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ECONOMY JUNE 1, 2011

A Tale of Two Deficits

Listening to today’s debates, one might think that the United States faces a budget deficit. Not so. America faces two budget deficits. The first challenge is near term. Once the economic recovery is well-advanced, we must find a way to cut spending or raise taxes to prevent government debt from rising faster than income. The second challenge is dual: to slow the growth of health care spending, in general, and Medicare spending, in particular, and to decide whether to make cuts to Social Security. Treating the two budget challenges as one, however, just hampers efforts at finding an adequate solution to either.

To understand why the debate about the role and size of social insurance is largely independent from the debate about closing the near-term deficit, consider the proposals advanced by House Budget Committee chairman, Representative Paul Ryan. The Medicare conversion he proposes would not take effect until 2023. The plan makes no mention of Social Security. In the past, Ryan has proposed pension cuts, but only after a delay of seven years. Likewise, various budget commissions have endorsed long-term changes in Social Security. None, however, has suggested changes that would save more than a pittance over the next decade.

The bipartisan unwillingness to cut benefit for people who are retired or nearing retirement is based on two solid foundations. First, it is bad policy. People who are retired or about to retire would have no time to adjust to major cutbacks in Social Security and Medicare. Belying talk of greedy geezers, median income of people over age 65 was less than $25,000 a year in 2008. Fewer than one in four had income over $50,000. Added work may be an option for some, but not for most. Second, it is bad politics. The elderly vote in large numbers. They would, with justification, punish elected officials who renege abruptly on longstanding promises. That is why implementation of most of the cuts on Social Security benefits enacted in 1983 didn’t even start until 2000 and won’t be fully implemented until 2022—and then only for new retirees. These two considerations explain why Representative Ryan delayed replacing Medicare with a cash voucher for twelve years.

But near-term deficit reduction cannot wait that long. No one knows just how high the outstanding U.S. debt can go before investors, private and public, at home and abroad, come to doubt the nation’s capacity or willingness to service that debt. Some nations, less economically robust than the United States, have gotten into trouble when their debt was less than annual output, but the prevailing consensus is that the United States would be well advised to prevent its total debt from exceeding its annual income, particularly because so much of that debt is held abroad and the United States is currently running large trade deficits as well. Under current projections, the 100 percent threshold will be crossed sometime after 2020, but well before 2025. In short, the job of cutting the deficit must be finished in ten to twelve years. 

Quite independently, a debate over the size and role of social insurance is entirely appropriate and salutary. The nation’s two principal social insurance programs are too big and too central to the lives of individual Americans and to the functioning of the entire economy to escape scrutiny as circumstances change and views evolve. It is necessary, as well, for the nation to debate how best to rein in the growth of health care spending. Whether or not measures to slow the growth of spending on these two programs prove eventually to be necessary, they can not materially affect the fiscal balance within the next decade.

Right now, however, the U.S. budget deficit equals 10 percent of gross domestic product, and one can explain the entirety of it without mentioning Medicare or Social Security. All of the current deficit and all of the deficits projected for the next decade can be explained—fully explained—by tax cuts enacted during the Bush administration, the costs of two wars, the economic downturn and measures to counter it, and the costs of servicing the resulting debt.   Were it not for these factors, the budget today would be fully in balance.

Economic recovery will lower the deficit, but not enough. Additional measures will be necessary to stop debt from rising to potentially dangerous levels. Cuts in Medicare and Social Security spending, as a practical matter, cannot be agreed to and implemented fast enough to contribute materially to meeting that challenge. The only solutions are cuts in other government spending or tax increases.

Cutting the nation’s deficits as soon as the recovery is well under way is therefore imperative. Deciding how much the nation can and should spend on health care and pensions will be a long and tortuous debate—as is proper. But linking the two is virtually guaranteed to delay essential near term measures that would help sustain America’s hard-earned and priceless reputation as the world’s safest financial center.

Henry J. Aaron is a Bruce and Virginia MacLaury Senior Fellow at the Brookings Institution.

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I'd actually say we have three deficits. As you say, the short-term deficit is almost entirely explained by irresponsible Bush policies and the long recession they brought on. If the Republican Party were a good-faith party of fiscal responsibility, they would have reversed course in 2002 and started to pay for things. 9/11 helped them thoroughly ruin the US financial outlook. Note that the ~$8T debt accrued won't just disappear. It, in the form increased interest, contributes to the medium-term deficit, which is mainly the extrapolation of health care cost growth. This is a serious problem, and is thoroughly exacerbated by the complex system of payers, insurers, government, for-profit providers, pharma, and confused patients. The solutions with the best chance of fixing this problem scrap this system with its many choke-points for increasing the cost of an already socialized good. The elderly won't stand for gross and capricious inequalities in care or insurance, though, which is why Ryan's Medicare proposal can probably never be faithfully implemented. This isn't welfare reform, where the Republican Party can just demonize without much factual basis a vulnerable group--seniors are decently organized and will fight it. Because Republicans can't be trusted to abide by a very highly regulated private system, the eventual winner will probably be something fully socialized--medical costs are already far too great and need to be controlled humanely, but relatively quickly. Finally, there is a long-term deficit in Social Security. It actually isn't really worth mentioning because its apparent magnitude is much smaller and we are far enough out that a very simple solution could be implemented pretty painlessly. Unless you can fix the short and medium term deficit, what is the use in addressing an inconvenience that is 25 years off? In the real world, of course, there is a pretty justifiable reason: pensions were savaged over the last three years, people who are middle-aged right now have very little saved for retirement, and people under say, 35 have mountains of inalienable student loan debt (and/or are going to spend the most important investment decade of their life trying to find a job and start a life in this economy). It might actually be in our interest to try to institute a social pension system so that the SS insurance system does not keep even more seniors at the poverty level than it already does. But that assumes you're not going to privatize the system and lose retirees' wealth (2005?) or use the long-run shortfall and ongoing raiding of "the SS surplus" as an excuse to shut down the program.

- chaitless

June 2, 2011 at 1:39am

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Thank you. Must be some interesting water cooler discussions over there at Brookings.

- rayward

June 2, 2011 at 7:21am

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