Wonder why President Obama’s trip this week to China didn’t go more smoothly? Meetings between Obama and top Chinese leaders were reportedly stiff; the Chinese also limited domestic press coverage of Obama’s appearances. The explanation is disarmingly obvious: huge disagreements separate the two countries that can’t easily be papered over.
In my Newsweek column this week (" Obama's Malpractice: Why the health-care bill isn't reform "), I argued that-contrary to the Administration's claims-none of the various proposals now floating around Congress would reduce future budget deficits or the rapid rise in national health spending. Quite the opposite: the proposals would probably increase both deficits and national health spending. Now comes Richard Foster, chief actuary of the Centers for Medicare and Medicaid Services (CMMS), a federal agency, making the same points with a lot more detail. In a study published after my column was written, Foster estimates that H.R. 3962, which passed the House of Representatives on Nov. 7, would raise national health spending by about $289 billion from 2010 to 2019. He also casts considerable doubt on whether the "savings" in Medicare that are used to pay for expanded insurance coverage would actually materialize; if not, the expansion of health-care would lead to higher federal budget deficits.
There is an air of absurdity to what is mistakenly called "health-care reform." Everyone knows that the United States faces massive governmental budget deficits as far as calculators can project, driven heavily by an aging population and uncontrolled health costs. Recovering slowly from a devastating recession, it's widely agreed that, though deficits should not be cut abruptly (lest the economy resume its slump), a prudent society would embark on long-term policies to control health costs, reduce government spending, and curb massive future deficits. The president and his top economic advisers all say this. ( Click here to follow Robert J. Samuelson ).
When Nouriel Roubini talks, the world listens. Roubini is, of course, the once-obscure New York University economist whose dire warnings about a financial crisis proved depressingly prophetic. Last week, Roubini was shouting. Writing in the Financial Times, he warned that the Federal Reserve and other government central banks are fueling a massive new asset "bubble" that—while not in imminent danger of bursting—will someday do so with calamitous consequences. ( Click here to follow Robert J. Samuelson ).
In my latest NEWSWEEK column, I suggested that the unthinkable had become thinkable: some advanced society—say, the United States, Spain, Italy, Japan, or Great Britain—might someday default on its government debt. It wouldn't pay its creditors all they were owed or wouldn't pay them on time. Just a few days later, and completely coincidentally, the International Monetary Fund (IMF) issued a report that, without saying so, added credence to this unsettling hypothesis. ( Click here to follow Robert J. Samuelson ).
Does the Obama administration ever plan to balance the budget? Apparently not. In a speech at New York University, Peter Orszag, head of the Office of Management and Budget, suggested that the administration’s goal was to reduce the deficit to a “fiscally sustainable level,” which he said is “roughly 3 percent” of gross domestic product (GDP). That would be much lower than the deficit of $1.4 trillion for fiscal 2009, which ended in September and totaled $1.4 trillion. But it would still be a lot of money, about $420 billion annually in today’s dollars. The idea behind keeping the deficit to a “fiscally sustainable level” is to stabilize the outstanding federal debt as a share of GDP. In 2008, the federal debt held by the public was $5.8 trillion, or 41 percent of GDP. When the Congressional Budget Office estimated the prospective Obama budgets in June, it projected that there would be continuous deficits for the next decade and that by 2019 the federal debt would reach $17.1 trillion, about 82 percent of estimated GDP. Other estimates have put the debt-to-GDP ratio even higher. The annual deficits during this decade would average more than 5 percent of GDP, the CBO said. (The federal debt represents all the money borrowed to cover annual deficits.) In his speech, Orszag conceded that present deficit projections are “well above” fiscally sustainable levels. Orszag didn’t say when the administration would start curbing the deficits, except to indicate that the process might start once the economic recovery seemed well established.
We have yet another study that disputes the Obama administration's claims that the various congressional health proposals will somehow muffle the relentless rise in medical spending. In the past week, both Peter Orszag, head of the Office of Management and Budget, and Christina Romer, head of the Council of Economic Advisers, have repeated earlier assertions that health-care "reform" amounts to "deficit reform" because it will reduce the health-spending spirals that contribute to bulging budget deficits. So far, their arguments aren't resonating with the economic models.
The idea that the government of a major advanced country would default on its debt—that is, tell lenders that it won't repay them all they're owed—was, until recently, a preposterous proposition. Argentina or Russia might stiff their creditors, but surely not the likes of the United States, Japan, or Great Britain. Well, it's still a very, very long shot, but it's no longer entirely unimaginable. Governments of rich countries are borrowing so much that it's conceivable that one day the twin assumptions underlying their burgeoning debt (that lenders will continue to lend and that governments will continue to pay) might collapse. What happens then? ( Click here to follow Robert Samuelson ).
In the health-care debate, the "public plan" is all things to all people. For supporters, it would discipline greedy private insurers and make health-care coverage affordable. For detractors, it's a way station on the path to a single-payer insurance system of government-run health care. In reality, the public plan, also known as the public option, is mostly an exercise in political avoidance: It pretends to control costs and improve access to quality care when it doesn't.
Obama administration officials have repeatedly emphasized the need to "bend the curve" of health-care costs. Reducing increases in health spending, they argued, was essential to controlling future federal budget deficits and making insurance affordable for most Americans. Now, in the first comprehensive evaluation of one of the major congressional health-reform bills, analysts find that it does bend the cost curve—in the wrong direction. The study of H.R. 3200 , as reported by the House Ways and Means Committee, concludes that the legislation would raise total national health spending by $750 billion over the decade from 2010 to 2019.