Senate Governmental Affairs Committee Issues Testimony From Henry Aaron
Thank you for your invitation to appear today on this important topic. Projected fiscal shortfalls pose an important long-term challenge to
* restoring and upgrading the nation's infrastructure;
* increasing resources devoted to scientific research and training;
* increasing investments in early childhood education to create a better educated and more productive citizenry;
* establishing better ways to provide and pay for the explosive increase in long-term care that will be necessary as the baby-boom ages;
* fulfilling current commitments to the elderly and people with disabilities through
* taking effective steps to curb emissions of greenhouse gasses and combat global warming.
Given the importance and prospective costs of meeting these challenges, the first and most important implication is that cutting taxes was, and remains, not just unwise but foolhardy.
Let me be clear, in making that statement I am not defending the current design of the
Tax reform is needed. Tax cuts are not. More revenue, not less, will be needed if
It is worth noting that a tax on carbon, supported by economists aligned with both major parties, is one of those rare policy instruments that would help solve one problem and provide revenue to help pay for solutions to others. It would encourage private sector investors and consumers to reduce greenhouse gas emissions even as it narrows the prospective gap between spending and revenues.
Deficit Reduction
Simple arithmetic tells us that when the budget deficit, measured as a percent of gross domestic product (GDP), exceeds the growth of GDP, the ratio of debt to GDP increases.
Blanchard did not argue - and I am certainly not arguing - that low interest rates render harmless any amount of debt, however massive. What Blanchard said, and what I am saying, is that low interest rates enable the nation to carry more debt without harm than it could if interest rates were high. And that means that worries about growing debt should shrink in comparison to worry about the harms from failing, out of a fear of deficits, to address other urgent problems.
The point at which deficits or debt become imprudently large is a matter of judgment. We are clearly nowhere near such a point. Financial markets, which are not infallible but are the best source of information about future prospects, confirm that
If you believe, as I do, - that the problems I listed at the start of my testimony are urgent, - that solving them will be costly, - that other nations, with far fewer resources than
For at least three decades we have known that accumulated reserves and current revenues dedicated to
The story is rather different from a political standpoint. Although most analysts-including, I suspect, all of us here today-have long thought that early action to assure sustainable balance is desirable, it has been the revealed preference of elected officials to leave to their successors that task of either raising taxes or cutting benefits.
The clear purpose of the TRUST Act (S. 2733) is to nudge
Health Care
Health care spending poses more serious problems for two reasons. First, there is general agreement that Americans now spend more than they need to for the services that they receive. This problem afflicts both public and private budgets. Indeed, it a bigger problem for private than for public budgets, as Medicare and Medicaid have done a better job of controlling spending per person than have private payers.
Second, projected increases in public health care spending is the principal cause of the growing gap between government expenditures and revenues. Projected growth of public spending on health care dwarfs that on
Much of this increase is desirable. The nation has committed to providing the elderly and the disabled health care commensurate to that enjoyed by the rest of the population. I hope that this commitment is unbreakable and that no member of
While the overall rise in health care spending has generated enormous benefits, too much of current and projected future health care spending goes to pay for over-priced drugs and medical equipment and for services that provide little or no benefit to patients. This hearing is not the place to try to diagnose the myriad features of the
But it is the place to note that when
The TRUST Act
Early action to put the major 'trust-funded' programs on sustainable long-term footing is desirable. The beneficiaries of the major social insurance programs deserve the assurance that commitments now being made will be honored. Other things equal, it is better to act soon than to delay in addressing projected imbalances in these programs.
These programs merit attention for reasons in addition to the looming depletion of the trust funds. For example, over the past four decades, since
* Should long-term, low-wage workers be provided with more generous benefits than
* Should long-term beneficiaries be provided some protection against the likely erosion of other assets?
* Should Social Security benefits be modified because life-expectancy of high earners has risen but life-expectancy of low earners has stagnated or fallen?
* In light of the growing recognition of the importance of early childhood development, should
The committee envisioned in The TRUST Act, in my view, is a particularly poor venue for designing changes in Medicare. A large part of the projected growth of Medicare spending depends on the progress of medical science. Anticipating the state of medical science seventy-five, or even twenty-five years, in the future is a proper subject for science fiction, not legislators. No one can reliably forecast the medical interventions that will be available fifty or seventy-five years from now. It would be indefensible to determine the medical services available now to the elderly or people with disabilities based on assumptions that can be little more than guesses about the medical technology that will be available decades in the future and what it will cost. But that is just what the committee that would be created under the TRUST Act would be asked to do... and under expedited legislative procedures.
To be sure, the Medicare actuaries now make seventy-five-year projections and publish estimates of trust fund balance over that period. But



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