Social Security, Medicare — uh oh!

Social Security and Medicare are both moving toward their insolvency dates. If everyone likes them, why not fix them?

A legend has it that Henrietta Nesbitt, Eleanor Roosevelt’s head housekeeper for the White House, commented negatively on a chandelier that was draped in cobwebs. The implication being, well golly, she’s the housekeeper! New Social Security and Medicare reports made me think of Henrietta.

Much like Nesbitt, members of Congress admire problems but they’re not looking at dust bunnies. They’re looking at what their own analysts and auditors call an unsustainable fiscal situation. Any way you look at it, the outlook is dark.

Just yesterday the Social Security Board of Trustees released its annual report to Congress. It’s 270 pages long, four shy of the length of the Government Accountability Office tome. Starting next year, Social Security’s income from payroll taxes and interest on its Trust Fund won’t be sufficient to cover outlays. The Old Age and Survivors Insurance (OASI) and Disability Insurance (DI) programs will have to start dipping into the reserves. For that matter, the nearly $3 trillion reserves are sort of an accounting fiction, an IOU that Social Security has on the Treasury. Whatever. This year the trustees say that under current policy it’ll all be gone by 2035.

Fiscal news is busting out all over. The Medicare Board of Trustees also released its annual report, a mere 249 pages. The Hospital Insurance Trust Fund can pay full benefits for, oh, another six years. Meanwhile the “actuarial” deficit has gone up a tick. “Actuarial” means long term, and the projections are pretty much inescapable. Fiscally, Medicare and Medicaid are runaway trains without some change in policy.

The numbers are everywhere. The debt (accumulated deficits) to GDP radio will zoom to 530% in the next 75 years if there’s no change in policy. In its 274-page consolidated financial statement for the government, GAO notes the government has assets of $3.8 trillion and liabilities of $25.4 trillion. The deficit-to-GDP ratio will spike from 1.9% now to 4.1% in 2019 — the peak of the baby boomer retirement wave. After that it will settle down to 2.5% as the retirement wave recedes and we boomers depart the surly bonds.

Each year Congress argues over agency requests for $1.2 trillion to $1.3 trillion in “discretionary” spending. But the government’s real net cost in 2018 was $4.5 trillion, and its intake was $3.4 trillion.  Social Security’s OASI and DI programs cost a trillion. Medicare cost another $740 billion, though comfortably below premiums for now. Unfortunately, trustees “project deficits in all future years until the trust fund becomes depleted in 2026.”

That $1.3 trillion of “discretionary” spending, which pays for the federal workforce, the grants for scientific research, the operation of a system of justice, defense of the nation, care for veterans, you get the idea. A lot of Medicare payments are for fraudulent claims, but it takes a Justice-Health and Human Services-IRS team to discover and prosecute a scheme.

So will Henrietta keep tsk-tsking the dirty chandelier, or will she pull out a ladder, climb up and polish the darn thing?

The problem is, it takes cross-partisan give-and-take. Benefits, retirement age, taxes — they’ve all got to be on the table. The fiscal facts are accurate. Short term economic ups and downs change the short term picture, but not the long term. Here’s how actuarial work operates:  People are born. In five years, they’ll all be five years older. We know within tenths of a percent how many will die.

Earlier Congresses and administrations have reworked the benefits programs before to extend their sustainability. Maybe the difference today is social media, which amplifies differences and spurs ever greater intolerance and language intemperance? Maybe the political extremes are exerting too much gravitational force?

Now it’s time for the grown ups to step up, but who are they?

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