Although some loopholes could be plugged, moderate Democrats and Republicans agree U.S. corporate taxes are too high for American companies to be competitive. Most revenue that might be found fixing abuses will eventually have to be put into lower corporate taxes for those firms bearing more than their fair share of the burden.
At the core of the fiscal mess are the rapidly growing bills for Medicaid and Medicare, and Social Security.
On health care, the fundamental problem is that federal and state governments pay 55 cents of every dollar spent on health care. A private market for health care no longer exists, and government reimbursements set most prices for health care services.
Germany and Holland, like the United States, have systems of private insurers. In those countries, although government reimbursements account for nearly 80 percent of payments, health care costs are half of what Americans pay.
Those governments keep costs down by better regulating prices, but in the United States drug manufacturers, health insurance companies and hospitals each have enough influence with the Congress or the President to keep real reform from happening.
A solution requires significantly lower prices for drugs and many health care services, and the President’s health care law doesn’t provide for those—witness the jump in cost of drugs, health insurance premiums and the like in 2011. Now the President is boxed in by past actions to defend a policy that adds additional subsidies to a broken system and increases the deficit.
The Republican plan—Congressman Paul Ryan’s Path to Prosperity—would replace federal Medicaid with block grants to the states and Medicare with vouchers to seniors to buy private insurance, but those tactics would merely shift the problem of paying too much for health care services onto state budgets and the backs of the elderly.
Also, Europeans don’t have the additional burden of abusive malpractice suits but tort lawyers have among their ranks too many prominent contributors to the Democratic Party for any solution to be possible there.
On Social Security, the basic problems are that Americans are living much longer and retiring long before their health requires, and the ratio of retirees to working age Americans is too high and rising. Higher taxes would cripple U.S. international competitiveness with rising Asian economies, and individual retirement accounts risk leaving many elderly without adequate support, especially if they live past 75.
Simply, the retirement age needs to be raised to 70 for Americans under the age of 55. Only that solves the problem and other solutions are unworkable.
When Democrats and Republicans are willing to start seriously regulating prices for health services, and embrace a substantial and immediate increase in the retirement age, Americans will know they are serious. Until then, it would be great drama but for the fact we are saddling our children with an unbearable debt.
Peter Morici is a professor at the Smith School of Business, University of Maryland, and former Chief Economist at the U.S. International Trade Commission.