Silicon Investor (SI) -- The First Internet Community

STOCKTALK

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor. We ask that you disable ad blocking while on Silicon Investor in the best interests of our community. If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.

Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: John Carragher who wrote (21898)	12/28/2003 1:22:30 PM
From: LindyBill	Respond to of 793625

Country must start facing fiscal realities A nonpartisan budget report projects a deep hole, and soon. Matthew Miller is a syndicated writer and a senior fellow at the Center for American Progress. Philidelphia Inquirer A Christmas gift from the nonpartisan Congressional Budget Office in the form of a report titled "The Long-Term Budget Outlook" offers a depressing reminder of how deep our fiscal crisis will be when baby boomers start to retire in a few years - and how both President Bush and his potential Democratic foes are ignoring the hard choices ahead. Without making your eyes glaze over with the numbers, here's the CBO's basic message: The trajectory of federal spending in health care, when combined with the lower revenue path implicit in the tax cuts the President has enacted, is leading America toward an explosion of debt that is unsustainable. The current "plan" would also leave us with a government able to do little more than fund health care and pensions for seniors. The CBO's other clear message is that the changes this fiscal collision will entail for programs such as Social Security and Medicare (as well as for our tax structure) are better made sooner than later. This is the only way to assure that Americans can intelligently plan for their retirement, and that the costs of adjustment are shared by different generations over several decades - not imposed suddenly in a crisis. Unfortunately, the CBO's analysis, with options coolly laid out to address the coming crisis, isn't echoed anywhere on the campaign trail - where both parties operate on the principle that some facts are simply too unpleasant (and thus too risky) to share with the American public. Take Social Security, about which the "debate" has been predictably unhelpful. The Republican Party has pledged, most recently in the 2002 election, "to oppose any proposal that would cut benefits, raise taxes, or raise the retirement age." Democrats hold these positions, too. Sounds great, except that, as the CBO report points out, to keep Social Security solvent we'll soon have to do some of the following: cut future benefits, raise taxes, and raise the retirement age. It's comforting to know both parties have categorically ruled out anything that might solve the problem - and to see them bristle at the notion that any scoundrel would suggest otherwise. The Medicare debate is equally courageous. The CBO catalogs several macro-level options for slowing the growth of federal health spending. You can reduce the number of people receiving benefits. You can reduce the share of health costs paid by the government. Or you can somehow reduce total health costs per beneficiary (ideally by reengineering health-care delivery to deliver the same or greater quality for less). Sounds straightforward, right? Not for our fearless leaders. The President hides behind the rhetoric of increased "choice" in health care while ruling out ways government might negotiate better prices in high-cost areas such as prescription drugs. Howard Dean, meanwhile, is being pilloried by Richard Gephardt and John Kerry for having sensibly supported the idea of slowing the growth of Medicare costs in the 1990s. What will it take to make genuine headway in areas such as health costs? A smart Wall Street Journal series recently inventoried some of the most promising ideas. The movement to promote "evidence-based medicine," for example, seeks to purge billions in unnecessary and even harmful care that researchers say is rampant in our $1.4 trillion health sector. New efforts at chronic-disease management could lower the cost of caring for the relative handful of Americans who account for the lion's share of health costs. Medicare's reimbursement system needs to be updated to reward low-cost innovations that boost quality, instead of perpetuating incentives for providers to deliver high-cost interventions that may not be needed. The problem is that every dollar of health-care waste is somebody's dollar of income. Purging such waste is politically difficult; the effort will require bolder leadership (and better followership) than we've grown used to in recent years. Pete Peterson wrote a book a few years back prophetically titled Will America Grow Up Before It Grows Old? It's the right question, and it would be nice to think leading Democrats and Republicans are making New Year's resolutions to give us the more adult political conversations we need. But somehow I wouldn't count on it. It may take all of us resolving to demand more from leaders on all sides if we're to make the world safe for the debate the country deserves. philly.com