjoy lower costs on other goods.
Times are tough, the pain should be shared as equally as possible. Yet I suspect Congress in a bi-partisan manner will approve a COLA, why? Because seniors vote in big numbers. This would be wrong. This epitomizes why our fiscal future has been and continues to be under very serious stress.
From Huffington Post:
"Millions of older people face shrinking Social Security checks next year, the first time in a generation that payments would not rise. The trustees who oversee Social Security are projecting there won't be a cost of living adjustment (COLA) for the next two years. That hasn't happened since automatic increases were adopted in 1975.
By law, Social Security benefits cannot go down. Nevertheless, monthly payments would drop for millions of people in the Medicare prescription drug program because the premiums, which often are deducted from Social Security payments, are scheduled to go up slightly.
...Advocates say older people still face higher prices because they spend a disproportionate amount of their income on health care, where costs rise faster than inflation. Many also have suffered from declining home values and shrinking stock portfolios just as they are relying on those assets for income.
"For many elderly, they don't feel that inflation is low because their expenses are still going up," said David Certner, legislative policy director for AARP. "Anyone who has savings and investments has seen some serious losses."
...All beneficiaries received a 5.8 percent increase in January, the largest since 1982.
More than 32 million people are in the Medicare prescription drug program. Average monthly premiums are set to go from $28 this year to $30 next year, though they vary by plan. About 6 million people in the program have premiums deducted from their monthly Social Security payments, according to the Social Security Administration."
http://www.huffingtonpost.com/2009/08/23/millions-face-shrinking-s_n_266404.html
Thursday, May 14, 2009
Social Security Is NOT Okay
TW: Headlines earlier this week spoke of trustees for Medicare and Social Security warning their respective funds were depleting faster than anticipated. Such headlines imply something that is not real. Then Reich does something several progressive economists and pundits try to do something else which really aggravates me.
First re the headlines, when one speaks of a "fund" one generally perceives an actual pool of money sitting somewhere. But in the case of the Social Security and Medicare "funds" this is just not true, those "funds" are merely paper numbers. There are no pools of money sitting around earning interest or even just sitting around. When you payroll taxes for Social Security and Medicare are deducted from your check that money goes right into the federal budget where it funds the Iraq War, the EPA, and yes current Social Security benefits. Those "trust funds" are merely paper trails keeping track of what one agency of the government is spending versus another but the money all flows through one bucket. When the trustees warn about the funds, they are saying what we all know, our long-term fiscal deficits are very challenging.
Two and related to the above, Reich and others claim Social Security is basically solvent and could continue to be so with relatively minor tweaks. This is true if one only considers Social Security in complete isolation. But the current Social Security "surpluses" of payroll taxes over benefits being paid out to current beneficiaries is what is funding the rest of the budget (which even then is in deficit). Remove the Social Security "surplus" and the net deficit skyrockets even higher.
The reason Reich seeks to frame the discussion this way is because he is afraid, rightly, that Social Security benefits will be traded away during negotiations to address the overall fiscal challenges facing the country. But Reich is wrong that these benefits should be walled off. Social Security benefits should absolutely be part of the discussions on our future fiscal solvency. To make them sacrosanct would be to memorialize yet another sacred cow and continue the shift of our nation's resources from younger generations to older generations.
From Robert Reich's blog:
"What are we to make of yesterday's report from the trustees of the Social Security and Medicare trust funds that Social Security trust will run out of assets in 2037, four years sooner than previously forecast, and Medicare’s hospital fund will be exhausted by 2017, two years earlier than predicted a year ago?
...Even if you assume Social Security is a problem, it's not a big problem. Raise the ceiling slightly on yearly wages subject to Social Security payroll taxes (now a bit over $100,000), and the problem vanishes even under harsher assumptions than I'd use about the future. President Obama suggested this in the campaign and stirred up a hornet's nest because this solution apparently dips too deeply into the middle class, which made him backtrack and begin talking about raising additional Social Security payroll taxes on people earning over $250,000. But Social Security would be in safe shape if it were slightly more means tested, or if the retirement age was raised just a bit. The main point is that Social Security is a tiny problem, as these things go.
...Social Security is a tiny problem..."
http://robertreich.blogspot.com/2009/05/truth-behind-social-security-and.html
First re the headlines, when one speaks of a "fund" one generally perceives an actual pool of money sitting somewhere. But in the case of the Social Security and Medicare "funds" this is just not true, those "funds" are merely paper numbers. There are no pools of money sitting around earning interest or even just sitting around. When you payroll taxes for Social Security and Medicare are deducted from your check that money goes right into the federal budget where it funds the Iraq War, the EPA, and yes current Social Security benefits. Those "trust funds" are merely paper trails keeping track of what one agency of the government is spending versus another but the money all flows through one bucket. When the trustees warn about the funds, they are saying what we all know, our long-term fiscal deficits are very challenging.
Two and related to the above, Reich and others claim Social Security is basically solvent and could continue to be so with relatively minor tweaks. This is true if one only considers Social Security in complete isolation. But the current Social Security "surpluses" of payroll taxes over benefits being paid out to current beneficiaries is what is funding the rest of the budget (which even then is in deficit). Remove the Social Security "surplus" and the net deficit skyrockets even higher.
The reason Reich seeks to frame the discussion this way is because he is afraid, rightly, that Social Security benefits will be traded away during negotiations to address the overall fiscal challenges facing the country. But Reich is wrong that these benefits should be walled off. Social Security benefits should absolutely be part of the discussions on our future fiscal solvency. To make them sacrosanct would be to memorialize yet another sacred cow and continue the shift of our nation's resources from younger generations to older generations.
From Robert Reich's blog:
"What are we to make of yesterday's report from the trustees of the Social Security and Medicare trust funds that Social Security trust will run out of assets in 2037, four years sooner than previously forecast, and Medicare’s hospital fund will be exhausted by 2017, two years earlier than predicted a year ago?
...Even if you assume Social Security is a problem, it's not a big problem. Raise the ceiling slightly on yearly wages subject to Social Security payroll taxes (now a bit over $100,000), and the problem vanishes even under harsher assumptions than I'd use about the future. President Obama suggested this in the campaign and stirred up a hornet's nest because this solution apparently dips too deeply into the middle class, which made him backtrack and begin talking about raising additional Social Security payroll taxes on people earning over $250,000. But Social Security would be in safe shape if it were slightly more means tested, or if the retirement age was raised just a bit. The main point is that Social Security is a tiny problem, as these things go.
...Social Security is a tiny problem..."
http://robertreich.blogspot.com/2009/05/truth-behind-social-security-and.html
Wednesday, May 13, 2009
Lets Just Keep Voting Ourselves More Benefits
TW: This article is about the increasing power of older folks politically in Germany. They have just managed to get themselves an increase in federal pensions amidst the recession even though historically any increases have been tied to private sector wages, which are going down. The last thing Germany likely needs given its serious demographic challenges is further re-distribution of wealth from younger folks to older folks but that is exactly what they are getting.
Many complain about inept politicians but politicians in democracies reflect the will of the people (kind of at least). As voters age they will tend to take care of themselves, just like they did when they were younger. We have the same dynamics. What do YOU want to cut back on? Social security, medical care, defense...if none of the above get ready to pay more taxes.
From NYT:
"The two biggest political parties in Germany spend much of their time these days squabbling over everything from nuclear power to Guantánamo detainees. But in this election season they found time Wednesday to join together on one issue: protecting pension benefits.
With Germany’s federal elections less than five months away, the two parties are competing to win over the bloc of older voters that has become one of the biggest and most powerful segments of the population...
On Wednesday, the German cabinet voted overwhelmingly to prevent any reduction in pensions, agreeing to end a decades-old law that linked pension payments to a rise or fall in average income...meaning that Germany’s 20.2 million pensioners, who make up a quarter of the population, will largely be protected from the impact of the global financial crisis — not only for this year but for 2010 as well.
But things could get even better for pensioners. Several weeks ago the cabinet agreed to actually increase benefits this year...It will be the second increase in pension benefits in the past 12 months.
These measures reflect the growing influence of the pensioners at a time when overall membership in both major parties is shrinking but the percentage of senior voters is rising.
...“Woe to the conservatives or the Social Democrats if they dare ignore the pensioners,” said Gero Neugebauer, political science professor at Berlin’s Free University. “They are one of the main powers in this coming election.”
The protection of benefits comes despite the growing impact of the economic downturn on the German people. Unemployment is rising. Wages are lower. More people are on shorter work weeks. Traditional perks, like extra pay at Christmas time, are being abolished, and the extra month’s pay that many workers received until recently has been scrapped.
...The new legislation will prevent them from declining as wages fall this year.
...But the biggest problem facing all the political parties may be Germany’s birth rate. It remains one of the lowest in Europe — despite attempts by Mrs. Merkel’s government to create incentives, especially for professional women, to have children.
...If the birth rate remains low, an increase in pension benefits now will make it difficult to meet payments for the next generation of elderly. “There are too few people of working age to support the pensioners and when this younger generation reach retirement age, who is going to pay for them?” said Otto Wulff, chairman of the Christian Democrats’ senior citizens association..."
http://www.nytimes.com/2009/05/07/world/europe/07pension.html?_r=1&scp=1&sq=german%20elections&st=cse
Many complain about inept politicians but politicians in democracies reflect the will of the people (kind of at least). As voters age they will tend to take care of themselves, just like they did when they were younger. We have the same dynamics. What do YOU want to cut back on? Social security, medical care, defense...if none of the above get ready to pay more taxes.
From NYT:
"The two biggest political parties in Germany spend much of their time these days squabbling over everything from nuclear power to Guantánamo detainees. But in this election season they found time Wednesday to join together on one issue: protecting pension benefits.
With Germany’s federal elections less than five months away, the two parties are competing to win over the bloc of older voters that has become one of the biggest and most powerful segments of the population...
On Wednesday, the German cabinet voted overwhelmingly to prevent any reduction in pensions, agreeing to end a decades-old law that linked pension payments to a rise or fall in average income...meaning that Germany’s 20.2 million pensioners, who make up a quarter of the population, will largely be protected from the impact of the global financial crisis — not only for this year but for 2010 as well.
But things could get even better for pensioners. Several weeks ago the cabinet agreed to actually increase benefits this year...It will be the second increase in pension benefits in the past 12 months.
These measures reflect the growing influence of the pensioners at a time when overall membership in both major parties is shrinking but the percentage of senior voters is rising.
...“Woe to the conservatives or the Social Democrats if they dare ignore the pensioners,” said Gero Neugebauer, political science professor at Berlin’s Free University. “They are one of the main powers in this coming election.”
The protection of benefits comes despite the growing impact of the economic downturn on the German people. Unemployment is rising. Wages are lower. More people are on shorter work weeks. Traditional perks, like extra pay at Christmas time, are being abolished, and the extra month’s pay that many workers received until recently has been scrapped.
...The new legislation will prevent them from declining as wages fall this year.
...But the biggest problem facing all the political parties may be Germany’s birth rate. It remains one of the lowest in Europe — despite attempts by Mrs. Merkel’s government to create incentives, especially for professional women, to have children.
...If the birth rate remains low, an increase in pension benefits now will make it difficult to meet payments for the next generation of elderly. “There are too few people of working age to support the pensioners and when this younger generation reach retirement age, who is going to pay for them?” said Otto Wulff, chairman of the Christian Democrats’ senior citizens association..."
http://www.nytimes.com/2009/05/07/world/europe/07pension.html?_r=1&scp=1&sq=german%20elections&st=cse
Thursday, May 7, 2009
"We Can't Afford Government"
TW: Cory Booker is a hotshot Democratic politico with ambition. He is laying paper for higher office with quotes like these, but they are true. As I have posted previously, our governments in particular state and local governments have vastly over-promised on wages and benefits to government employees. At some point these increases have to be reined in and eventually pulled back.
I keep pounding on the need for fiscal conservatism at the right time. Once this worldwide recession eases, efforts must be made to either increase taxes or cut spending. At the state and local level taxes generally are already very high if not through the income tax but through various fees, levies, sales taxes etc. Booker knows taxes are not the answer but jabbering about "efficient spending or the occasional earmark" is not the answer either. Government payrolls either through headcount reductions or benefit cuts or both need to be addressed. Of course good luck to any politician trying to implement the obviously needed changes. The solutions are not always complex getting a democratically based populace to acquiesce is a challenge.
From Bloomberg:
"New Jersey’s tax-strapped residents can’t afford their government and the state needs to rein in the mounting costs of public worker benefits, said the mayor of Newark, the state’s largest city. Cory Booker, 40, said rising expenses for health care, pensions and salaries are impinging on government finances.
“New Jersey will go bankrupt in 10 to 20 years because we cannot afford our employees as a state,” Booker said. “I’m talking about every worker from the cities and counties to the state government. Eventually, we’re going to price ourselves out as a government or tax ourselves to death.”
Governor Jon Corzine in March proposed a $29.8 billion spending plan for next fiscal year that includes $4.3 billion to operate state government. Seventy percent of that, $3 billion, is for salaries and wages. Corzine, a first-term Democrat facing re-election in November, is seeking unpaid leaves and an 18- month wage freeze to save $400 million.
In Newark, Booker said he is looking to cut “hundreds” of jobs from the city’s 4,000-person workforce as he seeks to create a long-term balance in the municipality’s budget, which is currently $659 million. The mayor also wants to force city employees to take 18 unpaid days off to help reduce expenses and close an $180 million deficit by 2012.
Personnel accounts for 70 percent of the budget of Newark, Booker said. The first-term Democrat said the employment reduction was among “very difficult decisions” he faces.
“There should be a tax revolt in the state of New Jersey,” Booker said. “We’re the most inefficient state in the country. We have more government per person than we need. You would never manage a business the way we manage our government - - we have overlapping provision of services and in my opinion, it’s insane...”
http://www.bloomberg.com/apps/news?pid=20601103&sid=a6g6isp6ZlCI&refer=us
I keep pounding on the need for fiscal conservatism at the right time. Once this worldwide recession eases, efforts must be made to either increase taxes or cut spending. At the state and local level taxes generally are already very high if not through the income tax but through various fees, levies, sales taxes etc. Booker knows taxes are not the answer but jabbering about "efficient spending or the occasional earmark" is not the answer either. Government payrolls either through headcount reductions or benefit cuts or both need to be addressed. Of course good luck to any politician trying to implement the obviously needed changes. The solutions are not always complex getting a democratically based populace to acquiesce is a challenge.
From Bloomberg:
"New Jersey’s tax-strapped residents can’t afford their government and the state needs to rein in the mounting costs of public worker benefits, said the mayor of Newark, the state’s largest city. Cory Booker, 40, said rising expenses for health care, pensions and salaries are impinging on government finances.
“New Jersey will go bankrupt in 10 to 20 years because we cannot afford our employees as a state,” Booker said. “I’m talking about every worker from the cities and counties to the state government. Eventually, we’re going to price ourselves out as a government or tax ourselves to death.”
Governor Jon Corzine in March proposed a $29.8 billion spending plan for next fiscal year that includes $4.3 billion to operate state government. Seventy percent of that, $3 billion, is for salaries and wages. Corzine, a first-term Democrat facing re-election in November, is seeking unpaid leaves and an 18- month wage freeze to save $400 million.
In Newark, Booker said he is looking to cut “hundreds” of jobs from the city’s 4,000-person workforce as he seeks to create a long-term balance in the municipality’s budget, which is currently $659 million. The mayor also wants to force city employees to take 18 unpaid days off to help reduce expenses and close an $180 million deficit by 2012.
Personnel accounts for 70 percent of the budget of Newark, Booker said. The first-term Democrat said the employment reduction was among “very difficult decisions” he faces.
“There should be a tax revolt in the state of New Jersey,” Booker said. “We’re the most inefficient state in the country. We have more government per person than we need. You would never manage a business the way we manage our government - - we have overlapping provision of services and in my opinion, it’s insane...”
http://www.bloomberg.com/apps/news?pid=20601103&sid=a6g6isp6ZlCI&refer=us
Wednesday, April 22, 2009
Where Reich (And the Left) Is Wrong
TW: Reich makes three points: 1) social security is not broken therefore leave it alone, 2) reforming Medicare will solve all problems without cutting much if anything, 3) screw the Republicans
Re #1: Reich and others on the left state a truism- the social security program in isolation is in fact more or less solvent if relatively minor tweaks are made to the future cash flows (either raise the taxes or cut the benefits). The challenge with that approach is that while the social security program may exist in a vacuum outside of the rest of the federal budget in theory it most definitely does not in practice. The social security surpluses have subsidized the rest of the budget for decades as the social security program moves from surplus to deficit the balance of the budget will come under tremendous stress. The social security program will need to take cuts in order to help support the rest of the program unless folks are comfortable with even more drastic reductions in health care and defense expenditures than will be needed otherwise. Seeking to treat the SS program in isolation is knowingly placing blinders on one's head.
Re #2: yes reform is needed but reform without acknowledging Americans consume much more service than they can afford is to deny reality. Those on the left seem to think that "reform" will magically solve the problem without pain, those on the right seem to believe if everything is privatized a similar if different magic world will result. Americans consume much more health care than almost any other nation whilst achieving results barely better than most. We are inefficient that means fewer services and lower pricing is needed. There are no magic wands, we have a complex, confusing, inefficient public/private hybrid that feeds on more and more services and reduced risks to the patients and providers. We need fewer services and for consumers to assume and get comfortable with more risks.
Re #3: while I would love to tell many Republicans to go pound (and many deserve it), one does not govern effectively that way. Obama knows this, but he will continually face chirping from the left to do so, which is fine it makes him appear more moderate.
From Robert Reich:
"...Obama must be careful not to put entitlement programs on the chopping block as part of a "grand bargain" to elicit Republican support for health care and cap-and-trade. Social Security is not in dire straights; it can be made flush for the next 75 years by ever-so-slightly lifting the ceiling on the portion of income subject to Social Security payroll taxes (and if Democrats are reluctant to do that on incomes over $100,000, then they could do so on incomes over $250,000).
Medicaid and Medicare are in trouble because health care costs are rising so fast, which argues for health-care reform rather than cuts in these important programs. Yet if health-care reform has any prayer of controlling the rising tide of health care costs, the plan must allow beneficiaries to opt into a public insurance plan -- something Republicans and the health-care establishment are determined to fight. So it's critically important that the Senate wrap health care into a reconciliation bill that can be enacted by a majority vote in the Senate.Obama should fast-track health care and stop trying to court Republicans. Every House Republican and all but three Senate Republicans voted against the stimulus; all Republicans in both houses voted against the budget. During the recess they hosted "tea parties" claiming that Americans are over-taxed. Over the weekend, House minority leader John Boehner called the idea of carbon-induced climate change "almost comical." Republicans are already off and running toward the midterm elections of 2010, even starting to run ads against House Democrats in close districts. They seem hell bent on on becoming a tiny, whacky minority -- the party that denies evolution, denies global warming, denies Americans need a major overhaul of health care, and denies the economy needs anything more than a major tax cut to get it moving again. The less Obama caters to them the better."
http://robertreich.blogspot.com/2009/04/where-government-spending-should-be.html
Re #1: Reich and others on the left state a truism- the social security program in isolation is in fact more or less solvent if relatively minor tweaks are made to the future cash flows (either raise the taxes or cut the benefits). The challenge with that approach is that while the social security program may exist in a vacuum outside of the rest of the federal budget in theory it most definitely does not in practice. The social security surpluses have subsidized the rest of the budget for decades as the social security program moves from surplus to deficit the balance of the budget will come under tremendous stress. The social security program will need to take cuts in order to help support the rest of the program unless folks are comfortable with even more drastic reductions in health care and defense expenditures than will be needed otherwise. Seeking to treat the SS program in isolation is knowingly placing blinders on one's head.
Re #2: yes reform is needed but reform without acknowledging Americans consume much more service than they can afford is to deny reality. Those on the left seem to think that "reform" will magically solve the problem without pain, those on the right seem to believe if everything is privatized a similar if different magic world will result. Americans consume much more health care than almost any other nation whilst achieving results barely better than most. We are inefficient that means fewer services and lower pricing is needed. There are no magic wands, we have a complex, confusing, inefficient public/private hybrid that feeds on more and more services and reduced risks to the patients and providers. We need fewer services and for consumers to assume and get comfortable with more risks.
Re #3: while I would love to tell many Republicans to go pound (and many deserve it), one does not govern effectively that way. Obama knows this, but he will continually face chirping from the left to do so, which is fine it makes him appear more moderate.
From Robert Reich:
"...Obama must be careful not to put entitlement programs on the chopping block as part of a "grand bargain" to elicit Republican support for health care and cap-and-trade. Social Security is not in dire straights; it can be made flush for the next 75 years by ever-so-slightly lifting the ceiling on the portion of income subject to Social Security payroll taxes (and if Democrats are reluctant to do that on incomes over $100,000, then they could do so on incomes over $250,000).
Medicaid and Medicare are in trouble because health care costs are rising so fast, which argues for health-care reform rather than cuts in these important programs. Yet if health-care reform has any prayer of controlling the rising tide of health care costs, the plan must allow beneficiaries to opt into a public insurance plan -- something Republicans and the health-care establishment are determined to fight. So it's critically important that the Senate wrap health care into a reconciliation bill that can be enacted by a majority vote in the Senate.Obama should fast-track health care and stop trying to court Republicans. Every House Republican and all but three Senate Republicans voted against the stimulus; all Republicans in both houses voted against the budget. During the recess they hosted "tea parties" claiming that Americans are over-taxed. Over the weekend, House minority leader John Boehner called the idea of carbon-induced climate change "almost comical." Republicans are already off and running toward the midterm elections of 2010, even starting to run ads against House Democrats in close districts. They seem hell bent on on becoming a tiny, whacky minority -- the party that denies evolution, denies global warming, denies Americans need a major overhaul of health care, and denies the economy needs anything more than a major tax cut to get it moving again. The less Obama caters to them the better."
http://robertreich.blogspot.com/2009/04/where-government-spending-should-be.html
Wednesday, April 15, 2009
Obama Gets It Do You?
From POTUS Obama April 14, 2009
"For too long, too many in Washington put off hard decisions for some other time on some other day. There's been a tendency to score political points instead of rolling up sleeves to solve real problems. There is also an impatience that characterizes this town – an attention span that has only grown shorter with the twenty-four hour news cycle, and insists on instant gratification in the form of immediate results or higher poll numbers. When a crisis hits, there's all too often a lurch from shock to trance, with everyone responding to the tempest of the moment until the furor has died away and the media coverage has moved on, instead of confronting the major challenges that will shape our future in a sustained and focused way. This can't be one of those times. The challenges are too great. The stakes are too high. I know how difficult it is for Members of Congress in both parties to grapple with some of the big decisions we face right now. It's more than most congresses and most presidents have to deal with in a lifetime."
TW: Easy to say difficult to execute. Certainly W. Bush was not capable of pushing this rock, but neither was Clinton. I get the feeling Obama is. Our fiscal future is very challenging, for the past thirty years the can has been kicked down the road in a bipartisan manner. Again I apply my very simple filter, if a politican proposes fiscal measures that deal with either:
1) reducing defense/homeland security spending
2) reducing social security
3) reducing medicare/medicaid
4) raising taxes
Then I take her seriously, if not he is posing and/or ignorant of reality.
Timing is everything, reducing spending or raising net taxes amidst a massive economic contraction is not the answer but defining policies that will do one or both once growth returns is. Below is the latest pro forma for the social security fund piece of the budget. The forecast is cratering because revenues are plunging due to the Great Contraction. Tax revenues are like business revenues, you can cut costs but at the end of the day a good business requires strong revenues, we must get the economy fixed before focusing on deficits.
In the longer run social security benefits will have to be reduced in one form or the other (as will health care spending and probably defense). The sooner we act the better. Social Security has been a third rail of politics not because no one knows what to do but because a clear majority of the populace does not want to face up to realities. It is time.
"For too long, too many in Washington put off hard decisions for some other time on some other day. There's been a tendency to score political points instead of rolling up sleeves to solve real problems. There is also an impatience that characterizes this town – an attention span that has only grown shorter with the twenty-four hour news cycle, and insists on instant gratification in the form of immediate results or higher poll numbers. When a crisis hits, there's all too often a lurch from shock to trance, with everyone responding to the tempest of the moment until the furor has died away and the media coverage has moved on, instead of confronting the major challenges that will shape our future in a sustained and focused way. This can't be one of those times. The challenges are too great. The stakes are too high. I know how difficult it is for Members of Congress in both parties to grapple with some of the big decisions we face right now. It's more than most congresses and most presidents have to deal with in a lifetime."
TW: Easy to say difficult to execute. Certainly W. Bush was not capable of pushing this rock, but neither was Clinton. I get the feeling Obama is. Our fiscal future is very challenging, for the past thirty years the can has been kicked down the road in a bipartisan manner. Again I apply my very simple filter, if a politican proposes fiscal measures that deal with either:
1) reducing defense/homeland security spending
2) reducing social security
3) reducing medicare/medicaid
4) raising taxes
Then I take her seriously, if not he is posing and/or ignorant of reality.
Timing is everything, reducing spending or raising net taxes amidst a massive economic contraction is not the answer but defining policies that will do one or both once growth returns is. Below is the latest pro forma for the social security fund piece of the budget. The forecast is cratering because revenues are plunging due to the Great Contraction. Tax revenues are like business revenues, you can cut costs but at the end of the day a good business requires strong revenues, we must get the economy fixed before focusing on deficits.
In the longer run social security benefits will have to be reduced in one form or the other (as will health care spending and probably defense). The sooner we act the better. Social Security has been a third rail of politics not because no one knows what to do but because a clear majority of the populace does not want to face up to realities. It is time.
Friday, March 20, 2009
Health Care: Another Treatment Example
TW: I found this example interesting in that it frames several issues: skewed incentives for the service providers, lack of standards and insurance myopia amongst others. An example of how system frequently incentivizes neither quality nor efficiency.
From Int'l Herald Tribune:
"When Gail Kislevitz had an MRI scan of her knee, it came back blurry, "uninterpretable," her orthopedist told her.
Her insurer refused to pay for another scan, but the doctor said he was sure she had torn cartilage that stabilizes the knee and suggested an operation to fix it. After the surgery, Kislevitz, 57, of Ridgewood, New Jersey, received a surprise: the cartilage had not been torn after all.
She had a long rehabilitation. And her insurer paid for the operation. But her knee is no better.
More than 95 million high-tech scans are done each year, and medical imaging, including CT, MRI and PET scans, has ballooned into a $100-billion-a-year industry in the United States, with Medicare paying for $14 billion of that. But recent studies show that as many as 20 percent to 50 percent of the procedures should never have been done because their results did not help diagnose ailments or treat patients.
"The system is just totally, totally broken," said Dr. Vijay Rao, the chairwoman of the radiology department at Thomas Jefferson University Hospital, in Philadelphia.
Radiologists say a decent MRI scan should have clearly shown whether Kislevitz's cartilage, a meniscus, was torn. But bad scans, medical experts say, are part of a growing problem with medical imaging.
Many factors contribute. Insurers pay the same for a scan done on a 10-year-old machine as for one on the latest model, though the differences in the images can be significant.
Insurers do not distinguish between scans that are done poorly or done well or read by less- or more-qualified doctors. Aside from mammography, whose standards were established by a law that went into effect more than a decade ago, the field is largely unregulated in the United States. And increasingly, doctors refer patients to scanning centers they own and profit from.
...But logical as it might seem to pay more for a better scan, there are problems. Health insurers have no way of knowing whether scans are good, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, a trade group. Doctors, not insurers, receive the images and reports, and all insurers can do is notice if there are frequent requests to redo scans from a particular center.
"We see a lot of poor-quality scans," said Dr. Freddie Fu, the chief of orthopedic surgery at the University of Pittsburgh Medical Center. "I joke with the patients: The insurance pays the same amount of money for the scan. You get a hamburger somewhere else and a prime rib here for the same price."
Another concern is the growing number of doctors who refer patients for imaging done by scanners they own and profit from. Studies have found that up to 3.2 times as many scans are ordered in such cases.
In a recent report, the Government Accountability Office said nearly two-thirds of the money Medicare paid for imaging was for scans in doctors' offices. And, the report added, doctors were receiving an ever larger part of their income from providing scanning services. Not only were patients more likely to have scans if a doctor did this, but the quality of some of the scans was questioned. "It's all profits," said Dr. Bruce Hillman, a radiology professor at the University of Virginia, adding that a group of doctors can make an extra $500,000 to $1 million a year simply by acquiring a scanner."
From Int'l Herald Tribune:
"When Gail Kislevitz had an MRI scan of her knee, it came back blurry, "uninterpretable," her orthopedist told her.
Her insurer refused to pay for another scan, but the doctor said he was sure she had torn cartilage that stabilizes the knee and suggested an operation to fix it. After the surgery, Kislevitz, 57, of Ridgewood, New Jersey, received a surprise: the cartilage had not been torn after all.
She had a long rehabilitation. And her insurer paid for the operation. But her knee is no better.
More than 95 million high-tech scans are done each year, and medical imaging, including CT, MRI and PET scans, has ballooned into a $100-billion-a-year industry in the United States, with Medicare paying for $14 billion of that. But recent studies show that as many as 20 percent to 50 percent of the procedures should never have been done because their results did not help diagnose ailments or treat patients.
"The system is just totally, totally broken," said Dr. Vijay Rao, the chairwoman of the radiology department at Thomas Jefferson University Hospital, in Philadelphia.
Radiologists say a decent MRI scan should have clearly shown whether Kislevitz's cartilage, a meniscus, was torn. But bad scans, medical experts say, are part of a growing problem with medical imaging.
Many factors contribute. Insurers pay the same for a scan done on a 10-year-old machine as for one on the latest model, though the differences in the images can be significant.
Insurers do not distinguish between scans that are done poorly or done well or read by less- or more-qualified doctors. Aside from mammography, whose standards were established by a law that went into effect more than a decade ago, the field is largely unregulated in the United States. And increasingly, doctors refer patients to scanning centers they own and profit from.
...But logical as it might seem to pay more for a better scan, there are problems. Health insurers have no way of knowing whether scans are good, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, a trade group. Doctors, not insurers, receive the images and reports, and all insurers can do is notice if there are frequent requests to redo scans from a particular center.
"We see a lot of poor-quality scans," said Dr. Freddie Fu, the chief of orthopedic surgery at the University of Pittsburgh Medical Center. "I joke with the patients: The insurance pays the same amount of money for the scan. You get a hamburger somewhere else and a prime rib here for the same price."
Another concern is the growing number of doctors who refer patients for imaging done by scanners they own and profit from. Studies have found that up to 3.2 times as many scans are ordered in such cases.
In a recent report, the Government Accountability Office said nearly two-thirds of the money Medicare paid for imaging was for scans in doctors' offices. And, the report added, doctors were receiving an ever larger part of their income from providing scanning services. Not only were patients more likely to have scans if a doctor did this, but the quality of some of the scans was questioned. "It's all profits," said Dr. Bruce Hillman, a radiology professor at the University of Virginia, adding that a group of doctors can make an extra $500,000 to $1 million a year simply by acquiring a scanner."
Wednesday, January 28, 2009
We Have Made Promises We Cannot Keep
TW: Have spoken of this before but our public employee retirement liabilities both health care and pensions are nearly out of control. Over the past twenty years of relatively good economic growth, instead of storing more nuts we have been promising more nuts than the relatively good economic times created. The piper will eventually have to be paid (i.e. reduced benefits) but public employees will not like it one bit.
The current Illinois situation is merely a prelude.
From Economist:
"[IL's] five pension funds are looking pasty. Illinois has $54.4 billion of unfunded pension liabilities, with just 54% of the assets it needs to pay for future promises to its workers; 80% is the proportion experts usually consider adequate. These figures, the most recent available, are from June 2008. Since then, they have probably got worse.[TW: not probably and not a little, alot worse].
Other states face similar woes. A sample of 109 state pension funds lost $865 billion, about 30% of their value, between October 2007 and December 2008
State and local governments’ retirement plans differ greatly from those in the private sector. In 2006, according to the CRR, over 60% of private workers with a retirement plan relied on a defined-contribution scheme such as a 401(k) account. Workers bear the risks of the market; many cheer when their accounts rise, but watch in anguish as they plummet. State and local workers, however, should be more calm. In 2006 80% of them relied on defined-benefit plans, which pay a pension based on wages and years on the job. The employer, not the worker, weathers market turmoil. What is more, public pensions are often protected by a state’s constitution, as in Illinois.
Before the financial collapse most states were moving towards full funding. In the CRR’s sample of pension plans, about 60% had funding ratios of at least 80% in 2006. The problem then seemed to be health-care liabilities, which states usually pay for out of general revenues rather than invested trust funds. The financial mayhem, however, has put pensions back in the spotlight.
Private defined-benefit plans are under most pressure. Firms, thanks to a law passed in 2006, face strict rules for shoring up their obligations. States have more leeway, but many will have to pump more money into their pension funds to offset losses on the market. Some states have been more battered than others. The value of America’s biggest pension fund, the California Public Employees’ Retirement System, shrank from $253 billion at the end of 2007 to $181 billion in November 2008. Trouble descended on cities as well. Philadelphia’s pension fund lost 23% of its value in 2008, according to the city’s controller.
Illinois’s pension funds were skimpy even before the crisis. “The big-picture problem for Illinois has nothing to do with markets,” explains William Atwood, director of the state board of investments. “It has to do with policymakers’ decisions to allocate money to places other than pensions.” After years of starving its retirement systems, in 1995 the state adopted a plan to ensure that its ratio of assets to liabilities reached 90% by 2045. But this was scuppered by generous new benefits for workers and lax payments to the funds themselves. Meagre returns have not helped. In June 2008 the state’s five pension funds had $64.7 billion in assets. At the end of October they had $50.5 billion.
...Illinois could follow a few other states and pass reforms for new workers. Kentucky’s changes include setting a minimum retirement age. New employees in Kansas must give a bigger share of their wages to the retirement fund. But current workers’ pensions are protected by law. Past promises remain a heavy burden.
...“Taxpayers”, explains the CRR’s Alicia Munnell, “will have to ante up.” The main question is when, and how much."
http://tinyurl.com/c87j55
The current Illinois situation is merely a prelude.
From Economist:
"[IL's] five pension funds are looking pasty. Illinois has $54.4 billion of unfunded pension liabilities, with just 54% of the assets it needs to pay for future promises to its workers; 80% is the proportion experts usually consider adequate. These figures, the most recent available, are from June 2008. Since then, they have probably got worse.[TW: not probably and not a little, alot worse].
Other states face similar woes. A sample of 109 state pension funds lost $865 billion, about 30% of their value, between October 2007 and December 2008
State and local governments’ retirement plans differ greatly from those in the private sector. In 2006, according to the CRR, over 60% of private workers with a retirement plan relied on a defined-contribution scheme such as a 401(k) account. Workers bear the risks of the market; many cheer when their accounts rise, but watch in anguish as they plummet. State and local workers, however, should be more calm. In 2006 80% of them relied on defined-benefit plans, which pay a pension based on wages and years on the job. The employer, not the worker, weathers market turmoil. What is more, public pensions are often protected by a state’s constitution, as in Illinois.
Before the financial collapse most states were moving towards full funding. In the CRR’s sample of pension plans, about 60% had funding ratios of at least 80% in 2006. The problem then seemed to be health-care liabilities, which states usually pay for out of general revenues rather than invested trust funds. The financial mayhem, however, has put pensions back in the spotlight.
Private defined-benefit plans are under most pressure. Firms, thanks to a law passed in 2006, face strict rules for shoring up their obligations. States have more leeway, but many will have to pump more money into their pension funds to offset losses on the market. Some states have been more battered than others. The value of America’s biggest pension fund, the California Public Employees’ Retirement System, shrank from $253 billion at the end of 2007 to $181 billion in November 2008. Trouble descended on cities as well. Philadelphia’s pension fund lost 23% of its value in 2008, according to the city’s controller.
Illinois’s pension funds were skimpy even before the crisis. “The big-picture problem for Illinois has nothing to do with markets,” explains William Atwood, director of the state board of investments. “It has to do with policymakers’ decisions to allocate money to places other than pensions.” After years of starving its retirement systems, in 1995 the state adopted a plan to ensure that its ratio of assets to liabilities reached 90% by 2045. But this was scuppered by generous new benefits for workers and lax payments to the funds themselves. Meagre returns have not helped. In June 2008 the state’s five pension funds had $64.7 billion in assets. At the end of October they had $50.5 billion.
...Illinois could follow a few other states and pass reforms for new workers. Kentucky’s changes include setting a minimum retirement age. New employees in Kansas must give a bigger share of their wages to the retirement fund. But current workers’ pensions are protected by law. Past promises remain a heavy burden.
...“Taxpayers”, explains the CRR’s Alicia Munnell, “will have to ante up.” The main question is when, and how much."
http://tinyurl.com/c87j55
Saturday, January 24, 2009
Why Reform Is So Damn Hard: A Medicare Example
TW: As Obama embarks on his crusade, one issue that almost all agree must be addressed else it suck the marrow out of our fiscal bones is Medicare. But the Atlantic frames an example of why reforming Medicare is so infuriatingly difficult. This example merely addresses trying to reduce the price Medicare paid for some medical equipment. Never forget your cost is someone else's revenue.
From Atlantic:
"How hard will it be for President Obama to fulfill his campaign promise to reform the health care system by the end of the first term? The answer, of course, is "very." In large measure, this is because reform requires trade-offs and nobody's volunteering to make them. When the ball gets rolling, look for Big Insurance, Big Pharma and their ilk to push back the hardest against reforms that threaten their bottom lines (or even their entire business models). But let's not forget Big Durable Medical Equipment Suppliers.
...Starting in 2007, the federal agency that runs the Medicare program started implementing a congressionally mandated new competitive bidding process for durable medical equipment, known in Medicare circles as DME. As of July 1, 2008, suppliers in 10 metropolitan areas were supposed to be subject to the bidding process and only winning bidders could provide supplies to the lucrative Medicare market. The program was to phase in nationwide over several years. Compared to overhauling the entire health care system, this was small potatoes. Only it never happened. The DME industry's mounted a lobbying campaign, resulting in an 18-month delay of the bidding program. I covered their lobbying efforts pretty extensively. In the process, learned that rearranging even a relatively small corner of the health care market can be very, very hard indeed.
The concept behind the DME competitive bidding program was simple: If suppliers of oxygen tanks, power wheelchairs, canes, diabetes test strips . . . etc . . . etc . . . etc . . . were forced to submit bids to offer their wares to Medicare beneficiaries on a regional basis, the government would save money.
The impetus behind this program was also simple: a federal audit in 2006 concluded that Medicare was grossly overpaying for these products. Noticing that Medicare spending on durable medical equipment was skyrocketing (and not knowing why) the auditors dug down into the numbers.
They started, cleverly enough, with prices. For example, they compared the Medicare rate for oxygen tanks to the retail price. The result? Medicare paid $7,215 to rent this equipment, when comparable devices were available through internet vendors for $587. No, that is not a typo. Thus was born the competitive bidding program.
The Bush administration said it would reduce government spending on durable medical equipment by 26%. DME companies, including heavyweights like Invacare and Lincare, went to war to stop it. They had lots of complaints, chief among them was the fact that the auditors' report did not account for their costs to service the equipment they rented or sold.
Of course, in grand lobbying fashion, they also griped about the bidding process, threatening to go out of business of prices were set that law, and issuing dire warnings about grandmas choking for breath while their oxygen tanks went unfilled. And in grand lobbying fashion, lawmakers were swayed by their efforts. Though they did extract a tribute of sorts, in the form of a 9.5 percent cut in Medicare fees for the equipment, Congress delayed the competitive bidding program, which died on the vine.
Despite near-universal recognition on the part of Congress that Medicare spends too much on this equipment, legislators found they just could not stomach the political or economic disruption that would result from market intervention. Congress-the same folks charged with translating Obama's health care platform into legislation-blanched at taking a tiny baby step towards tackling rising health care spending in this one small area of our massive healthcare market. Rinse and repeat with insurers, doctors, nurses, and pharmaceutical companies, and you've got some idea of the herculean task facing Obama and his allies if they want to get serious about health care reform."
http://business.theatlantic.com/2009/01/pay_up_or_grandma_gets_it_the_perils_of_medicare_reform.php
From Atlantic:
"How hard will it be for President Obama to fulfill his campaign promise to reform the health care system by the end of the first term? The answer, of course, is "very." In large measure, this is because reform requires trade-offs and nobody's volunteering to make them. When the ball gets rolling, look for Big Insurance, Big Pharma and their ilk to push back the hardest against reforms that threaten their bottom lines (or even their entire business models). But let's not forget Big Durable Medical Equipment Suppliers.
...Starting in 2007, the federal agency that runs the Medicare program started implementing a congressionally mandated new competitive bidding process for durable medical equipment, known in Medicare circles as DME. As of July 1, 2008, suppliers in 10 metropolitan areas were supposed to be subject to the bidding process and only winning bidders could provide supplies to the lucrative Medicare market. The program was to phase in nationwide over several years. Compared to overhauling the entire health care system, this was small potatoes. Only it never happened. The DME industry's mounted a lobbying campaign, resulting in an 18-month delay of the bidding program. I covered their lobbying efforts pretty extensively. In the process, learned that rearranging even a relatively small corner of the health care market can be very, very hard indeed.
The concept behind the DME competitive bidding program was simple: If suppliers of oxygen tanks, power wheelchairs, canes, diabetes test strips . . . etc . . . etc . . . etc . . . were forced to submit bids to offer their wares to Medicare beneficiaries on a regional basis, the government would save money.
The impetus behind this program was also simple: a federal audit in 2006 concluded that Medicare was grossly overpaying for these products. Noticing that Medicare spending on durable medical equipment was skyrocketing (and not knowing why) the auditors dug down into the numbers.
They started, cleverly enough, with prices. For example, they compared the Medicare rate for oxygen tanks to the retail price. The result? Medicare paid $7,215 to rent this equipment, when comparable devices were available through internet vendors for $587. No, that is not a typo. Thus was born the competitive bidding program.
The Bush administration said it would reduce government spending on durable medical equipment by 26%. DME companies, including heavyweights like Invacare and Lincare, went to war to stop it. They had lots of complaints, chief among them was the fact that the auditors' report did not account for their costs to service the equipment they rented or sold.
Of course, in grand lobbying fashion, they also griped about the bidding process, threatening to go out of business of prices were set that law, and issuing dire warnings about grandmas choking for breath while their oxygen tanks went unfilled. And in grand lobbying fashion, lawmakers were swayed by their efforts. Though they did extract a tribute of sorts, in the form of a 9.5 percent cut in Medicare fees for the equipment, Congress delayed the competitive bidding program, which died on the vine.
Despite near-universal recognition on the part of Congress that Medicare spends too much on this equipment, legislators found they just could not stomach the political or economic disruption that would result from market intervention. Congress-the same folks charged with translating Obama's health care platform into legislation-blanched at taking a tiny baby step towards tackling rising health care spending in this one small area of our massive healthcare market. Rinse and repeat with insurers, doctors, nurses, and pharmaceutical companies, and you've got some idea of the herculean task facing Obama and his allies if they want to get serious about health care reform."
http://business.theatlantic.com/2009/01/pay_up_or_grandma_gets_it_the_perils_of_medicare_reform.php
Friday, January 16, 2009
"We Have Kicked the Can Down the Road For Too Long"
TW: Obama is absolutely right about Americans, not our government but us as Americans, have kicked the entitlement can down the road. Everyone knows we have over promised on Medicare and Social Security (and government employee pensions as well), but few are willing to confront potential solutions. Many talk about solutions and perhaps that is all Obama will do but I have hopes that he will be the one to actually confront the options and campaign to enact solutions.
From WaPo:
"President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements..."We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect.
...Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said."
http://voices.washingtonpost.com/thefix/2009/01/obama_to_hold_fiscal_responsib.html?wprss=thefix
From WaPo:
"President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements..."We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect.
...Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said."
http://voices.washingtonpost.com/thefix/2009/01/obama_to_hold_fiscal_responsib.html?wprss=thefix
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