Entitlement Spending

The United States will soon confront a major economic problem, perhaps one unparalleled in the nation's history. Starting today and continuing during the next twenty years, the post-World War II baby-boom generation will nearly double the nation's aged population; the lingering baby trough that followed will slow the growth of the working population. The baby boomers and the major advances in life expectancy affecting subsequent generations will cause the number of recipients of Medicare, Medicaid, and Social Security to rise, causing the expenditures of those programs, whose creation and inherent promises largely preceded the birth of those who now or will soon seek their benefits, to soar Our looming economic tsunami is simply the mountain of debt those promises portend. In Entitlement Spending: Our Coming Fiscal Tsunami, David Koitz makes the compelling case that Medicare, Medicaid, and Social Security have the potential to devour our country's productive capacity if not soon constrained. He argues that what's ultimately at issue is risks to our way of life--to our economy, our ability to grow, our standard of living, and our national security--and thus why we must deal with them now. Although Koitz acknowledges that there are many wasteful programs--extravagant earmarks, bridges to nowhere, defective weapons systems, fraud in Medicare and Medicaid, noncompetitive contracting, "pork barrel" politicking, and congressional perks--the big money lies in Medicare, Medicaid, and Social Security benefits. Those big-three entitlements, he shows, are the major drivers of the long-range escalation of government spending. The author offers various directions to address the fiscal problem, such as raising Medicare's eligibility age, increasing out-of-pocket cost-sharing, raising the age for full Social Security benefits, and reducing all forms of spending, revenue indexing. and cost-of-living adjustments. Although guaranteed to be unpopular, those alternatives may well be the only way to avoid economic disaster. When push comes to shove, the author argues that we will need to tighten our belt; as the wealthiest nation on earth, we have the ability to do so while protecting the poor and disabled. If we impede the future economy with enormous debt or large tax increases, everyone will suffer.