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The Medicare Crisis

Josh Marshall, quite rightly, calls bullshit on media outlets drawing a moral equivalence between Democrats and Republicans. The theory in question is that the GOP does wrong when it pretends there's a Social Security crisis even though there isn't. But this is okay -- or at least no worse than what the Democrats are doing -- because there really is a Medicare crisis and neither party likes to talk about it. Even taking that at face value, you have one strike against either (won't talk about Medicare crisis) and then an additional strike against the GOP (pretending there's a Social Security crisis). One could add to this the fact that Medicare's problems have hardly been ameliorated by Bush's approach -- adding a new, unpaidfor, entitlement which will cost over $100 billion in its first year with costs accelerating thereafter. One could also add that there's a crisis in the general fund, driven almost entirely by the president's tax cut and the president's pet war.

But I'd also like to note something I've noted before. It's not simply that because Medicare's problems are more severe, it deserves to be tackled first. It's that Medicare's problems are logically prior to any sort of thinking about what is and is not an appropriate way to provide for Americans' retirement. The purpose of Social Security -- or any successor system -- is to give people enough money to live on when the retire in a manner that's consistent with other policy goals, notably the continued growth of the American economy. One of the major things senior citizens spend money on is health care. This health care spending is driven almost entirely by the program design of Medicare. Premiums went up 17 percent last year, far higher than Social Security's annual COLA adjustment, and way higher than any reasonable expectation of stock market returns. If that sort of trend continues because the Medicare crisis is met merely by making it less generous without any fundamental changes, then no possible retirement security system will be adequate. If, by contrast, premium and out-of-pocket expenditures could somehow be reduced to a rate of growth lower than CPI growth, then Social Security could easily be made somewhat less generous (by adjusting the COLA to something a bit less than the CPI, say) without creating any major difficulties. The point is that the programs are related, and you can't think reasonably about what Social Security needs to achieve without having some picture of what Medicare is going to do.

Now not Democrats, but Ted Kennedy in particular, can be rightly castigated for last week's irresponsible suggestion that we simply expand Medicare into a universal, age-independent entitlement. Despite Medicare's popularity, it's something of a policy disaster area. As Phillip Longman writes in The Washington Monthly we should be looking at more successful public-sector health programs, like the Veterans' Health Administration.

But bringing this back to the beginning, pretending there's a Social Security crisis when there isn't in no way resolves Medicare's problems. Instead, it detracts from our ability to solve them by creating a massive public distraction. And deferring action on Medicare prevents us from thinking about Social Security reform in a reasonable way. And not to get too moralistic about it, but lying about major policy areas isn't okay.

January 15, 2005 | Permalink


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I know Medicare has its problems, but why is it a "disaster" in the policy arena?

Posted by: Brian | Jan 15, 2005 1:25:48 PM

This administration is aiming at destroying Social Security. That is certainly no secret. So, that is all that should be needed for all Democrats and reasonable Republicans to vote against any Social Security bill that appears in the Congress. Too often the conference committee approach to legislation has been used by this administration, and that is the opening they will use, if they can, to destroy Social Security.

Medicare is probably another area that should be off limits for the current administration. It would be foolish in the extreme to risk having any bill affecting Medicare passing both houses of Congress.

I think we should be pushing to drastically alter Congress's conference committee procedures. There is the real crisis facing us today.

Posted by: Vaughn Hopkins | Jan 15, 2005 1:31:38 PM

I think part of the problem is that there aren't very many good ideas about what to do regarding Medicare. It is a policy morass.

Posted by: Sebastian Holsclaw | Jan 15, 2005 1:37:26 PM

I no longer castigate Senator Kennedy. I am so grateful for his leadership during this great vacuum of Democratic leaders. His extraordinary speech last week to the National Press Club was desperately needed for the presently directionless Democratic Party.

Posted by: Deborah White | Jan 15, 2005 1:38:06 PM

On a related note, LIAR LIAR, pants on fire.

Bush's radio address today, replete with lies and distortions.

Posted by: praktike | Jan 15, 2005 2:04:54 PM

Deborah White, are you some kind of pro-Kennedy troll? What about that speech was good and provided direction? Ted Kennedy sucks and he needs to retire.

Posted by: praktike | Jan 15, 2005 2:06:39 PM

Well, this is in complete oppostion to what Matt is saying (and indeed, to what the latest Samuelson column is saying in WaPo), but, I think one thing that must be considered is the very non-trivial issue of a complete lack of consensus as to what would work vis a vis Medicare (and really, healthcare in general; let's face it -- it's the latter that's in trouble. Children and young adults need healthcare, too).

Now, we know that demographic pressures are building, and will affect both SS and Medicare. Many have commented that future economic growth projections are unduly pessimistic, and that SS's woes are likely to be minor, and easily repairable. I say, "fair enough", but we can't be certain. And even if those critcs are correct, SS's take of national income will continue to grow. And the worker/retiree ratio will continue to shrink. And the cashflow basis for Social Security will eventually go into the red (maybe not in 2018, but definitely, I think, in the 2020s).

My point is: there is at least some doubt about Social Security's longterm financial stability, because nobody has a crystal ball that predicts what the US economy will be doing over the next half century. And we know -- liberals and conservatives alike -- that there are measures that can be taken that would completely remove this doubt. It's true that there's no political consensus on what the most agreable way to go about doing this is. But there's no lack of emprical knowledge as to what our options are. Unfortunately, this is very much in contrast to the case with Medicare/healthcare.

So, I say, let's not gloss over the major fact that we're at least several years from coming up with a consensus on what might work on dealing with Medicare. I fear that this program (or, again, healthcare in general) may need to await the coming of a crisis to force us to make changes.

Completely removing the demographic/financial doubts about Social Security's longterm stability can be done right now. Why not take care of this low-hanging policy fruit, and leave ourselves a less cluttered to do list in a few years time when we're forced to take action on the Medicare/healthcare issue?

Posted by: P. B. Almeida | Jan 15, 2005 2:19:14 PM


Agency Running Social Security to Push Change

The Social Security Administration is preparing a major public relations campaign to market the idea that Social Security faces dire financial problems requiring immediate action and private accounts.

Posted by: lise | Jan 15, 2005 2:30:12 PM

P. B. Almeida:

My point is: there is at least some doubt about Social Security's longterm financial stability, because nobody has a crystal ball that predicts what the US economy will be doing over the next half century. And we know -- liberals and conservatives alike -- that there are measures that can be taken that would completely remove this doubt.

Nope. If the "high cost" projections of the SSA come true -- ie, the US economy performs not just badly, as in the "intermediate cost" projections, but horribly -- then Social Security would have to be dealt with again.

Sadly, it's impossible to "completely remove the demographic/financial doubts about Social Security's longterm stability."

Posted by: A Tiny | Jan 15, 2005 6:04:14 PM

Nope. If the "high cost" projections of the SSA come true -- ie, the US economy performs not just badly, as in the "intermediate cost" projections, but horribly -- then Social Security would have to be dealt with again.

A Tiny: Well, ok, I'll concede your point, which makes my point (dealing with Social Security now because we already possess solid knowledge of how to make it less costly) all the more valid (I think). I mean, even if it's an overstatement to say we can completely remove the potential problems with Social Security, we definitely can make it less expensive than it ultmately will be without changes. We can make it less burdensome than it ultmately will be to the economy, and we can free up resources to help with healthcare.

Posted by: P. B. Almeida | Jan 15, 2005 9:09:25 PM

P. B. Almeida,

Either you're not thinking clearly about this issue, or you're not being honest. Please make clear precisely what it is that worries you.

Are you concerned that the elderly will consume a greater percentage of GDP in the future? If so, then why cut Social Security benefits specifically? The elderly don't just get Social Security. They also receive pensions and have income from assets, which combined are about the same percentage of GDP as Social Security. See "Shares of aggregate income, by source, 2001," here.

Thus, instead of cutting Social Security benefits, we could just massively raise taxes on the asset income of the wealthy retired. All Social Security benefits would be paid, but the total % of GDP going to the elderly would remain the same.

Also, if the % of GDP going to the elderly is your concern, then you'd also be against private accounts. At least if they turn out as conservatives claim they will, retirees will increase the % of GDP they're getting. It will just be called "capital gains" or "profit" rather than "Social Security." But a dollar of profit is exactly the same burden on workers as a dollar of FICA taxes.

Do you see my point? If you're worried about the burden that the income of the future elderly will be on future workers -- which you shouldn't be; see point #7 here -- then you'd focus on much broader issues than just Social Security. And yet you don't. Why?

Posted by: A Tiny | Jan 15, 2005 9:51:04 PM

It is obvious that there is no way elderly American workers can be expected to take care of themselves in the past, present, or ever in the future. Actually and morally, independent retirement support is a crazy dream. This is why we have Social Security. It is not just a big unstable handout perpetuated to gain votes from grasping, short-sighted retirees. On the contrary, it is our moral duty to forcibly support all older Americans, not just our own parents, uncles and aunts, and relatives. We are one nation-state, we are born into collective responsibility, and we retire into collective responsibilty.

There is no condition under which we can alter that perpetual responsibility. If it was right then, it is right now, and it will be right tomorrow, whatever the cost.

Elderly Americans have every right to expect to be supported by the generation now working. And the generation now working has every right to be supported by the next generation, and so on and so forth, forever.

We don't need to privatize anything, because each retiring generation can simply live on the fruits of the previous generation via tax. That is the power of the vote, and the prudent use of the redistributed wealth of our democracy.

Posted by: Dick Freely | Jan 16, 2005 12:34:10 AM

Using the VA as a good example from a policy perspective might or might not make sense (one article from Washington Monthly isn't enough to convince me), but from a political perspective it is suicide. People have a positive perception of the Medicare system, while they see VA hospitals as filth-ridden shitholes. Rightly or wrongly, this is the perception, and I doubt it will change. Why not use the very successful UK NHS as an example? Point out that many of the strawmen held up by the right on national health care simply aren't the case in this well-run system. (They don't have a shortage of doctors. They have a thriving drug industry. People are free to choose their own doctor. If the system chooses not to cover something, people are allowed to purchase services outside of the system.) The bottom line is that everyone else in the civilized world has a functional health care system and we have a dysfunctional one. We spend a far larger proportion of GDP for far worse results. There is no excuse for this.

Posted by: Firebug | Jan 16, 2005 2:32:54 AM

So why was there a need to "shore up" Social Security back when we had a surplus?

Why do Democrats keep changing their story on whether Social Security is in crisis or not depending on what the Republicans are proposing?

Yes, there's moral equivalence going on here: Democrats are the ones lying more than Republicans. Republicans say there is a crisis, which is stretching the truth but not an outright lie.

Democrats are lying in all sorts of ways. They say that Social Security is good until 2042. That's a lie, because it's only going to be made good if we do some really bad things to the general fund so that it can pay benefits.

They say that private accounts are "risky". First, no one has to invest in stocks, they can invest in Treasuries if they feel so confident about the government's creditworthiness. Secondly, since when is stock market risk greater than political risk? The stock market has returned 11% a year on average and never lost money over the time horizons we are talking about, 40-50 years. However, politicians can and do go back on promises. Politicians can and do arbitrarily cut programs. Both parties are talking and have been talking about cutting benefits, means testing, etc. In 1993, Clinton made SS benefits taxable, which in effect is a benefit cut. That's political risk and it's empirically proven to be more risky than market risk.

Sorry, but I'm seeing the deceptions 90% on one side: the Democrats. Which is sad, because on most issues they've been far more honest than the Bush administration. But it seems they have a blind spot for Social Security and they'll do anything to protect it. Why? It's become like religion to them. An end in itself, rather than a means to eliminate senior poverty.

Posted by: Adam Herman | Jan 16, 2005 3:25:21 AM

Adam do you believe that the economy grew 2.7% in 2004? Do you believe the economy will grow 1.8% in 2005? Do you think the economy will never grow at better than 1.9% and will sink to an average long term of 1.6%? Because those are the numbers that produce the 2042 exhaustion date. Any numbers better than those push exhaustion out, any numbers above 2.2% produce an overfunded Trust Fund. 2004 SSA Report: Economic Assumptions & 2004 SSA Report: Trust Fund Ratios

Be a mensch, explicitly embrace the numbers underlying "crisis", commit to that 1.6% number. Jump on the the "crisis" bandwagon that uses numbers that assume future productivity will barely outpace population growth, assert that as a nation we will never get richer.

And then explain why you hate America so much.

Or alternatively you could join the Reality-Based Community. Privatizers are slowly awakening to the horrific reality that they just don't have the numbers. And their current attempt at mounting a "Swift Boat Veterans against the Business Page" campaign has already run up on the rocks of real-world 2004 growth of 4.0%.

Extrapolate this table, understand that the forces that are shoving exhaustion into the future an average of 1.3 years per year are still at work. All you have to do is believe that America will be as productive in the future as it was in the past. EPI: Changes in Trustees Projections over time

You know that Bush doesn't believe the economy will sink to a long term rate of 1.6% growth. He doesn't, he can't, and neither can you and still look at yourself in the mirror. If you are ignorant of these numbers then fine, I have given you the tools you need to educate yourself. If you are willingly ignoring them then you are just spreading right-wing propaganda. Because we have the numbers, and the Bush Administration is lying - again.

Posted by: Bruce Webb | Jan 16, 2005 8:43:02 AM

And to everybody else.

If you look at the numbers it is clear why the Administration is moving first on Social Security rather than address the much bigger problem of Medicare. Their time window is closing. Only by desperate measures have they been able to keep the economic tables from being an absolute joke. In 2004 their "best guess" was that the economy would slow from 3.4% (2003) to 2.7% (2004) and then to 1.8% (2005). Exactly what was in the business pages in March 2004 that would support this? Similarly the 2003 Report predicted a drop from 3.6% (2002 - revised to 3.8% in the 2004 report) to 1.9% (2003) with a small bump to 2.3% (2004) and the start of the long slide to 1.6% with a 2.1% (2005)

So we have a model that predicted 1.9% for 2003. Reality responded with 3.4% and a revised 3.8% for 2002. How do the Trustees respond? They grudgingly drag up that patently ridiculous 2.3% number for 2004 to 2.7% and try to compensate by dragging the 2005 number from 2.1% (already sounding kind of low) to 1.8%. You don't have to be a math whiz to know something is fishy here, particularly the manipulation of the 2005 number. What could possibly have justified the downward revision?

The answer is pretty clear. The Intermediate Cost Alternative was rapidly closing in on the Low Cost (fully funded) Alternative. And yet you have to keep some sort of gap or abandon the fiction that you are presenting a range. Already the 2.7% Intermediate and the 2.8% Low Cost numbers for 2004 were dangerously close. Keeping that 2.1% number for 2005 in the Intermediate Cost and simulatneously using it in the Low Cost leaves two models only a sliver apart, just .1 percentage points in a single year over the near term. So they punted. They just hoped no one would notice the downward revision for 2005 in the face of an economy that had come in 1.5 points higher for 2003 than their previous prediction.

But now they are on a hook. The can't not use 4.0% for 2004, that is in the books. And they cannot maintain a prediction of 1.8% for 2005, still less suppress it. But the minute they drag it above 2.1% bells and whistles go off. We have officially exceeded the numbers of the Low Cost Alternative that show the Trust Fund fully funded with no changes needed.

All of which explains the cart before the horse timing of Social Security "reform" before addressing Medicare. They don't have the numbers, and you can bet they know it. They are trying a Hail Mary pass under the faith-based belief that they can score a privatization touchdown without ever using a single number.

Sorry for the blizzard of numbers. But it is important to understand that under the Bush Administration the Trust Fund Report is a political instrument designed to support privatization. Unfortunately for privatizers it is forced to use real numbers for 2004 and years past and those numbers simply don't support "crisis". The Social Security Humpty-Dumpty Crisis has fallen off the wall and all of Bush's horses are all of Bush's men are not going to put this particular Humpty-Dumpty back together again.

Posted by: Bruce Webb | Jan 16, 2005 9:35:51 AM

Are you concerned that the elderly will consume a greater percentage of GDP in the future? If so, then why cut Social Security benefits specifically? The elderly don't just get Social Security.

A Tiny: Well, in a general way, yes, I'm concerned about this. Mind you, if, say, 6-18 year olds make up a greater percentage of the population in 2050 than they do now, we can expect that, ceteris parabus, the percentage of national income devoted to schooling will increase. In this general sense, it doesn't particulary shock or worry me that the amount we'll transfer to the elderly will increase. But it is this very demographic determinism that I think means we ought to structure Social Security as carefully as possible -- to minimize damage to our economy. Clearly we're far from that sort of a standard right now.

Thus, instead of cutting Social Security benefits, we could just massively raise taxes on the asset income of the wealthy retired. All Social Security benefits would be paid, but the total % of GDP going to the elderly would remain the same.

Um, yeah, we could do that. And your point is?...

Also, if the % of GDP going to the elderly is your concern, then you'd also be against private accounts. At least if they turn out as conservatives claim they will, retirees will increase the % of GDP they're getting. It will just be called "capital gains" or "profit" rather than "Social Security." But a dollar of profit is exactly the same burden on workers as a dollar of FICA taxes.

I question your logic here. A bigger pool of financial assets in 2050 implies more growth along the way (than otherwise would be the case) and higher overall standards of living for everybody.

If you're worried about the burden that the income of the future elderly will be on future workers -- which you shouldn't be; see point #7 here -- then you'd focus on much broader issues than just Social Security. And yet you don't. Why?

I don't think we should focus on "just Social Security". But I constantly hear Social Security's voracious and growing appetite blithely dismissed as trivial. It isn't. Of the total amount of increased economic output that will flow to old people over the next half century or so, a portion of that (20%? 25%?) will be in the form of Social Security checks. This ain't chump change. Social Security will have to bear at least some part of the "adjustment burden" along with healthcare. The problem is, while there are conceptually simple steps we know right now that will realize future savings from Social Security, the steps are by no means as clear when it comes to Medicare (though if you've got some ideas I'm all ears). All I'm saying is: since we know how to deal with the former right now, let's do it. Let's put the program on a path to savings. We'll be forced to do so soon enough, I'm sure, when it comes to Medicare.

Or, to but it bluntly, it's conceivable that the political will and votes exist in Congress to get a bill to the president's desk this year that will reduce the amount of money the government owes in the form of future Social Security checks. The same cannot be said of Medicare. If it did, we wouldn't be having this particular sub-debate.

Posted by: P. B. Almeida | Jan 16, 2005 1:41:44 PM

Shorter Almeida: Even though I lost my keys in a dark alley, I'm going to look for them under the lamppost instead, because the light is better there.

Posted by: Firebug | Jan 16, 2005 8:04:34 PM

Shorter Almeida: Even though I lost my keys in a dark alley, I'm going to look for them under the lamppost instead, because the light is better there.

Wrong: your metaphor would only be correct if looking under the lamppost would help me to find my keys. Cutting future Social Security outlays will indeed help us reduce our fiscal/demographic burden. It may only address a quarter or so of that burden, but when you're talking about trillions of bucks, a "mere" 25% is still a lot of dough. If the steps to make the same type of economies vis a vis Medicare were apparent, I'd be banging my drum loudly for the country to be taking such steps; sadly, I don't clearly see those steps. Do you?

Posted by: P. B. Almeida | Jan 16, 2005 9:14:14 PM


You make an interesting claim when you say right now, we know how to do deal with the problems facing Social Security. That's in many ways true. But at the same time, the "solution" being offered by the administration only gives us a lot of what we all fear--massive increases in debt--while possibly degrading the quality of the program. Something else to consider is the actual date of the start of the problems. If what I've read is correct, Social Security will not really start to bother us until the middle of the century or so. Medicare/Medicaid, meanwhile, will be facing much bigger problems in ten to twenty years. What's more, we aren't totally in the dark about the solutions, although the debate and solutions are far, far more complex.

All of this leads me to believe that the administration isn't that serious about tackling the challenges facing this country.

Posted by: Brian | Jan 16, 2005 11:23:59 PM

My apologies to Matthew for eating up his bandwidth like this. And my apologies to anyone else for taking up all this space. I just got started and couldn't stop. If you're interested, I've also posted this on my own site here. My conclusions look a little too good even to me, so I suspect I made a mistake somewhere. (Likely this is because only part of GDP can go to consumption, plus perhaps some double counting.) In any case, I'll refine this and make it more accurate on my own site, and also look for examples of actual, careful studies of this done by qualified people.

P.B. Almeida,

First, let me apologize for my tone earlier. It had an element of sneering to it that wasn't appropriate. My only defense is that many, many people who discuss Social Security are dishonest or uninformed, and deserve to be sneered at. I assumed you were one of them, but I was wrong.

Nevertheless, I still believe you're not thinking clearly about this.

First of all, here's my perspective: I don't see an increasing percentage of GDP going to the elderly as an automatically bad thing. In fact, I generally see it as a sign of America's success. After all, people have always wanted to live longer. It's only natural that a society with increasing life expectancy will want to spend some of this extra life retired, and with a reasonable income.

(In the same way, I don't see an increasing percentage of GDP going to vacation time, or time in college, as a bad thing. You'd expect to see both as a society grows richer... even with demographic changes.)

The only problem would be if productivity increased so slowly that the amount left over not going to the elderly didn't increase as well. We're very far from such a problem.

Here's my attempt to put some numbers on this. Of course, it's extremely rough. Plus, I'm tired right now, and not as familiar with the health cost numbers, so I might have made some errors. Still, it should be good enough for a blog comment.

Of the total amount of increased economic output that will flow to old people over the next half century or so, a portion of that (20%? 25%?) will be in the form of Social Security checks.

My best guess is 15.5%. (This is under the SS and Medicare intermediate assumptions.)

2004 SS % of GDP

2054 SS % of GDP (same page)

SS increase 2004-2054

If we assume 2004 and 2054's retirees have the same proportion of asset income, pensions and "other" as 2001's retirees (95% of SS), the asset income, pension and "other" % of GDP come to:

2004 Other Over-65 Income % of GDP

2054 Other Over-65 Income % of GDP

Other Over-65 Income increase 2004-2054

2004 Medicare % of GDP

2054 Medicare % of GDP (same page)

Medicare increase 2004-2054

Medicare currently accounts for about 50% of health care spending for those over 65. Because of the new prescription drug benefit, let's make a generous (from your perspective) assumption that this will increase to 66% in the future. Thus:

2004 over-65 non-Medicare health care % of GDP
2.68 (2.68 X 1.00)

2054 over-65 non-Medicare health care % of GDP
5.02 (10.03 X .5)

over-65 non-Medicare health care increase 2004-2054

2004 total elderly consumption
4.33 + 4.11 + 2.68 + 2.68 = 13.80% of GDP

2054 total elderly consumption
6.49 + 6.17 + 10.03 + 5.02 = 27.71% of GDP

total % of GDP elderly consumption increase 2004-2054
27.71 -13.80 = 13.91

% of increase attributable to Social Security
2.16 / 13.91 = 15.5%

% of increase NOT attributable to Social Security

% of increase attributable to health care
(7.35 + 2.34) / 13.91 = 69.7%

There are many ways of looking at this. Here are two.

1. Let's say we slice SS benefits (both guaranteed benefits and returns from any personal accounts) in half from 6.49% of GDP to 3.25%. This is a gigantic cut, to a level far below that of today. But it would only reduce the % of GDP going to the elderly by 11.73% (3.25 / 27.71).

By contrast, we could achieve exactly the the same thing by reducing health care costs by only 21.59% (3.25 / (10.03 + 5.02)).

So, in terms of total elderly consumption in 2054, every percentage point of reduction of health care costs gives us 2.3 times as much as an equivalent percentage point of reduction in Social Security benefits. ((10.03 + 5.02) / 6.49)

2. It's probably more sensible to look at the increase from today's levels, rather than the absolute projected amounts in 2054.

If we hold SS benefits steady at today's level of 4.33% of GDP, in 2054 costs would be 2.16% of GDP lower than with scheduled benefits.

Under these projections, health care costs are assumed to increase by 9.69% of GDP (7.35 + 2.34), from the 2004 level of 5.36% to 15.05% total (10.03 + 5.02).

Thus, if health care costs for the elderly only rise 240% in GDP terms ((15.05 - 2.16) / 5.36) instead of 280% (15.05 / 5.36), then we're in just as good shape as if Social Security increases by 0%.

Put another way: the increase in health care costs is four and a half times as large a problem as the increase in Social Security costs (9.69 / 2.16).

Again: I may well have made a mistake, in arithmetic or otherwise. If so, I'd appreciate it if you'd point it out. But as it stands, I see no reason -- particularly with proven incompetents running the country -- to tinker with America's most successful government program ever. Not when the increase in health care costs is four and a half times as large a problem. (Although there is one thing I'd endorse re SS -- raising the payroll cap to cover 90% of wages. That in itself would eliminate much of the shortfall, according to the CBO's projections.)

And now, I will go truly crazy. It would be much more efficient to just search for a good study of this, rather than estimating it myself. But who cares?

Let's assume that nothing whatsoever is done, and the percent of GDP going to the elderly DOES rise from 13.80% of GDP today to 27.71% in 2054. That seems pretty bad. So what are the consequences of that for the non-elderly, according to the SSA intermediate projections?

(I'm fading on this, so again: please let me know if you see any mistakes.)

2005 population

2005 over-65 population

2005 under-65 population

2005 GDP
$11,911,330,000,000 (12,090 / 1.05)

2005 GDP going to elderly
$1,643,764,000,000 (2005 GDP X 0.138)

2005 GDP going to under-65 population
$10,267,570,000,000 (2005 GDP X 0.862)

2005 per capita GDP for under-65 population
$38,720.85 ($10,267,570,000 / 265,196)

2055 population

2055 over-65 population

2055 under-65 population

2055 GDP
$27,528,190,000,000 (109,843 / 3.9902)

2055 GDP going to elderly
$7,628,061,000,000 (2055 GDP X 0.2771)

2055 GDP going to under-65 population
$19,900,130,000,000 (2055 GDP X 0.7229)

2065 per capita GDP for under-65 population
$65,068.62 ($19,900,130,000 / 305,833)


With no changes to anything, under the intermediate Trustee assumptions -- which of course, seem likely to be pessimistic -- plus my assumptions, the per capita GDP for everyone under 65 would be 68% HIGHER IN 2055 THAN TODAY (65,068.62 / 38,720.85 = 1.68).

So, if nothing is done, in 2055 people under 65 will suffer the crushing burden of having 68% more per capita GDP than those under 65 today. Of course, it seems quite likely we'll find a way to slow down health care cost inflation, making the 2055 picture even brighter for 2055's under-65s -- even under the intermediate projections.

Speaking of which, you ask:

if you've got some ideas [re health care costs] I'm all ears

Okay: how about we switch to a health care system like Sweden's?

In 1995, 17.3% of Sweden's population was over 65, and they spent 7.2% of GDP on health care (for everyone, elderly and non-elderly).

We're a younger society than Sweden. The SSA projects that we won't get to 17.3% over 65 until 2025. Yet we spent 14.2% of GDP on health care in 1995.

So, if we switched to a system like Sweden's, we could theoretically cut our health care % of GDP in half by 2025 -- while providing coverage for all citizens, including the increased percentage of elderly. This saving of 7% of GDP would be more than three times the scheduled increase in Social Security costs.

Sounds like an incredibly sweet deal to me. What do you say?

And finally, you write:

I question your logic here. A bigger pool of financial assets in 2050 implies more growth along the way (than otherwise would be the case) and higher overall standards of living for everybody.

You're not questioning my logic. You're questioning the logic of the Social Security Administration and the Congressional Budget Office. None of their projections show increased economic growth anywhere near high enough to allow retirees to get higher benefits from individual accounts while also allowing non-retirees to have a higher per capita GDP.

Also, when I suggested raising taxes on the asset income of the elderly, you said:

Um, yeah, we could do that. And your point is?...

My point is that this would reduce the % of GDP going to the elderly just as cutting SS benefits would. Yet you speak of the "voracious and growing appetite" of SS while not speaking of the "voracious and growing appetite" of the elderly's asset income. It's either both or it's neither.

Whew! Well, that was exciting. As I say, I've posted this on my own website here. In the near future I'll doublecheck this, while also looking for a good study on it done by people who actually know what they're talking about.

Posted by: A Tiny | Jan 17, 2005 1:07:09 AM

I'm not sure what the problem is. You delete routine doctor's visits and prescriptions from coverage and raise the "deductible" that the elderly have to pay. And after 90, no more coverage. Making that politically feasible is the hard part.

- Josh

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