Michelle Bachmann was quoted in a piece from NPR today. Speaking about the Tea Party, she said, “They believe that we are taxed enough already, that the federal government should not spend more money than it takes in, and that the Congress should act within the constitutional limitations as given to us by the Founding Fathers,” she said. “That is the banner that we believe in.”

Okay, let’s do the math piece by piece:

  1. “[W]e are taxed enough already.” No tax increases — check.
  2. “[T]he federal government should not spend more money than it takes in.” No budget deficits — check.
  3. The federal deficit is now running about $1.4 trillion annually — check.

So if we are not to increase taxes and we are not to incur deficits, and if the deficit is $1.4 trillion, then Michelle Bachmann needs to either (a) Present her plan for cutting $1.4 trillion in federal spending, or (b) Shut her pie hole.

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Let’s imagine the most improbably successful outcome imagineable for the tea party movement. Suppose they actually managed to obtain a majority in Congress, or at least to unseat the Democratic majority in favor of Republicans. What happens when, two years later, voters see that spending has increased again, and federal debt has continued to rocket upward? To paraphrase Mr. Grayson from Kentucky, what happens when people learn that honking horns does not solve traffic? The Tea Party movement seems to be based on the notions that government spending can be controlled without shrinking popular programs, and that government debt can be curtailed without increasing taxes. Both are absurd fantasies. So is the idea that Republicans have any intention of reducing spending or reducing federal debt. What happens when that lesson is learned?

There are only two possibilities, mathematically speaking — either we have a balanced budget, or debt goes up. Can people of all political stripes agree on that?

Here is my question to my friends on the conservative end of the spectrum. Assuming that continuously increasing debt is intolerable, we must balance the budget, right? Okay, how do we accomplish that? There are only two variables in the balanced budget equation: spending and taxation. But you flatly reject taxation as a solution. So that leaves us trying to balance the budget ENTIRELY through spending cuts. With the deficit running at $1.3 trillion annually, we would need spending cuts in that amount to balance the budget. I would be curious just what cuts you have in mind of that magnitude. If you cannot cut $1.3 trillion in spending, and if we cannot raise taxes, then how is it mathematically possible to balance the budget? And if you cannot balance the budget, are you not advocating for for increased federal debt? The math is inescapable.

Here is my question to my friends on the liberal end of the spectrum. This is a breakdown of Obama’s FY2010 budget:

Mandatory spending: $2.184 trillion (+15.6%):
$695 billion (+4.9%) – Social Security
$453 billion (+6.6%) – Medicare
$290 billion (+12.0%) – Medicaid
$0 billion (−100%) – Troubled Asset Relief Program (TARP)
$0 billion (−100%) – Financial stabilization efforts
$11 billion (+275%) – Potential disaster costs
$571 billion (−15.2%) – Other mandatory programs
$164 billion (+18.0%) – Interest on National Debt

Discretionary spending: $1.368 trillion (+13.1%):
$663.7 billion (+12.7%) – Department of Defense (including Overseas Contingency Operations)
$78.7 billion (−1.7%) – Department of Health and Human Services
$72.5 billion (+2.8%) – Department of Transportation
$52.5 billion (+10.3%) – Department of Veterans Affairs
$51.7 billion (+40.9%) – Department of State and Other International Programs
$47.5 billion (+18.5%) – Department of Housing and Urban Development
$46.7 billion (+12.8%) – Department of Education
$42.7 billion (+1.2%) – Department of Homeland Security
$26.3 billion (−0.4%) – Department of Energy
$26.0 billion (+8.8%) – Department of Agriculture
$23.9 billion (−6.3%) – Department of Justice
$18.7 billion (+5.1%) – National Aeronautics and Space Administration
$13.8 billion (+48.4%) – Department of Commerce
$13.3 billion (+4.7%) – Department of Labor
$13.3 billion (+4.7%) – Department of the Treasury
$12.0 billion (+6.2%) – Department of the Interior
$10.5 billion (+34.6%) – Environmental Protection Agency
$9.7 billion (+10.2%) – Social Security Administration
$7.0 billion (+1.4%) – National Science Foundation
$5.1 billion (−3.8%) – Corps of Engineers
$5.0 billion (+100%) – National Infrastructure Bank
$1.1 billion (+22.2%) – Corporation for National and Community Service
$0.7 billion (0.0%) – Small Business Administration
$0.6 billion (−14.3%) – General Services Administration
$19.8 billion (+3.7%) – Other Agencies
$105 billion – Other

Why must we have a 13.1% increase in discretionary spending? Isn’t that the height of irresponsibility in these times? The economy is booming again. The stock market is up by 60% in the past year. The massive job losses  of 2007-08 have ended, and all signs point to job creation around the corner as the economy continues to expand. Surely we can have a budget that acknowledges the economic drag that $1.3 trillion annual deficits, and $13 trillion of cumulative federal debt, have.

No matter how I look at things, I come back to the same conclusion. Ideologues are America’s greatest enemy.

Do you want to know why government keeps growing and growing and growing? Do you want to stop it?

I am going to whisper the secret answer to you. But you may not like it. The scope of government has been expanding rapidly since the 1980s because no one has to pay the cost. The culture of debt means that we borrow the funds needed to add the Americans with Disabilities Act, and No Child Left Behind, and Medicare Part D, and wars in Kosovo and Afghanistan and Iraq, and so on and on. Why not do all these things? What senior wouldn’t appreciate prescription drug coverage, or what community wouldn’t appreciate federal funds for its schools?

And there is no constituency to oppose these things, or to moderate them, because there is no levy on taxpayers. We just borrow the money.

So, here comes the painful conclusion. You want to control federal spending? You want to limit the scope of government? You want to, as the Tea Party folks like to say, ‘return government to its constitutional boundaries’? Simple answer: Demand taxation. Demand an end to deficits and debt accumulation. It is no different than managing your finances at home. If you discipline yourself to pay cash for everything, and cut up the credit card, your finances will be fine. Demanding taxation to fund our government is the same thing. Sure it will be painful for twenty years. But then we’ll be fine.

You think this is nuts? Fine. Just remember this post when federal debt hits $15 trillion… $20 trillion… $30 trillion……….

Which president is this?:

This president faced a severe recession early in his administration, which he battled with a combination of tax cuts and spending increases. The stock market responded to the economic improvement with a long, sustained rally. To be sure, federal debt skyrocketed as a result, but that was left for later generations to deal with.

Barack Obama?  Ronald Reagan? The answer is, of course, both.

That’s not to say there aren’t big differences, certainly. Federal debt nearly tripled under Reagan, where it is increasing at “only” about 10% per year under Obama, although from a much higher starting point. The economic crisis Obama has had to battle was far more severe than the Reagan recession. And there’s something we don’t know yet. Reagan’s years ended with a thud: the financial markets in free fall (remember the crash of 1987?) and the economy headed into another recession, which landed during GHW Bush’s term. We don’t yet know if that fate will befall Obama.

My point is, if you find yourself lauding President Reagan and critical of President Bush — or listening to pundits who adopt that posture — you should ask yourself why. Isolate what Reagan did right and what Obama is doing wrong, and then analyze how they are different. It’s harder to do than you may think.

· Cut the amount that America spends on healthcare in half.

· Provided universal health insurance coverage. Yep, 100%.

· If you have a serious illness, such as cancer, paid 100% of the costs of treatment.

· Used the private market to deliver all healthcare, including an option for doctors and others to opt out of participating in the government-funded plan. Retained the fee-for-service arrangement that dominates US healthcare system now, to minimize disruption. Provided doctors with greater independence in diagnosis and treatment than the European model.

·  Reduced infant mortality by 40%; raised life expectancy; lowered mortality rates from preventable diseases.

Would you support a plan like that? Welcome to France. If you would not support that, why not?

http://www.npr.org/templates/story/story.php?storyId=92419273

http://www.nationaljournal.com/njmagazine/wn_20090718_3933.php

Somewhere along the line, the inside-the-beltway debate has lost sight of the real mandate that we sent a new crop of elected officials to Washington to pursue: to provide a stable means of access to decent health care for the tens of millions who lack it.

The status quo fails vast numbers of Americans. Obviously, many millions simply lack insurance, and the problem starts right there. They are forced to rely on a costly and ineffective hodge-podge of solutions. Famously, our most expensive care-giving mechanism, emergency rooms, is used to provide basic care. Hospitals write off that bad debt and recoup the cost through higher insurance premiums on the rest of us. Or, people get themselves to a doctor, but then fail to take the expensive medication or get the follow up treatment. Health issues accumulate, and costs spiral higher still.

People fail to have insurance for a lot of reasons. Some people make too much money to qualify for Medicaid but not enough to afford insurance. Employers who rely upon low-paid workforces cannot remain competitive if they try to provide health insurance benefits costing $500 a month to people who make $1500 a month. Insurance companies somehow have settled on this practice of pre-existing conditions — perhaps not fully considering that, while they may avoid insuring the next unwell person, they also are retaining the current unwell person, who now cannot leave his job. Or, a person is stuck with sky-high COBRA premiums. Or simply is young and thinks herself immortal and unwilling to insure the risk of medical expenses.

Whatever all the causes, the status quo is clearly askew beyond all measure. We need only reflect on the often-repeated refrain that the US spends the most money in the world to achieve average, at best, health.

So, back to the mandate. How do we provide a stable means of access to decent health care for the tens of millions who lack it?

1. Cost containment. Without this, we cannot both provide access to all and not break the bank. But where is this in the Washington debate? Neither party in Congress is offering any clear-cut cost containment strategies. Democrats have taken taxation of health benefits off the table. Without that, the CBO says, people have no incentive to moderate consumption of healthcare. They also have taken tort reform off the table, another aspect that some analysts believe could hold down costs. Republicans are behind tort reform, but are offering nothing beyond that whatsoever, and tort reform is a small piece of the package. It’s like going on a diet by giving up sprinkles on your donuts.

2. Universal access. Forget about private versus public. One way or another, access to stable healthcare is the moral imperative here. Republican ideas are focused around helping people buy insurance by offering tax advantages for doing so. Not only does that smack of the recently exposed federal mortgage policies (which, oddly, Republicans have denounced, while advocating a nearly identical policy for healthcare — huh??), but also it fails to address the issue. The people who lack insurance skew hugely to the lower income population. These are people making $1500 to $2000 a month. Health insurance for a family of four costs $500, $600, $1000 a month. Giving a tax break worth 15% of that cost hardly puts it within reach. Democrat proposals are better in terms of access, but still will leave many millions on the outside looking in.

Here is what I wish we would hear from President Obama: “I will veto any plan which fails to provide health insurance to all Americans. This may be private, public, or a combination of both. I will veto any plan which increases the nation’s total expenditures on healthcare. Government spending may go up or down, private spending may go up or down, but the total of the two must not increase. Congress, keep working until you have a plan that fits those two simple — but devilishly challenging, I am sure — guidelines. Other than these two parameters, nothing is off limits.”

Hopefully Obama would allow lots of room for Congressional debate, within these parameters. Taxing benefits is not off limits; if healthcare spending does not increase, then by definition whatever Americans pay in taxes for it will be offset by decreased outlays in other ways. Tort reform is not off limits. Reforms of existing health insurance plans is not off limits. How about we scrap the entire costly, antiquated and ineffective VA medical system, and simply issue Medicare cards to all veterans (why do we have a whole separate healthcare system for that purpose, anyway???). How about we allow doctors to make any medical decision they wish to, but we lessen the payment when that decision is contraindicated by large-scale studies? (In other words, go ahead and get the unnecessary Caesarean section if you want to, but don’t expect your insurance company to pay more than it would for a routine delivery.)

That is to say, dig deep, be truly creative, be bold and innovative. The very worst part of this whole debate is that it is mired in staleness, mired in the dismal workings of Congress and government. But it doesn’t have to be that way. In fact, I venture to say, we elected President Obama precisely because he reminded us that it doesn’t have to be this way. So, Mr. President, go punch Congress in the freakin’ nose and get this right.