Personal Accounts–for Medicare
Last night, Newt Gingrich praised the Chilean Social Security system, which allows workers to save for their retirements in personal accounts, rather than contribute to the government pension scheme. Several of my Cato colleagues are far more qualified than I am to comment on that system, including Mike Tanner, Jagadeesh Gokhale, and Jose Pinera–who designed and implemented it. But personal accounts are as important for reforming compulsory health insurance schemes like Medicare as they are for reforming compulsory pension schemes.
In 2010, I traveled to Chile to deliver an address to the International Federation of Pension Fund Administrators (FIAP). I detailed the harms caused by compulsory health insurance schemes and explained how personal medical accounts would improve health care and generate wealth even for the poor:
In designing health care markets, perfection is not an option. Under any system, whether state-run or the free market, some patients will inevitably fall through the cracks.
Personal medical accounts can help fill in those cracks by enabling innovations that improve medical care and bring it within reach of the poor. Yes, some will not earn enough to provide for themselves. And when we are free to make our own decisions, a small number of people will make poor decisions. I believe we have a moral duty to care for patients who could not or would not provide for themselves. Personal medical accounts will make it easier for us to meet that moral duty.
Under compulsory health insurance schemes, those cracks widen, and more people fall through. Price and exchange controls block innovation. Governments waste resources on low-value medical care. Some would describe these as the unavoidable costs of creating an equitable society. But those wasted resources do not purchase solidarity. They purchase sickness and poverty.
FIAP turned my address into this book chapter, which also explains how to craft a system of personal medical accounts.
For current enrollees, who have not built up savings in a personal medical account, Congress should make Medicare look more like Social Security. That is, the government should subsidize Medicare enrollees by giving them cash, rather than creating a complex health-insurance scheme that effectively lets government officials shape the entire health care sector.
Filed under: Cato Publications; General; Government and Politics; Health Care
Fiscal Imbalance and Global Power
Over at National Journal‘s National Security Experts blog, this week’s question revolves around the health of the U.S. economy, and its relationship to U.S. power.
How serious a threat is the mounting debt to the nation’s standing as the world’s only superpower? Can the U.S. continue to spend more than all other countries combined on its military forces given burdensome debt levels? In what other ways does the mounting debt undermine the country’s strategic position? [...]
Our long-term fiscal imbalance, which increasingly amounts to a massive intergenerational wealth transfer, is clearly a sign of our decline. But it is a decline that has been a long time coming. (I first wrote about the insolvency of the Social Security system as a college sophomore, 23 years ago.) As such, it is tempting for people to assume that we’ll figure our way out of this mess before a complete collapse. Let’s call them, at the risk of a double negative, the declinist naysayers. And, even if they are willing to admit to the problem in the abstract, the naysayers can point to the more serious, and urgent, imbalances between pensioners and those who pay the pensions in Europe or Japan and say “At least we aren’t them.”
That is a pretty shoddy argument, but it seems to be ruling the day. We can talk about the obvious unsustainability of using taxes on current workers to pay benefits for retirees until we’re blue in the face. And my second grader can do the math on a system that was designed when workers outnumbered beneficiaries by 16.5 to 1, and in which, by 2030, that ratio will fall to 2 to 1. It simply doesn’t add up. (For more on this, much more, see my colleague Jagadeesh Gokhale’s latest.)
But this isn’t a math problem; this is a political problem. The incentive to kick the can down the road is overwhelming. The pain in attempting to deal with the problem in the here and now is, well, painful. It is hardly surprising, therefore, that members of Congress / Parliament / Bundestag / Diet, etc, have become very good at avoiding the issue altogether. And many of those who have chosen to tackle it are “spending more time with their families.”
What does all this mean for the United States’s standing as the world superpower? Less than you might think. Our difficulties in two medium-sized countries in SW/Central Asia have done more to puncture the illusion of American power than our political inability to deal with domestic problems. Our fiscal insolvency might convince other countries to play a larger role, if they genuinely feared for their safety. But other countries, especially our allies, are cutting military spending, while Uncle Sam continues to bear the weight of the world on his shoulders. In other words, our ability to maintain our global superpower status isn’t driven by our economic problems. But it is strategically stupid.
Ed Morrissey on The Struggle to Limit Government
Ed Morrissey kindly mentioned The Struggle to Limit Government and responds to the advice for Tea Partiers in my video.
Morrissey says:
I don’t think it’s accurate to say that some Tea Partiers “like” big government; it’s more like some aren’t enthusiastic about dismantling as much of the federal government as others, especially the more doctrinaire libertarians.
In the video I noted that polls showed a majority of the people who identify with the Tea Party movement also thought the entitlement programs were worth their cost. My colleague, Jagadeesh Gokhale, has estimated that paying for current entitlements would require 9 percent of GNP in perpetuity. This is unlikely. Entitlements will have to be changed since too much has been promised. People who think the programs have been worth their cost are not likely initially to support reining in the entitlements. In saying that, I expressed a concern, not a prediction. It may be that Tea Party people will also come to recognize, as Ed Morrissey does, that the entitlement state cannot continue.
I said in the video that Tea Party people should recognize that “Democrats are not always the enemy.” Morrissey rightly says I should not talk about enemies in domestic politics. He adds that the current House Democratic caucus does not deserve support because its leaders favor expanding government. He’s right. Divided government is what we need now. However, I had in mind the more centrist Democrats that supported the tax and spending cuts of 1981 and the tax reform of 1986. I am urging Tea Party people to avoid becoming too partisan. Perhaps some of them will still be in Congress in 2011.
Then there’s the question of foreign policy and defense spending. In the video I said that a limited government movement like the Tea Party should start thinking outside the box on spending. I suggested rethinking America’s expansive commitments in foreign affairs as a way to reduce our military spending. I did not deny — who could deny it? — that the Constitution entrusts the common defense to the federal government. I also recognize that the United States continues to have enemies. The question is: what should the government do to provide the common defense consistent with limited government?
In the past decade, we have spent enormous sums trying to transform two nations and the entire Middle East into liberal democracies. This was our “forward strategy” for dealing with terrorism. It reminded me of past Progressive crusades at home and abroad. The strategy was a domestic political disaster, and we shall see whether our massive outlays eventually produce stability in Iraq or Afghanistan. For my part, I remain partial to the conservative virtues of realism, restraint, and prudence in dealing with other nations.
The United States is currently spending about half of all military spending in the world. We have some room for restraint without endangering American lives. We will still have a Navy that protects trade routes to the extent they are threatened. As I said in the video, we need to rethink our overall place in the world if we are to corral the big government beast. The Tea Party folks can lead the way here.
The Pentagon is not most of the federal budget. It is the only part historically, however, that can vary downward as well as upward. Sometime soon, the non-defense parts of the budget are going to have to vary downward rather than just upward. Being serious about limiting government, however, requires that all spending be considered. Since I think the Tea Party movement is serious about cutting government, it would be better if they had a look at all spending from the start.
Globalization: Curse or Cure?
Globalization holds tremendous promise to improve human welfare but can also cause conflicts and crises. How will competition for resources, employment, and growth shape economic policies among developed nations as they attempt to maintain productivity growth, social protections, and extensive political and cultural freedoms?
In a new study, Cato scholar Jagadeesh Gokhale offers policy recommendations for developed nations to reduce globalization’s negative effects and, indeed, harness it for solving economic challenges.
New Paper: Would a Stricter Fed Policy and Financial Regulation Have Averted the Financial Crisis?
Many commentators have argued that if the Federal Reserve had followed a stricter monetary policy earlier this decade when the housing bubble was forming, and if Congress had not deregulated banking but had imposed tighter financial standards, the housing boom and bust—and the subsequent financial crisis and recession—would have been averted.
In a new study, Cato scholars Jagadeesh Gokhale and Peter Van Doren investigate those claims and dispute them.
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