The deficit in the federal budget was 9% of GDP in 2010, 
  and on December 1 of that year
  we were told by
  
  
  Erskine Bowles 
  and 
  
  Alan Simpson, co-chairs of
  the President’s 
  National Commission on Fiscal Responsibility and Reform, 
  that there was a 
  
  $5.4 trillion unfunded mandate in the 
  
  Social Security 
  system that 
  must be dealt with.  
  
  
  The last time we were told something like 
  this was back in 1983 
  when the federal deficit was 
  
  6.0% of GDP in the aftermath of the 1981-1982 
  recession, following the 
  
  
  1981
  Reagan tax cuts, and at the beginning of Reagan's 
  
  anti Soviet defense buildup.  At that time, the Social 
  Security trust funds were dwindling, and Social Security was in danger of 
  running out of money.  In the midst of that fiscal mess, President Reagan 
  established the 
  
  Greenspan Commission to reform Social Security. 
  
  
  
  
  In accordance with the
  
  
  recommendations of the Greenspan 
  Commission, Congress agreed to
  
    - 
    
    Increase the payroll taxes paid by self 
    employed individuals. 
- 
    
    Increase the retirement age from 65 to 67 
    by 2022. 
- 
    
    Accelerate previously scheduled payroll 
    tax increases. 
- 
    
    Require that 50% of the Social Security 
    benefits received by higher income beneficiaries be taxed and paid into the 
    Social Security trust fund. 
- 
    
    Expand Social Security coverage to 
    nonprofit and newly hired federal employees.      
  Congress also made a number of
  
  
  additional changes that, when combined with previously 
  scheduled payroll tax and income cap increases, not only dealt with the trust 
  fund problem, but changed Social Security from a 
  pay-as-you-go system in which 
  the money received by current beneficiaries is paid by current workers, to a 
   
  
  
  
  partial-advanced-funding system in which the current workers prepaid a portion of 
  their own retirement, Medicare, disability, and death benefits as they also 
  paid 
  for the benefits of the current beneficiaries.  (SSA)  
  As a result, Social Security has had an annual surplus since 1984—a surplus 
  that  increased the Social Security 
  Old-Age Survivors and Disability Insurance (OASDI) trust fund to $2.6 trillion by 2011 with an additional $0.3 trillion in the 
  Medicare and supplementary medical insurance trust funds as well. 
  
  
  
  This $2.9 trillion represents the prepayment of the current 
  working generations for their own retirement, medical, disability, and death 
  benefits—payments they made into these trust funds while they fully supported 
  (paid for) the retirement, medical, disability, and death benefits of the 
  generations that went before.  And what happened to this $2.9 trillion?  It 
  was placed in the safest investment on Earth: United States government bonds 
  backed by the full faith and credit of the United States of America.  Why?  
  Not only because this  is the safest investment on Earth, but because there was 
  no acceptable alternative way to invest these funds.  
  
  If the Social Security Administration were to invest in 
  non-government securities, it would involve the federal government in the 
  private securities markets in a massive way.  The potential for corruption 
  with so much money involved was daunting, so much so that virtually no one 
  thought this was a good idea.  At the same time, the idea that these funds be 
  divided into private accounts and invested in private securities by private 
  individuals was also deemed unacceptable.  This would make them vulnerable to 
  the vagaries of the private-securities markets, and, as such, would defeat the 
  central purpose of the Social Security System.  
  
  Social Security was created to provide a system of 
  government guaranteed social insurance that is not dependent on the private-securities markets.  It was the lack of such a system following the financial 
  disaster in 1929 that inspired the Social Security System in the first place.  
  What's more, the idea that the trust funds should have been invested in 
  private securities was put to the test in the 2000s.  It is only because these 
  funds were invested in government bonds that they survived the stock market 
  crash of the early 2000s and the financial crisis of 2008.   
  
  
  The baby boomer retirement problem is explained in
  
  
  The 2011 Annual Report of the Board of Trustees of the Federal Old-Age and 
  Survivors Insurance and Federal Disability Insurance Trust Funds.  
  A concise statement of this problem can be found in the Trustees' message to 
  the public in the summary of this report:
  
  Social Security expenditures exceeded the program’s 
  non-interest income in 2010 for the first time since 1983. . . . This deficit 
  is expected to shrink to about $20 billion for years 2012-2014 as the economy 
  strengthens. After 2014, cash deficits are expected to grow rapidly as the 
  number of beneficiaries continues to grow at a substantially faster rate than 
  the number of covered workers. Through 2022 . . . redemptions will be less 
  than interest earnings, [and] trust fund balances will continue to grow. After 
  2022, trust fund assets will be redeemed in amounts that exceed interest 
  earnings until trust fund reserves are exhausted in 2036 . . . .  Thereafter, 
  tax income would be sufficient to pay only about three-quarters of scheduled 
  benefits through 2085.  (SSA)
  
  The Trustees further explain in this message that
  
  Program costs equaled roughly 4.2 percent of GDP in 2007, 
  and are projected to increase gradually to 6.2 percent of GDP in 2035 and then 
  decline to about 6.0 percent of GDP by 2050 and remain at about that level. (SSA)
  
  This is what all of the fuss is about:
  
    - 
    
    If we do nothing, the current payroll tax structure and 
    trust fund is expected to carry the system into 2036 at which point the trust fund 
    will be exhausted and payroll taxes will cover only 75% of the promised 
    benefits.  At that point either taxes will have to be raised or 
    benefits cut to make up the difference. 
- 
    
    The annual costs of Social Security benefits were 4.2% of
    
    
    GDP in 2007 and are expected to increase to 6.2% in 
    2035, then decline to 6.0% by 2050 and thereafter.  This means that in 
    order to maintain benefits, the proportion of GDP devoted to Social Security 
    benefits must increase by 2.0% of GDP (6.2-4.2=2.0) between 2007 and 2035 
    and decrease thereafter by 0.2% of GDP between 2035 and 2050 for a net 
    increase of 1.8% of GDP from 2007 through 2050.   
  Where's the crisis?  According to the Trustee’s report, the 
  Social Security trust fund is expected to continue to increase until 2022, and 
  Social Security is fully funded until 2036.  Social Security benefits must 
  increase by 2% of GDP by 2035, which would not seem like much of a problem 
  since the United Sates is one of the wealthiest countries on Earth. 
   Increasing Social Security benefits by 2% of GDP between now and 2035 should 
  not be a major problem.  
  
  What's more, the trustees assume in their report that over 
  the next 75 years productivity, as measured by output produced per hour of 
  labor, will increase in the United States at an annual rate of 
  
  
  1.7%.  This is the average rate of productivity growth 
  for the past forty years, and if productivity continues to grow at this rate 
  it means, through the magic of compounding, our economy will be 50% (1.017 
  multiplied by itself 25 times = 1.52) more productive in 2035 than it was in 
  2010.  Even if productivity only grows by the worst case scenario considered 
  in the trustees’ report, 
  
  1.3% a year, we will still be almost 40% (1.013 
  multiplied by itself 25 times = 1.38) more productive in 2035.  Why should we 
  believe that an increase of Social Security benefits equal to 2% of GDP 
  between now and 2035 is going to be a crushing burden on society in a world in 
  which the labor force that produces that GDP will be able to produce 40% to 
  50% more per hour of work than we do today?   (Baker)     
  
  
  It's time to step back, take a deep breath, and remember 
  what we are talking about here.  We are talking about increasing the share of 
  GDP that is devoted to the payment of Social Security benefits from 4.2% today 
  to 6.2% by 2035, then a decline in this share to 6.0% by 2050.  This is a net 
  increase of only 2.0% of GDP over the next twenty-five years.  At the same time, 
  productivity is supposed to increase 40% to 50% by 2035.  This is the economic 
  problem posed by the baby boomers' retirement, a problem that most certainly 
  must be dealt with, but it is not a problem that portends a budget crisis that 
  will require drastic changes in the Social Security System to solve.   
  
  
   Figure 1, which plots federal expenditures as a percent of GDP from 
  1960 through 2013, should help to put this problem in perspective.  
  
  
   
 
  
  
  
  Source:  
  Source:  
  
  Office of Management and Budget.  (1.2)
  
  As is indicated in this figure, the average 
  of federal expenditure as a percent of GDP during the 1980s (22.2%) was 2 
  percentage points above the average in the 2000s (20.3%).  In other 
  words, an increase in Social Security benefits equal to 2% of GDP by 2035 
  would be the equivalent of taking us back to where we were in the 1980s in 
  terms of the federal budget.  This would hardly require a dramatic change 
  in the American way of life, especially since productivity today is
  40% 
  to 50% greater than it was in the 1980s and is expected to be 40% to 50% 
  greater in 2035 than it is today.  What’s the big deal about the baby boomers 
  increasing Social Security payments by 2% of GDP between 2010 
  and 2035 in a world in which output, and, hence, real income per worker is expected to be 40% to 50% 
  greater than it is today?  
  
  
  
  It is essential to recognize, however, that even though the 
  existence of a $2.6 trillion trust fund goes a long way toward solving the 
  funding problem the baby boomers present to the Social Security 
  Administration, it adds nothing toward solving the fiscal problem faced by the 
  federal government.  The reason is that the Greenspan Commission’s
  
  
  
  partial-advanced-funding scheme does not change the fiscal situation of the government when 
  it comes time for the baby boomers to retire.  
  
  Back 
  in the 1980s, the 
  
  Reagan Tax Cuts led to huge 
  deficits in the federal budget that were not brought under control until the 
  1990s.  One of the mechanisms that helped to bring these deficits under 
  control was the
  increase payroll taxes paid by 
  working people as the Social Security System was 
  converted from a
  
  pay-as-you-go system  to a 
  
  partial-advanced-funding system.  As was noted 
  above, since the mid 1980s
  Social Security has had an annual 
  surplus, a surplus that increased the Social Security OASDI trust fund by $2.6 trillion.  These  funds were, in 
  turn, lent to the federal government 
  to help finance its general expenditures, to the effect that by 2001 
  the money 
  borrowed from the Social Security System’s trust funds in that year alone 
  amounted to 8.75% of the federal 
  budget.  
  
  The problem is, as the baby boomers began to retire 
  in the early 2000s, the amount of cash available to be borrowed from the 
  Social Security System began to dwindle, and in 2010 there was no cash left to 
  borrow even though the Social Security System still had a surplus in that 
  year.  The reason is that even though there was a surplus in the budget 
  for Social Security in that year, the amount of cash the system took in from payroll 
  taxes was less than the amount of cash it paid out in benefits and costs.  
  This situation is explained in the passage from the Trustee's Report 
  quoted above:
  
  Social Security expenditures exceeded the program’s 
  non-interest income in 2010 for the first time since 1983. . . .Through 2022 . 
  . . redemptions will be less than interest earnings, [and the] trust fund 
  balances will continue to grow.  After 2022, trust fund assets will be 
  redeemed in amounts that exceed interest earnings. . .  (TRSUM) 
  
  
  This means that in 2010 the government could no longer simply credit the 
  interest it owed the Social Security System to its account and borrow its surplus cash since there was no surplus cash left to borrow.  
  There was a cash deficit in the Social Security systems accounts, and 
  the federal government was forced to pay a portion of the interest it owed the 
  system in cash in order to fund this cash deficit.
  
  As a result, since 2010 the federal government has been 
  forced to pay a portion of its interest obligation to the Social Security 
  System in cash in order for the Social Security System to pay its benefits and 
  administrative costs in cash.  At the same time, the amount of money the federal government owes the Social 
  Security trust funds each year continues to grow because the amount of cash the federal 
  government has been forced to pay into the Social Security System each year 
  has been less than the amount of interest that accrues each year on the debt 
  the federal government owes to the system.  The difference must be 
  credited to the Social Security System's trust fund which, in turn, increases 
  the trust fund.  
  
  This situation is expected to continue through 2022 when 
  the Social Security System's cash deficit is expected to equal the 
  amount of interest the government owes the system in that year. At that point the Social Security 
  trust fund is expected to peak, and from then on the trust fund is expected 
  to fall as the federal government is forced to redeem the government 
  bonds in the Social Security trust fund (as well as pay the interest that 
  accrues each year on its remaining debt to the Social Security trust fund) in 
  cash in order for the Social Security System to 
  meet its obligation to pay its administrative costs and benefit payments to the baby boomers 
  in cash. 
  
  There are only two ways the federal government can come 
  up with the cash needed to pay the interest on its debt to the Social 
  Security System and to begin paying back the principal it borrowed from 
  working people:  It can either raise taxes or borrow the needed funds. If it 
  doesn’t raise taxes, it will have to borrow, and 
  it can’t borrow without 
  increasing the national debt. The only alternative is for the federal 
  government to default on its obligations to the baby boomers by reducing their 
  Social Security benefits.
  
  Thus, when it comes to making up the difference between 
  payroll tax receipts taken in and benefits paid out it makes no difference 
  whether there is a trust fund or not.  In either case, the government must 
  either borrow or tax to make up this difference.  As a result, the trust fund 
  has no effect on the fiscal situation facing the government when the benefits 
  owed the baby boomers come due.[1]
  
  But if prepaying a portion of their Social Security 
  benefits did not contribute to a solution to the government's fiscal problem 
  when the baby boom generation retires, just what did the Greenspan Commission 
  accomplished?  What it accomplished was an increase in the taxes paid by 
  working people to support the general expenditures of the government.  That 
  increase yielded the government $2.9 trillion from working people since 1983 
  that it would not have received if the Social Security System had stayed on a 
  pay-as-you-go basis.  That's what prepaying a portion of the Social Security 
  benefits accomplished, and that's all it accomplished from the perspective of 
  the fiscal soundness of the government. 
  
  This is where the real crisis in Social Security lies, and 
  this is not an economic crisis.  We are still talking about increasing 
  Social Security benefits by only 2% of GDP by 2035 in a situation where 
  increases in productivity is expected to increase output per worker by 40% or 
  50%.  It is a moral and political 
  crisis, however, because our society has to decide how it is going to come up 
  with the funds necessary to make this adjustment or if it is going to not come 
  up with these funds and renege on its promise to the baby boomers. (Surowiecki)
  
  
  The bipartisan 
  
  Moment of Truth report written by 
  
  Alan Simpson and 
  Erskine Bowles
  is the end product of the President’s 
  
  
  National Commission on Fiscal Responsibility and Reform.  While this report 
  was formally rejected by the Commission, it puts forth a set of recommendations  to deal with 
  our federal 
  deficit and debt problems in a comprehensive way, recommendations that have 
  gained a significant amount of political support.  Of particular interest 
  in this report are the recommendations regarding Social Security, Medicare, 
  and revisions of the tax code.   
  
  
  Concerning Social Security, the Simpson-Bowles 
  recommendations are summarized in Figure 2.  
  
  
  
  Source:
   
  Moment of Truth Report.
  
  These recommendations contain five key elements 
  where the percentage in parentheses following each item indicates its 
  contribution toward eliminating the expected shortfall in Social Security 
  funding over the next seventy-five years:
  
    - 
    
    
    Gradually phase in progressive changes to the benefit formula while 
    increasing the minimum benefit and adding a longevity benefit. (29%) 
- 
    
    Index 
    retirement age and earliest eligibility age to increase with longevity. 
    (18%) 
- 
    
    Use a 
    chained CPI rather than the standard CPI to adjust benefits for changes in 
    the cost of living. (26%) 
- 
    
    
    Gradually increase the income cap to cover 90% of wage income. (35%) 
- 
    
     Add 
    newly hired state and local government employees to the program after 2020. 
    (8%)  
  The first element in this list combines the first, second, and forth 
  items in Figure 2 where the savings are supposed to be achieved by 
  making the benefit payout system more progressive—that is, by lowering the 
  benefits paid to high income recipients while, at the same time, increasing 
  the benefits paid to low income recipients.  The suggestion that these 
  savings are coming from making the system more progressive is rather 
  disingenuous, however, in that the savings come from a net cut in benefits, not from the fact that the resulting payout scheme is 
  more progressive.  If the increase in benefits paid to low wage earners were 
  equal to the decrease in benefits paid to higher wage earners there would be 
  no savings from this adjustment in progressivity.  
  
  The second item obviously achieves the savings, without any 
  pretext, through a straightforward 
  
  across the board cut in benefits by increasing the 
  retirement age.  The third also achieves the savings by cutting benefits by 
  way of a controversial change in the way the Social Security cost of living 
  adjustment is calculated.  (WSJ
  
  
  SGS)  The last two achieve their savings by increasing 
  the payroll tax base.  
  
  Thus, when we do the math, we find that these 
  recommendations solve Social Security’s future revenue problem by cutting 
  benefits to cover 73% of the expected shortfall and by expanding the tax base 
  to cover an additional 43% of the shortfall.  (Presumably, the redundant 16% 
  of savings is there to maintain the Social Security trust fund that will be 
  lent to the government.)  According to 
  
  Simpson and 
  
  Bowles, if we accept their recommendations Social 
  Security will be on a sound financial footing for the next 75 years. 
  
  
  
  It is worth 
  noting, however, that if these recommendations are implemented they will have 
  the effect of converting Social Security from an insurance program in which 
  the benefits provide some protection against a catastrophic loss into a kind 
  of non-means-tested 
  
  welfare program for the elderly 
  in which there are hardly any benefits at all.  The extent to which this 
  is so is indicated in Figure 3 which shows the expected payout under 
  the current law and how the payout structure would change under the 
  Simpson-Bowles recommendations.
  
  
  
  Source: 
  
  www.StrengthenSocialSecurity.org, 
  
  Benefits Chart. 
  
  Under this scheme 
  benefits would fall by 47% for "'Maximum' Earners($106,800)", 39% for "'High' 
  Earners ($68,934)",  27% for "'Medium' Earners ($43,084)" and even "'Low 
  Earners' ($19,388)" would see a decrease. 
  
  
  Even worse, the Simpson-Bowles scheme proposes to fund this 
   
  program through the payroll tax.  The payroll tax is one of the most 
  regressive taxes there is.  It is levied only on earned income (income 
  received from wages and salaries) with no deductions and only minor 
  exemptions, and the total amount of earned income taxed is capped where 
  the cap in 2011 was $106,800.  It is not levied on unearned income (income 
  received in the form of interest, dividends, capital gains, rent, and 
  corporate profits) or on earned income above the $106,800 cap.  As a result, 
  virtually all of the income of low income families is subject to the Social 
  Security tax since virtually all of their income comes from wages and 
  salaries below the cap, while virtually none of the income of the wealthy is subject to this 
  tax since virtually all of their income is either above the cap on earned 
  income or comes from unearned income.  
  
  The payroll tax is hardly an equitable way to finance a 
  welfare type program.  The burden of financing this sort of program should fall 
  heaviest on those who can afford to pay, not on the backs of the working poor 
  as is the case when the payroll tax is used.  It makes sense to use a payroll 
  tax to finance  an insurance program.  It does not make sense to use a 
  payroll tax to finance a welfare-type program.
  
    
    
    Our
    multiple-payer, third-party, 
    fee-for-service payment healthcare system whereby healthcare providers decide 
    with patients what services to provide and how much to charge while insurance companies or 
    the government picks up the tab virtually guarantees continually increasing 
    costs. There is a powerful incentive to over prescribe in this system and 
    little incentive to deliver quality healthcare in a cost effective manner 
    since the decisions as to what to charge and how much to prescribe are made primarily by 
    providers.   
    
    To make matters 
    worse, rising healthcare costs virtually guarantee that a continually 
    increasing share of the healthcare costs will be passed on to the government 
    as the higher costs force people, especially those with poor health,  out of the private 
    healthcare system.  This is so because as people are forced out of the 
    system society must decide the extent to which the government should pick up 
    the tab for those who can no longer afford the cost of private healthcare.  
    To the extent the government picks up the tab, it reinforces the process of 
    third-party payment irrespective of cost that leads to the increasing costs 
    that forces people out of the private healthcare system in the first place.  
    To the extent the government does not pick up the tab, people who could 
    otherwise be saved are left to die or to suffer with maladies that could 
    otherwise be cured.  This choice begs the question: How many poor 
    people who cannot afford to pay for the cost of healthcare should be allowed 
    to suffer or die—in the wealthiest country on Earth—in order to lower the 
    costs for those who can afford to pay?   
    
    
    There is no 
    optimal answer to this question that is in any sense humane, and our attempt 
    to find one over the past 75 years while at the same time attempting to hang 
    on to our archaic  
    multiple-payer, third-party, 
    fee-for-service payment system has caused the American 
    healthcare system to become the least efficient among the  advanced 
    countries of the world.  We rank 
    
    51th in terms of life expectancy, 
    
    51th in terms of infant mortality, 
    
    24th in terms of the availability of doctors,
    
    
    25th in terms of mother’s health, 
    37th in terms of the overall performance of our healthcare system, and 
    at the same time, we spend more for healthcare 
    
    
    per person and as a 
    
    
    percent of GDP than any other country 
    in the world.  
    
    (OECD
    
    
    OECD Charts 
    
    NYT 
    
    IOM 
    
    JAMA1 
    
    JAMA2
    
    STC
    
    WHO)
    
    Over the past thirty years healthcare expenditures as 
    a percent of GDP have increased at the rate of 2.2% per year.  At this 
    rate, expenditures as percent of GDP will double every 32 years.  
    Obviously something is going to give before this can occurred.  The 
    only question is what: the government’s budget, employer sponsored health 
    insurance, or both?   
    
    
    The 
    
    Patient Protection and Affordable Care Act has attempted to address this 
    rising healthcare cost problem, but while there are a number of cost saving 
    provisions in this bill, 
    
    the Affordable 
    Care Act hangs on to the fee-for-service, multi-third-party-payer model.  There is 
    no 
    
    
    
  
    single-payer mechanism or 
    
    public-option plan provided for in this 
    act to provide a direct mechanism by which costs can be controlled.  In 
    addition, the 85% payout restriction on insurance companies that is part of this 
    bill means that once insurance companies reach this limit they will only be able to increase their profits 
    in the aggregate 
    if healthcare costs increase, thereby, increasing what insurance companies 
    can make from their 15% cut.  This does not exactly provide an 
    incentive for insurance companies or providers to hold down costs, and if 
    healthcare costs continue to grow the way they have in the past, the cost of
    
    
  
    Medicare and 
  
    Medicaid, which together make up the largest single component of our 
    social insurance system today, will eventually become unbearable. 
     
  
  In dealing with 
  healthcare, the main thrust of the Simpson-Bowles recommendations is to 
  reduce healthcare costs by forcing healthcare recipients, both public and 
  private, to pay a larger proportion of the cost.  But, as was noted 
  above, this plan can only 
  reduce costs to the extent it forces those who cannot afford the added costs 
  out of the healthcare system with all of the implications that has for the 
  health of our population; to the extent the government picks up the 
  tab for those who cannot afford the added cost there is no saving.  This 
  plan is just more of the same kind of thing we have been doing for the past 65 
  years, and there is no reason to think the results will be different: rising 
  healthcare costs with a larger and larger portion of the tab being picked up 
  by the government.  
  
  
  What is particularly disturbing about the Simpson-Bowles 
  bipartisan plan for deficit reduction, however, is that while they recommend 
  massive cuts in Social Security and Medicare benefits, at the same time they 
  recommend the top marginal income tax rate paid by corporations and the 
  wealthy be cut from 
  
  35% to 28%, that the marginal income tax rate paid by 
  middle-income earners be set at 
  
  22%, and that the lowest income tax rate paid by the 
  not so wealthy be increased from 
  
  10% to 12%.  
  
  It these changes are passed into law, the combined
  
  
  14.2% [2] employee/employer payroll tax rate plus the 
  income tax rate in the lowest income bracket will equal 26.3%—less than two 
  percentage points below the maximum marginal rate corporations and 
  multibillionaires will pay.  Those in lower end of the middle tax bracket will 
  face a combined marginal rate of  
  
  36.2%—8.2 percentage points above the 
  marginal rate multibillionaires and corporations will pay.  Even though 
  
  Simpson and 
  
  Bowles also recommend treating dividends and capital 
  gains as ordinary income and recommend a few other changes that will make the 
  tax code somewhat more progressive, there is something very wrong here.  
  
  
  There was a surplus in the federal budget equal to
  
  
  2.4% of GDP in 2000 before the massive 
  
  2001-2003 Bush tax cuts, before the invasion of Iraq, 
  and before  those who ran our
   
  financial institutions devastated our economy.  The 
  fiscal problems we face today are clearly the result of the Bush cut taxes 
  combined with the increases in defense expenditures squandered in Iraq and the 
  devastating recession brought on by 
  the fraudulent, reckless, and 
  irresponsible behavior of those in charge of our financial institutions.  Social Security 
  and Medicare had nothing to do with this mess.
  
  And yet—in the name of fiscal responsibility—Alan Simpson and
  
  
  Erskine Bowles, acting as co-chairs of 
  the 
  
  National Commission on Fiscal Responsibility and Reform, released their 
  Moment of Truth report in which they propose we 1) cut 
  Medicare benefits and increase the private cost of healthcare dramatically, 2) 
  convert Social Security into a welfare-type program paid for with payroll taxes in 
  order to avoid paying an increase in benefits equal to 2% of GDP, and, at the 
  same time, 3) give additional tax cuts to those at the top of the income 
  distribution, many of whom made fortunes out of the Iraq war and through 
  financing the housing bubble that devastated the economy of the entire world.  And to add 
  insult to injury, we are also supposed to increase the taxes paid by those in 
  the lowest income tax bracket.  This not only defies common sense, it 
  defies common decency.   
  
  
  
  The
   
  
  Moment of Truth report released by the co-chairs of the  
   
  
  
  National Commission on Fiscal Responsibility and Reform does not deal with the deficit problem in a substantive 
  way.  There is no discussion as to how the optimum level or quality 
  healthcare can be provided to the population in the most cost effective manner in 
  their report.  No discussion as to how Social Security and Medicare can 
  be maintained as viable insurance programs.  No discussion as to how the 
  optimum level of essential government services can be made available in their 
  most cost effective manner.  
  
  This report concentrates only on cutting government 
  services and lowering tax rates paid by the ultra wealthy.  As a result, 
  it simply ignores obvious solutions 
  to our Social Security, healthcare, and fiscal problems—solutions that do not 
  entail emasculating Social Security and Medicare. 
  
  
  There are many ways to deal with the expected shortfall in Social Security 
  revenues needed to finance the benefits promised to the baby boomers that 
  would not involve drastic changes in the Social Security program.  One would be to
  
    - 
    
    
    Increase 
    the payroll cap to apply to 90% of covered earnings
    
    
    as Congress intended back in 1977 or, perhaps, to an 
    even higher percentage.  
- 
    
    Convert 
    the federal estate tax to a 
    
    dedicated Social Security tax that is credited 
    automatically to the Social Security trust fund. 
- 
    
    Expand 
    the program to cover newly hired 
    
    state and local workers.    
- 
    
    Implement 
    modest changes in payroll taxes and Social Security benefits, if needed, after 
    the above changes have been made and, perhaps, extend the payroll tax to 
    include unearned income and/or remove the income cap altogether.   
  Approaching the expected Social Security deficit problem in 
  this way would not require the draconian cuts in benefits put forth in the
  
  Moment of Truth Report nor would it require draconian 
  payroll tax increases.  
  
  
  
  It is the rising cost of healthcare that poses the most serious fiscal 
  problem faced by the federal government, and, as has been noted above, every 
  advanced country in the world that has better health statistics and lower 
  healthcare costs than we do has abandoned the cost ineffective  
  multiple-third-party payment system for 
  a  
  
  
  single-payer universal healthcare system that provides government 
  subsidized healthcare for all—paid for through taxes—where costs are 
  controlled through government negotiated prices. They pay higher taxes than we 
  do, but their higher taxes are more than offset by the savings in insurance 
  premiums and lower healthcare costs—not to mention the fact that they are 
  healthier than we are, and they live longer than we do.  (OECD
    OECD Charts NYT
  
  IOM JAMA1
  
  JAMA2)
  
  The simplest, most efficient, and most cost effective way 
  to provide a comparable system for the United States would be to extend the 
  Medicare program to the entire population.  This program works, and the 
  institutions necessary to run it are already in place.  It would take 
  very little effort to retool Medicare to meet the needs of the entire 
  population compared to the massive  effort it is going to take to 
  implement the 
  
  Patient Protection and Affordable Care Act.        
  
  
  
  By 2000, increases in the Social Security trust fund was 
  adding over $150 billion a year in cash flow and deferred interest payments to 
  the government’s general fund, and it continued to do so for the next eight 
  years.  From 1996 through 2008, the federal government relied on the 
  increase in the OASDI trust fund to finance over 6% of its outlays and, as was 
  noted above, this 
  reached a peak in 2001when the money 
  borrowed from the Social Security System’s trust funds in that year alone 
  amounted to 8.75% of the federal 
  budget.  
  
  
  Now that the baby boomers are starting to retire, this 
  source of revenue is coming to an end.  While some of the interest the 
  government owes the Social Security System each year can still be simply added 
  to the System's trust funds, cash receipts from payroll taxes have fallen 
  below the cash benefits and administrative costs the Social Security System 
  must pay out.  As a result, the government must either borrow the difference 
  or it must increase non-payroll taxes in order to pay that portion of the 
  interest it owes the Social Security System each year in cash to meet this 
  cash shortfall—if that’s what our government chooses to do.  It also has the 
  option of reneging on its agreement with the baby boomers by reducing their 
  benefits or increasing the payroll taxes paid by their children and 
  grandchildren.  
  
  
  Even though there are a number of 
  simple fixes that will solve the Social Security baby boomer retirement 
  problem, and it would be fairly easy to fix our healthcare system, none of 
  these fixes will work if the federal government is not 
  made fiscally sound.  These fixes can only work if we come up with 
  the funds needed to make  them work while, at the same time, coming up 
  with the funds needed to provide the other government services the American 
  people demand. 
  
  
  What 
  this means is that, if we are to preserve Social Security, Medicare, and 
  provide for all of the other government services that are demanded by the 
  American people, we must raise taxes. 
  (Fieldhouse 
  Diamond  Sides)
  
  
  
  It will, of course, also be necessary to 
  reregulate our financial system if we are to keep our financial institutions 
  from creating the kinds of economic disasters that unregulated 
  financial 
  institutions have created
  throughout history. At the very lease we must
  
    - 
    
    reenact the
     
   
Glass-Steagall Act
    to eliminate the kinds conflicts of interests inherent 
    in conglomerate mega-bank financial institutions,
    break up those financial institutions 
    that are "too big to fail," and 
    
    
    provide for direct regulation of hedge 
    funds, over-the-counter derivatives, and the market for repurchase 
    agreements with the power to set margin requirements for repurchase 
    agreement loans and capital requirements for Credit Default Swaps.
  
  
  These are the minimum actions 
  required to keep those in charge of our financial institutions from creating 
  in the future the kind of economic catastrophes they have created in the past when unrestrained by government regulation—the 
  kind of economic catastrophe we are in the midst of today. 
  
  Simply passing laws, however, is not 
  enough. Government regulation 
  begins with the 
  law, but it ends with the regulators. It was the belief in free-market 
  ideology that was the primary cause of the financial crisis we face today, not 
  the absence of legislation. The 
  
  
  
  Home Ownership and Equity Protection Act 
  (HOEPA) passed 1994 
  gave the Federal Reserve the absolute authority to regulate the mortgage 
  market. Enforcing the laws against predatory lending practices, enforcing 
  strict underwriting standards for mortgage loans, and setting maximum loan to 
  value ratios on mortgages would have prevented the housing bubble that came 
  into being in the 2000s. The Federal Reserve had the absolute authority to do 
  all of these things under HOEPA during the housing bubble, but the ideological faith in free 
  markets to regulate themselves on the part of regulators, the administrations, 
  and the Congress kept the Fed from doing so.
   
  (Bair)
  
  
  In addition, 
  the regulators  could have 
  petitioned the government to bring 
  
  
  
  Money Market Mutual Funds,
  
  Cash Management Accounts, and repurchase agreements 
  under the purview of depository regulators during the Reagan administration 
  and to extend the regulatory authority of the 
  Security and Exchange Commission
  and 
  Commodity Futures Trading Commission to regulate 
  hedge funds and the markets for Credit Default Swaps during the Clinton 
  administration, but, again, ideology stood in the way. 
  
  Until the terribly 
  misguided view of reality embodied in the
  failed nineteenth-century ideology 
  of free-market capitalism is replaced in the minds regulators, 
  administrations, Congress, and the body politic by a pragmatic view of 
  financial regulation that recognizes the need for the government to rein in 
  and control the speculative and fraudulent urges of the financial sector there 
  is little hope of our being able to survive the current crisis with our basic 
  social institutions intact or to avoid similar economic catastrophes in the 
  future.