Years of cutting taxes, expanding benefits and rising health care costs with some unfortunate demographic trends sprinkled in for good measure have finally created a long-term fiscal outlook so daunting that not even our elected representatives can ignore it. As a result, our country now stands at a crossroads between two distinct and competing visions for our nation's very soul. These next couple of elections will define for generations the relationship between our government and its people, and will determine what our culture truly values. Americans should reflect long and hard before making such a grave decision, because either choice will have profound consequences on millions of Americans for generations to come.
It is an indisputable fact that our government will not generate anywhere near enough revenue in the future to keep pace with the ballooning costs of America's social safety net: Medicare, Medicaid and Social Security. If left unchecked, our national debt is set to exceed 200 percent of our GDP by 2037, a truly frightening outlook that would likely result in the collapse of the U.S. economy and a long-term fiscal austerity program.
There are basically two ways to solve a problem like this. One is the path put forward by House Budget Committee Chairman Paul Ryan, R-Wis., in his "Path to Prosperity." This essentially entails ending the social safety net as we presently understand it by making trillions of dollars of benefits cuts and trillions of dollars of broad-spectrum tax cuts. Medicaid would be re-organized into a series of block grants finite, fixed sums of money appropriated annually given to states, allowing states that ideologically oppose the program to cut or eliminate many benefits. In the long run, all states would be forced to cut benefits, restrict enrollment in the program and potentially leave up to 32 million low-income residents without health care.
Under Ryan's plan, Medicare would also be phased out over the next 10 years (with all people over 55 grandfathered in), and replaced with a system of private vouchers that would burden senior citizens with up to three times the current cost. This plan would save the government a tremendous amount of money (although much of it's deficit reduction impact would be offset by massive tax cuts) and would lower taxes dramatically for all Americans. But it would also likely return us to a system of widespread poverty among senior citizens and leave millions of poor Americans with no hope of ever having health insurance.
The alternate vision is to commit to short-term benefits reductions while using long-term government regulation to cap growth in health care costs. It would also require raising trillions of dollars in new tax revenues over the coming decade. President Obama is likely to propose something similar to but less ambitious than this approach on Wednesday. Under this program, taxes would be raised from their current lowest-since-the-'50s levels, but seniors and the poor would continue to be insulated from the kind of total pre-20th century desolation that has been largely absent in this country since the Great Depression.
This debate is, at its core, a question of values. Do we, as a society, value lower taxes and less government control over the suffering of the poor and aged? It's not an easy choice to make. It is difficult to sustain collective sacrifice that supports government programs that are often wasteful and inefficient. Such sacrifice requires a deep commitment to the well-being of our neighbors that is mostly absent in this country. On the other hand, without those programs, most working people would need to save substantially more during their lifetimes, and children would need to take care of their aged parents. Otherwise, the current lifestyle patterns of the typical American are unlikely to produce enough savings to survive the costs of old age, particularly if Social Security benefits are reduced in the coming years.
I hope that Americans aren't so mired in a money-grubbing moral myopia that we can't see the widespread social benefits of ponying up for these programs. I suspect, though, that in keeping with the trends of the last three decades, we will ultimately embrace a vision much closer to Ryan's plan. If that happens, Americans will experience a truly conservative society, and they might not be prepared for what they find.
