Editore"s Note
Tilting at Windmills

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December 14, 2007
By: Kevin Drum

ENTITLEMENTS....Speaking of charts and the CBO, here's the chart gracing their home page at the moment. It sure explains why Tim Russert and his pals are so obsessed with skyrocketing, out-of-control, demographic-tidal-wave, pick-your-favorite-metaphor Social Security spending, doesn't it?

Of course, Russert and his pals actually use medical services, of which Medicare is merely a reflection, and are thus not quite so keen to bang on endlessly about how we should be working to control medical costs and distribute medical care more efficiently and more equitably. After all, that might actually affect them. Slashing Social Security benefits really doesn't.

Kevin Drum 12:14 PM Permalink | Trackbacks | Comments (14)

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Other countries do quite well collecting higher taxes and paying for better services. The US is capable of providing such, though I agree that it is utterly foolish for us not to keep health care costs under control.

Posted by: freelunch on December 14, 2007 at 12:22 PM | PERMALINK

"Of course, Russert and his pals actually use medical services, and are thus not quite so keen to bang on endlessly about how we should be working to control medical costs and distribute medical care more efficiently and more equitably"

I think, in Russert's case, it's more plain stupidity, sensationalism for ratings (crisis!), and his conception of himself as a regular, blue-collar, don't need no handouts, John Wayne-type. He admires those types, and has fears that he's not one.

Ideology from barely concealed homo-eroticism and insecurity.

But as for his "pals" at, say, Heritage, Cato, AEI, etc.: they wanna gut the public sector. It's what the big-money benefactors who sponsor those think-tanks want - so they hire the like-minded and flood the intellectual space with propaganda. Very effectively.

It probably doesn't have anything to do with whether Timmy and his pals "use" health care or not. They're rich, they'll never be affected. Even if they were potentially affected, people vote against their financial interests all the time, out of identity appeals, personality, desire to stick it to someone else, etc.

Ideology as irritable mental gesture.

Posted by: luci on December 14, 2007 at 1:11 PM | PERMALINK

The amount of exercise we get pedaling up that ramp should keep us healthy!

Posted by: Matt on December 14, 2007 at 1:24 PM | PERMALINK

So ... what are the chances someone does a graph showing the comparison between entitlement* spending and military spending? Anyone ... ?

The truth is, if these clowns were really, truly interested in controlling government spending, they'd complain about military spending, waste and abuse.

(*I don't consider health care for the poor or elderly an "entitlement." I call it "what decent, non-evil human beings do in a moral society.")

Posted by: Mark D on December 14, 2007 at 1:30 PM | PERMALINK

That's why they're entitled to it. Don't let the selfish reactionaries redefine words for you.

Posted by: freelunch on December 14, 2007 at 2:25 PM | PERMALINK

Kevin,

If you want to reclaim the chartblogging crown, what I'd really like to see is someone layer in on top of that the following:

- % of GDP spent on private health insurance
- % of GDP spent by states and localities on health care

This would show that the problem is not Medicare/Medicaid, but health spending in general.

Posted by: Frank on December 14, 2007 at 2:33 PM | PERMALINK

The graph that comes with this post showing 75-year projections is, to some extent, comparing apples and oranges.

The Social Security projection is based on demographic considerations which can be made with some degree of confidence.

The more dramatic growth in the Medicare and Medicaid projections, however, is based on the assumption that the per-person cost of medical care will keep going up at a rate faster than GDP growth. That's a harder case to make -- because such costs can be influenced by a variety of factors in the future.

To accept this chart, you have to accept that the relative rate of growth in medical costs now in effect will remain constant for the next 75 years.

A study extrapolating current patterns into the future was published in 1972 ("Limits to Growth"). It came up with very colorful conclusions -- for example, that the planet would have completely run out of oil by 1992. It didn't happen that way. Most people who work with quantitative models know that it's very tricky to extrapolate certain kinds of variables for any period into the future -- never mind 75 years.

Posted by: JS on December 14, 2007 at 4:24 PM | PERMALINK

Frank, what you are asking for is in a chart that appears in the document linked by Kevin. The two categories you mention are combined into a single one named "All Other Health Care". From eyeballing it, it appears that it is growing at roughly the same pace as Medicare and Medicaid (as one would expect).

This chart covers only the past, and does not include projections. If you were to project it for 75 years, and using the same assumptions made for projections in the other chart, by my quick back-of-the envelope calculation total health care costs in 75 years will be almost 70% of GDP -- another indication that these projections are only meaningful in showing that current patterns simply cannot last for long.

To find that chart: click on the chart posted by Kevin, then go to page 22 of that PDF document (or page 32 using the page numbering on your browser).

Posted by: JS on December 14, 2007 at 4:35 PM | PERMALINK

We're going to have some kind of health care reform with the next administration. Wait a couple of years after that's in place and all the numbers will change.

Posted by: MarkH on December 14, 2007 at 4:51 PM | PERMALINK

Health care spending overall is growing unsustainably. If you assume exponential growth it wouln't be too long before it overwhelms us. At least the graph is illustrative of the fact that health care expenses are a big issue, and SS is really under control.

Posted by: bigTom on December 14, 2007 at 5:16 PM | PERMALINK

Does "debt service" include the cost of redeeming the bonds in the SS trust fund?

Posted by: jhm on December 14, 2007 at 6:45 PM | PERMALINK

Yes it does, jhm.

Posted by: CN on December 14, 2007 at 9:48 PM | PERMALINK

"we should be working to control medical costs and distribute medical care more efficiently and more equitably"

*waving magic wand* - POOF - Health care costs are under control. And equitably distributed!

How exactly are you going to do this without triggering the rationing of medical services? "That 'might' affect 'em?" Good luck with that.

Posted by: Eric Lindholm on December 15, 2007 at 8:14 AM | PERMALINK

"How exactly are you going to do this without triggering the rationing of medical services?"

Um, by doing WHAT EVERY OTHER DEVELOPED COUNTRY IN THE WORLD IS DOING?

We could for example extend MediCare to everyone. Simple and uses a system already working.

Posted by: Himself on December 16, 2007 at 12:31 AM | PERMALINK
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