Politics & Policy

For Presidential Candidates, Some Inconvenient Truths on Entitlements

(Juan Moyano/Dreamstime)

News coverage of Hillary Clinton’s proposal to allow individuals under age 65 to buy into Medicare has focused largely on describing how her plan might work, or how it fits into her Democratic primary battle with socialist Bernie Sanders — the left hand trying to imitate what the far left hand is doing. But these political stories mask a more important policy paradigm: While Sanders and Clinton both want to expand Medicare, the program is broke — and neither Sanders, nor Clinton, nor Donald Trump have admitted that inconvenient truth, or have proposed any specific solutions to fix the problem.

Astute readers may note the verb tense in the preceding sentence. It’s not that Medicare will become insolvent in ten or twenty years’ time — it’s practically insolvent now. The program’s Part A (hospital insurance) trust fund lost a whopping $128.7 billion between 2008 and 2014, according to the program’s trustees. The Congressional Budget Office projected earlier this year that the trust fund would become insolvent within the decade.

But in reality, the only thing keeping Medicare afloat at present is the double-counting budget gimmicks created by Obamacare. In the year prior to the law’s enactment, the program’s trustees estimated that the Part A trust fund would become insolvent by 2017 — just a few short months from now. But within months after Obamacare became law, the trustees pushed back their insolvency estimate twelve years, from 2017 to 2029.

The trustees’ estimates notwithstanding, Medicare hasn’t become more solvent under President Obama — far from it. Instead, the Medicare payment reductions and tax increases used to fund Obamacare are simultaneously giving the illusion of improving Medicare’s insolvency. When former Health and Human Services secretary Kathleen Sebelius was asked at a congressional hearing whether those funds were being used “to save Medicare, or . . . to fund health care reform [Obamacare],” Sebelius replied, “Both.”

The Madoff-esque accounting schemes included in Obamacare do not improve Medicare’s solvency one whit. In fact, they undermine the program, because the illusion of solvency has encouraged politicians to ignore Medicare’s financial shortfalls until it’s too late.

And ignore it they have. Sanders has proposed a “Medicare for all” plan that a liberal think tank this week estimated would cost the federal government $32 trillion over ten years. Hillary Clinton has proposed creating another new entitlement — this one a refundable tax credit of up to $5,000 per family to cover out-of-pocket medical expenses, for which many of the 175 million Americans with employer-sponsored coverage could qualify. And Donald Trump has run ads, in states including Pennsylvania, claiming he will “save Social Security and Medicare without cuts.”

By claiming he can ’save Social Security and Medicare without cuts,’ Trump is effectively signing Republicans up for a $28 trillion tax increase to ’save Medicare.’

But none of them have provided specifics about how they would reform our existing entitlements to prevent a fiscal collapse and preserve them for current seniors and future generations. The collective silence might stem from the fact that Medicare alone faces unfunded obligations of $27.9 trillion over the next 75 years — and that’s after the Obamacare accounting gimmicks that make Medicare’s deficits look smaller on paper. Shortfalls that large will require making tough choices; greater economic growth will make the deficits more manageable, but we can’t grow our way out of a $28 trillion shortfall.

Reaction to Speaker Paul Ryan’s comments about Trump last week has largely focused on the latter’s tone and temperament in his presidential campaign. But if Ryan has stood for anything in Washington, it is fiscal responsibility and entitlement reform. Conversely, by claiming he can “save Social Security and Medicare without cuts,” Trump is effectively signing Republicans up for a $28 trillion tax increase to “save Medicare” — and more besides for Social Security. Little wonder, then, that the Speaker expressed his reluctance to endorse Trump; at their meeting today, they could well address this topic in detail.

Four decades ago, as Britain plunged into its Winter of Discontent, Prime Minister James Callaghan returned from a South American summit and denied any sense of “mounting chaos.” The next day, the Sun’s famous headline shouted “Crisis? What Crisis?” Clinton, Trump, and Sanders should take note. For while the remaining candidates for president seem more interested in creating new entitlements than in making existing ones sustainable, ultimately voters will not look kindly on those who fiddled while our fiscal future burned.

Most Popular

U.S.

The Lies We’re Told about the American Story

Editor’s Note: The following essay was adapted from remarks delivered to the annual dinner of the Lincoln Club of Orange County, in California, on October 4. Every American heart must break when lies are told to boys and girls, who then grow up to think the worst about their past: that the American ... Read More
U.S.

The Lies We’re Told about the American Story

Editor’s Note: The following essay was adapted from remarks delivered to the annual dinner of the Lincoln Club of Orange County, in California, on October 4. Every American heart must break when lies are told to boys and girls, who then grow up to think the worst about their past: that the American ... Read More

The Pollster Who Thinks Trump Is Ahead

The polling aggregator on the website RealClearPolitics shows the margin in polls led by Joe Biden in a blue font and the ones led by Donald Trump in red. For a while, the battleground states have tended to be uniformly blue, except for polls conducted by the Trafalgar Group. If you are a firm believer only in ... Read More

The Pollster Who Thinks Trump Is Ahead

The polling aggregator on the website RealClearPolitics shows the margin in polls led by Joe Biden in a blue font and the ones led by Donald Trump in red. For a while, the battleground states have tended to be uniformly blue, except for polls conducted by the Trafalgar Group. If you are a firm believer only in ... Read More
Film & TV

Bill Murray: The King of Cool

Bill Murray’s Bill Murray impression is priceless in On the Rocks, the way John Wayne did a fantastic John Wayne parody in True Grit and Al Pacino found a new level of Pacino-ness in Scent of a Woman. I want to quote every line of dialogue Murray delivers in his new movie for Apple TV+ -- every hilarious piece ... Read More
Film & TV

Bill Murray: The King of Cool

Bill Murray’s Bill Murray impression is priceless in On the Rocks, the way John Wayne did a fantastic John Wayne parody in True Grit and Al Pacino found a new level of Pacino-ness in Scent of a Woman. I want to quote every line of dialogue Murray delivers in his new movie for Apple TV+ -- every hilarious piece ... Read More
Media

The Media’s Shameful Hunter Biden Abdication

In an interview with National Public Radio’s public editor today, Terence Samuel, managing editor for news, explained why readers haven’t seen any stories about the New York Post’s Hunter Biden email scoop. “We don’t want to waste our time on stories that are not really stories, and we don’t want ... Read More
Media

The Media’s Shameful Hunter Biden Abdication

In an interview with National Public Radio’s public editor today, Terence Samuel, managing editor for news, explained why readers haven’t seen any stories about the New York Post’s Hunter Biden email scoop. “We don’t want to waste our time on stories that are not really stories, and we don’t want ... Read More
Books

Orwell, Huxley, and Us

To hear some people tell it, America entered a dystopia long before the coronavirus and measures undertaken to combat it altered everyday life almost to the point of unrecognizability. As for which dystopia, and when, well — that depends on whom one asks. For many on the left, the annus horribilis was 2016, ... Read More
Books

Orwell, Huxley, and Us

To hear some people tell it, America entered a dystopia long before the coronavirus and measures undertaken to combat it altered everyday life almost to the point of unrecognizability. As for which dystopia, and when, well — that depends on whom one asks. For many on the left, the annus horribilis was 2016, ... Read More