The GAO just released an update to its long term projections about the health of the U.S. economy. The report indicates that the long term outlook is improved from its last analysis, but a structural imbalance still exists.

The GAO has published simulations of the economy since 1992. The model produces two projections, a baseline projection, and an alternative projection. In any projection, the assumptions of the analyst are key to understanding and evaluating the conclusions.

In the case of the baseline projection, the GAO follows the CBO’s baseline projections of August 2011 for the first 10 years, then projects most spending  will maintain a constant relationship to GDP. Interest on the national debt, and Social Security, Medicare and Medicaid payments use projections supplied by Social Security and Medicare trustees.  Adjustments were made in accordance with the deficit reduction plan passed by congress when they increased the debt ceiling.

The alternative projection adjusts the baseline projection with assumptions that congress will continue to act in a fashion similar to the way they have always acted. If tax loopholes are set to expire, the alternative projection assumes that congress will not allow them to expire, but rather will extend them. If reimbursement exceptions for providers of Medicare and Medicaid services are set to expire, the alternative projection assumes that congress will extend them.

In the baseline case, spending on Social Security, Medicare, and Medicaid trends up to about 15% of GDP, then remains relatively constant. In the alternative, and more realistic projection, spending on the three programs trends up to 14.5% by 2013, and almost 20% by 2080.

The report concludes:” The United States recently suffered from the most severe recession since the end of World War II. The economic downturn along with the federal government’s response to it and other actions taken to stabilize financial markets contributed to a rapid buildup in federal debt held by the public—increasing from roughly 36 percent of GDP at the end of 2007 to roughly 62 percent at the end of 2010—adding to the size and urgency of the federal government’s long-term fiscal challenge. Our simulations show that the Budget Control Act of 2011 will help reduce deficits. However, the longer-term fiscal challenge remains.”

The largest drivers in the long term are retiring Baby Boomers and the GOP’s continuing determination to repeal “ObamaCare” even though it has cost reductions for Medicare and Medicare built into it. Personally, I ‘d like to see some of the military spending cut so that Social Security, Medicare, and Medicaid are available to all Americans. Holding it steady at its current percentage of GDP is folly, considering that we already spend more on our military than the rest of the world combined.

Homework

Long Term Fiscal Outlook, Updated Fall 2011

My post yesterday elicited a response from my personal troll. He left a message that says, in part, “Why should the government be paying for abortions unless for the sole reason of population control? On top of that we get obamacare and now the government can kill off the elderly. Sick country we live in.”

Kevin King, you are absolutely wrong on so many levels that it makes my head spin.

First: Government does not pay for abortions, with limited exceptions for women who have been raped, are victims of incest, or when the woman might die without the procedure. Government has not paid for abortions since it was made illegal to do so. This isn’t about banning abortion; it is about making it impossible for American women to access both abortions and birth control, even if they pay for it themselves. What the bill passed by the House does is take away tax credits for companies who offer insurance to their employees if the insurance includes abortion as a covered procedure.

For people who claim to love and support the U.S. Constitution, the Tea Party seems to have a complete lack of respect for our body of laws. Abortion is a legal procedure in the U.S. Nobody is wild about willy-nilly use of abortion, and nobody considers U.S. policy to be focused on population control, except the lunatic fringe of the extreme right wing.

When a woman is raped, and becomes pregnant as a result of that rape, the lack of access to things like the morning after pill or abortion is making her a permanent victim. Her rapist may or may not be caught and tried. But without any consideration, that woman is sentenced to permanent victimhood. She endures at least nine months of physical stress, possibly followed by a lifetime of paying for a pregnancy that was not her choice, but was forced upon her. There is nothing about justice or freedom in that formula. There is nothing about justice or freedom in a nation that would force the victim of incest to suffer through a pregnancy that was not her choice, but was forced upon her. Sometimes I think that if a man could get pregnant, we wouldn’t see so much testosterone in health care debates.

Second, there is nothing in the Patient Protection and Affordable Care Act that kills seniors. There is a lot in the Ryan proposal to destroy Medicare and Medicaid that does. For some reason, legislators are ignoring the fact that before Medicare and Medicaid, seniors couldn’t get insurance. Insurance companies, especially those with a profit motive, are betting that you will give them your money, but that you’ll never need their services. They have a sophisticated actuarial with one focus, how to pay the bare minimum, so that profit can be maximized. No actuarial has figured out how to get money from seniors and make a profit, because seniors get sick and die. Before there was Medicare, that’s what seniors did. Other than the extremely wealthy, old people had no option, because most of them couldn’t afford health care. The life expectancy of Americans went up because of Medicare and Medicaid, not in spite of it.

When I was running for office, I kept hearing that nobody has ever read the Patient Protection and Affordable Care Act. Bullshit. I’m convinced that no Republican has ever read it, but I’ve read it, and lots and lots of medical professionals have read it. There is nothing in it about death panels. That idea came from Sarah Palin, who clearly never read the bill. The so-called death panels are not about restricting access to health care, they are about giving patients and their family useful information about the end of life process. Today doctors are not reimbursed for the time they spend at bedside talking about options and their impacts upon the patient’s quality of life. Having had many of those conferences last June, when my father was at the end of his life, I can tell you that it is some of the most important work that a doctor does. To call it a death panel is a bunch of bullshit dreamed up because the extreme right wing looks at everything as a political game. If the other side scores a point, the extreme right wing isn’t satisfied in putting up another point, they insist on taking the point off the scoreboard.

Life isn’t a game. Stop playing around with the health of women, children and seniors. Get your testosterone out of my health care and my government.  Kevin, I posted an annotated and highlighted copy of the Patient Protection and Affordable Care Act below. Read it before you post more nonsense at this site. You certainly seem bright enough, but you are not dealing with facts. You have been led astray by people who are playing a game instead of seriously looking to solve America’s problems. We need jobs, not more restrictions on freedom. This isn’t a game; it is a matter of life and death.

Homework:

ACLU Analysis of Abortion Funding

Highlighted and Annotated Patient Protection and Affordable Care Act

American Life Expectancy

The Story of How Medicare Came to Be