The Center on Budget and Policy Priorities (link;
http://www.cbpp.org/) has presented a report entitled “A Balanced Approach to Restoring Fiscal Responsibility”. The report was prepared by sixteen leading economists and budget experts. It is a critique of a recent proposal, “Taking Back Our Fiscal Future” built around a formula designed to trigger automatic budget cuts in the face of budget deficits. Prior efforts like this have failed. See http://www.brookings.edu/~/media/Files/rc/papers/2008/04_fiscal_future/04_fiscal_future.pdf for more details. This approach would address future federal budget deficits by making significant changes in budget procedures for Social Security, Medicare, and Medicaid. However, it is believed that a better approach than this can be identified, and given the sizable budget deficits, and the significant amount of outstanding debt accumulated by the federal government, this is an important issue. Here is the link to the report, “A Balanced Approach to Restoring Fiscal Responsibility”; http://www.cbpp.org/7-9-08bud.pdf.
The authors of the report “A Balanced Approach to Restoring Fiscal Responsibility” agree that the United States faces large and persistent budget deficits. Underlying this condition are the obligations related to Social Security, Medicare, and Medicaid. The authors suggest that an approach to dealing with the budget deficit can be identified that does not adversely affect the poor, and access to health care. They further argue that actions designed to restrain the growth of health care costs and reforming the tax code would better address the deficit situation than those identified in “Taking Back Our Fiscal Future”.
Specific criticism related to “Taking Back Our Fiscal Future” includes the following points. The first criticism is that the plan is unbalanced in that it would lead to automatic reductions to Social Security, Medicare, and Medicaid, but not reduce deficit financed tax cuts. In fact, the tax cuts enacted between 2001 and 2003 were heavily weighted to wealthier citizens and the costs related to these tax cuts are significantly greater than the entire Social Security shortfall. Instead, shared sacrifice is advocated in the Center on Budget and Policy Priorities report. A second criticism is that “Taking Back Our Fiscal Future” would lead to significant reductions in Medicare, and Medicaid without first taking steps to control health care spending in the United States as a whole. Finally, mandated reductions in spending on some programs do not necessarily mean that Congress and the President will reduce overall levels of spending. Reductions in programs like Social Security, Medicare, and Medicaid may occur, but spending increases may occur in other areas of the budget.
Instead, the authors of “A Balanced Approach to Restoring Fiscal Responsibility” advocate shared responsibility. Their recommendations are to adopt the recommendations made by Congress’ Medicare Advisory Commission (MedPAC), increase the Medicare premiums paid by more affluent people, and more vigorously research opportunities to evaluate the disparities in the cost of health care across the country and better evaluate the effectiveness of treatments and procedures. The MedPAC recommendations include advocating the elimination of overpayments to private insurance companies in the Medicare advantage (MA) program. This was partially addressed by Congress on July 10, 2008. Further reductions will require greater national health care reform. Additional proposals include reducing unproductive tax expenditures and loopholes, switching to a more accurate measure of inflation as measured by the Bureau of Labor Statistics used to compute annual cost-of-living adjustments in Social Security and other entitlement spending. Furthermore, the authors advocate Pay-As-You-Go rules for both increases in mandatory government programs and tax cuts and as a result finding a way to pay for these. The last recommendation was to reform farm price supports.