How Obama Cut the Deficit in Half — and Made Us Pay the Price

U.S. Budget Deficit Over Time

Remember when everybody was talking about the budget deficit?

It wasn’t that long ago. In fact, it was one of the biggest factors in the 2012 presidential election. After all, it was over $1 trillion at the time.

Today, it’s $500 billion. And falling.

This, of course, is one of Barack Obama’s legacies. He raised taxes on the rich and cut spending across the board. Even with strong growth in mandatory programs like Social Security and Medicare this year, the federal government is going to spend about the same amount of money it spent in 2012 — and less than it spent in 2011. Adjusted for inflation, the government has shrunk.

But it has come at a cost.

Case in point: We have run out of money to fight wildfires.

A couple decades ago, wildfires in the western United States typically consumed 2 to 4 million acres in a year. Nowadays, they consume 6 to 8 million acres. As a result, the cost of wildfire suppression has more than tripled in that amount of time. And yet, Congress continues to allocate funding based on what it cost a decade ago, instead of what it costs today.

So it’s not surprising that Agriculture Secretary Tom Vilsack ran out of money to fight wildfires this year, forcing him to divert money away from programs that preventwildfires — magnifying the problem in years to come.

Traveling to the other side of the country, a Pennsylvania official testified in court earlier this week that he and his fellow regulators didn’t investigate chemical leaks that were allegedly poisoning citizens’ drinking water near natural gas wells.

But this shouldn’t surprise us either. After all, the Associated Press recently discovered that 40 percent of new oil and gas wells haven’t been inspected in this country. The report described the regulators as “so overwhelmed by a boom in hydraulic fracturing, or fracking, that [they have] been unable to keep up with inspections of some of the highest priority wells.”

It’s not like those investigations really matter, right? The Pennsylvania trial revealed that landowners were drinking water with “explosive levels of methane.” Meanwhile, a new paper published this week by researchers at Stanford and Duke showed that even tiny amounts of fracking wastewater can contaminate drinking water with toxic compounds.

So I guess it’s no big deal that regulators are so underfunded that they’re neglecting almost half the country’s drilling wells.

You’d think we would’ve learned this lesson last year when the IRS scandal revealed that auditors were singling out political groups — conservative and liberal, by the way — for investigation without any apparent probable cause.

For years, the IRS has been underfunded. The National Taxpayer Advocate said so. A Boston Globe investigation said so. The Government Accountability Office said so. And they all predicted that underfunding would result in less enforcement and more cutting corners. In fact, they said taxpayers would lose money because every dollar in budget cuts led to seven dollars in lost tax revenue that they would’ve collected if they’d had the manpower to do so.

Then the scandal hit, revealing that IRS officials were so “overworked” that they felt they had no choice but to take shortcuts through the “flood of applications” on their desks.

These are only a few examples of the price we have paid for a smaller deficit.

Barack Obama deserves credit for delivering on his promise to shrink the deficit — a promise that Mitt Romney and his tax cuts would surely have violated — but Americans have to ask themselves whether they really want a smaller government. Do we really want millions of acres destroyed by fire, and drinking water contaminated with toxic chemicals, and government officials harassing the innocent? I know I don’t.

And I also know there’s a better way. It begins with the understanding that, for all its faults and inefficiencies, our government does many good, essential things in our society. And yes, those things come at a price. But that is a price worth paying.

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

Guess Who Tried to Prevent the VA Crisis — and Who Stood in Their Way!

The Three Trillion Dollar War

Linda Bilmes and Joseph Stiglitz predicted the VA scandal.

Back in 2008, the eminent researchers — one a professor at the Harvard Kennedy School, the other a Nobel laureate in economics — published a book called The Three Trillion Dollar War, where they argued that most Americans were drastically underestimating the cost of the Iraq War. They didn’t specifically describe the events that have unfolded in recent weeks, but they did point out the enormous burden that would be placed on the VA system as veterans returned from Iraq — a burden that we were not preparing for.

And that was before the surge in Afghanistan.

Upon taking the oath of office, Barack Obama tripled U.S. troop levels in Afghanistan, sending over 60,000 troops into combat. Only now, five years later, have troop levels reverted to the level they were at when he took office. So you can add 60,000 troops for five years on top of the costs projected by Bilmes and Stiglitz — projections that were verified and replicated by the Joint Economic Committee of Congress, as well as Nobel laureate Lawrence Klein, the father of modern economic forecasting.

And yet, Congress refused to boost the VA budget.

For years, discretionary funding for the VA health care system had been growing at approximately 6 percent per year, slightly less than health care costs for the average American family, making it the most cost-efficient system in the country. Meanwhile, it ranked at the top of quality rankings, better than all its private competitors, year after year. It was the best medical care system in America.

That is, until the troops came home.

“Republicans beat back a Democratic attempt to provide almost $2 billion in additional health care funding for veterans,” reported the Washington Post in 2005, “rejecting claims that Department of Veterans Affairs hospitals are in crisis.”

The following year, Bilmes told ABC News, “In 2004, the VA had a backlog of 400,000 cases. Last year it was 500,000 cases. Now the backlog is 600,000 cases. That’s just in two years. And the big wave of returning Iraqi veterans has not even hit yet.”

And yet, the VA budget kept growing by 6 percent per year, as if the war didn’t exist at all.

As if that wasn’t a big enough problem… “Proposed cuts in Department of Veterans Affairs spending on major construction and non-recurring maintenance threaten to derail efforts to update the department’s aging infrastructure,” reported the Washington Post in 2012. And so, Democratic Senator Patty Murray led the charge to boost the VA’s construction funding, only to have it beat down by Republicans.

Later that year, Paul Ryan, the Republican chair of the House Budget Committee, released the party’s annual budget proposal. Had it become law, the VA would’ve sustained billions of dollars in budget cuts, forcing smaller facilities to shut down in rural areas.

So it wasn’t surprising to Senator Murray when allegations surfaced of VA hospitals lying about the number of veterans on their waiting lists because they didn’t want the world to know that they were unable to give their patients lifesaving treatments. “In an environment where everybody is told, ‘Keep the cost down. Don’t tell me anything costs more.’ — it creates a culture out there for people to cook the books,” she said in a recent interview.

Who would’ve ever thought, after years of relentless cost-cutting in the halls of Washington, that the federal government actually spends our money on important stuff? Who would’ve thought that wars cost money, and tax cuts cost money, and maintaining our infrastructure costs money? Not the Republicans, that’s for sure. While the Bush administration plunged us into two wars and cut taxes on the rich, who were already taking a bigger piece of the pie than they had since the Roaring Twenties, Republicans in Congress were blocking every Democratic attempt to give the VA the funding they needed to give our veterans the medical care they were promised. And then, when the Obama administration tried to correct this funding crisis, Republicans responded by proposing deeper spending cuts.

Let this be a warning to every politician and every voter who thinks we can cut our way to prosperity: Those dollar figures represent real services that the government provides to real people. Every cut has a cost, and not just in money. In lives.

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

Yes, Obamacare Critics, Health Insurance Does Make You Healthier

Michael Barone and Charles Krauthammer have some medical advice for you: Don’t get health insurance, they say. It won’t make you healthier. It’s a waste of money.

Obamacare Enrollment SurgeThey must be desperate. They don’t want to admit that they’ve run out of criticisms of Obamacare. The website is working, enrollments are surging, and millions of Americans are getting affordablehigh-quality health insurance. They couldn’t deny these facts, so they needed a new argument to discredit the law — and they found it tucked away in the New England Journal of Medicine.

In 2008, Oregon conducted an experiment. They held a random lottery. They picked 20,745 names out of a waiting list of 90,000 low-income adults who wanted to sign up for Medicaid. Of the winners, half received Medicaid, and half did not. After two years, they compared the two groups to see if the ones who had Medicaid were any better off.

Barone and Krauthammer claim that the Medicaid group did not have better health than the uninsured group, proving the futility of health insurance, but their conclusion is based on a very narrow, selective reading of the evidence.

It’s true that the individuals on Medicaid did not fare any better than their uninsured counterparts on blood tests for cholesterol, blood sugar, and blood pressure. But it’s also true that the Medicaid patients scored higher on the mental quality-of-life test, experienced significantly lower rates of depression, and reported that they felt healthier.

The Medicaid patients also experienced significantly less financial strain. They were 25 percent less likely to have an unpaid medical bill sent to a collection agency.

In other words, health insurance has significant mental and financial benefits.

In this study, the physical benefits are less clear, but that’s not surprising, given that it only lasted two years and it only measured three simple blood levels. Fortunately, other researchers have measured more than just cholesterol.

A 2008 study in the prestigious medical journal The Lancet, for example, revealed that uninsured patients were significantly more likely to develop advanced-stage cancer because they didn’t receive early screening to detect it.

A year later, Harvard researchers published a study in the Annals of Surgery showing that uninsured patients who arrived at the emergency room with traumatic injuries were almost twice as likely to die in the hospital as patients with insurance, even if they had the same race, gender, age, and severity of injury. Later that year, a similar study was conducted at the Boston Children’s Hospital and published in the Journal of Pediatric Surgery. It found that uninsured children were more than three times as likely to die from traumatic injuries as children with commercial insurance.

And if all that wasn’t enough to convince you, the American Journal of Public Health published a study that same year comparing the death rates of the insured and the uninsured when they had the same education, income, weight, rates of smoking and drinking, etc. They concluded that 44,789 Americans die every year simply because they don’t have health insurance.

That is the bottom line we should be talking about.

If the Oregon experiment were carried out beyond two years, the differences between the insured and the uninsured would accumulate. They found that the Medicaid patients were 70 percent more likely to visit the doctor, 20 percent more likely to have their cholesterol monitored, and for the women, 60 percent more likely to get a mammogram. Those kinds of preventive measures don’t make a huge impact in two years, but in the long run, they can mean the difference between life and death.

Health insurance is so beneficial to your health, in fact, that its effects spillover and benefit those of us around you. Studies have shown, for instance, that companies that offer health insurance are more productive because insured workers take 52 percent fewer “sick days” than their uninsured co-workers.

I have to wonder if Barone and Krauthammer have ever even met anyone on Medicaid. I wonder if they know the terrible fear that uninsured Americans feel when they get sick and they’re forced to choose between astronomical medical bills and untreated illness.

I think they should find out. If they’re so confident that health insurance doesn’t affect your health, then I would like to issue this challenge to them: Give up your own health insurance. Don’t waste another penny on it. Join the ranks of the uninsured.

If not, if they’re unwilling to follow their own advice, then they should stop giving it. They should stop spreading misinformation that can hurt millions of Americans who read their op-ed columns and who depend on the access to lifesaving medical care that only health insurance can provide.

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This op-ed was published in today’s Huffington Post. An abbreviated version was published in the South Florida Sun-Sentinel.

Does Obamacare Infringe on Our Liberty? Or Does It Give Us Even More Freedom?

What right does the government have to make you buy health insurance?

That’s the question that riles Obamacare critics the most. It’s not the premiums or the website or the dropped coverage. It’s the infringement on their liberty.

Does Government Threaten Our Freedom?You hear it all the time: “This is a free country!” That’s what everybody says. But what do they really mean? Do they know what freedom is?

It seems obvious at first. Freedom is lack of coercion. Therefore, anything the government makes you do infringes on your freedom.

But there are different types of coercion, and the government isn’t the only one doing the coercing.

Let’s say that you want your daughter to attend the best school in America. But you can’t afford the tuition. Do you really have freedom of choice? If you choose the school you want, they won’t let you through the front door. If you force your way in, they’ll arrest you.

So you “choose” a more affordable school. You wanted a better school, but they forced you to settle for a different one. Sounds like coercion to me.

Let’s consider another example. You want to retire at the age of 65. You’ve worked hard throughout your entire adult life. Unfortunately, wages haven’t risen, and the bills kept piling up. You saved as much as you could, but it’s only enough to live off for a couple years. Oh, and one more thing: Social Security and Medicare don’t exist.

If you “choose” to retire, you’ll go broke. You’ll go without preventive health care. Your chances of dying early will increase significantly.

So you have a choice: Keep working or die young.

In this case, you actually have less freedom because the government is less involved. Without Social Security and Medicare, you do not have the freedom to choose a long, healthy retirement.

Freedom requires more than the absence of laws and taxes. True freedom of choice requires the capability to make that choice — and the free market doesn’t always give us that capability.

Jobs are scarce. Most of us don’t have the freedom to work anywhere we want. We take what we can get. For many of us, that means working at a company that doesn’t pay for our health insurance. So we “choose” to buy insurance on the individual market.

Before Obamacare, the individual market charged really low rates to healthy people and really high rates to sick people. So the people who needed insurance the most couldn’t afford it. They didn’t have the capability — and therefore the freedom — to buy it.

Obamacare outlaws that kind of discrimination. It requires insurers to charge the same rates to healthy and sick people alike, and that means that healthy people will have to pay higher rates. Some of them won’t want to, so they’ll stop buying insurance. When they drop out, they leave behind the sicker people who are most costly to insure, forcing insurers to raise rates even more. It’s a vicious cycle, a “death spiral,” that results in almost everyone being priced out of the market.

Virtually no one will have the freedom to buy health insurance on the individual market.

And that’s why we have an individual mandate. If the healthy people don’t drop out, there’s no death spiral, and the insurance remains affordable for the people who need it the most.

The government gives them a freedom that the free market cannot. It gives them the capability to purchase health insurance.

If we choose not to buy insurance, we pay a penalty. As Supreme Court Chief Justice John Roberts has written, “it makes going without insurance just another thing the Government taxes, like buying gasoline or earning income.” Those taxes pay for our roads and Army and Navy and Social Security and Medicare — and those things give us the freedom to live a life that we often take for granted. Without those taxes, without those government-funded investments, we could not call ourselves a free country.

In the same way, without Obamacare, without the government making us buy health insurance, we would be condemning millions of Americans to lives without health care. We would be restricting their freedom. And what right do we have to do that?

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.

The Poor Don’t Lie and Cheat Any More Than the Rest of Us

Those no-good, dirty, rotten poor people. They lie, and they steal, and they spend our money.

Or so I’ve been told by readers since my last op-ed column, where I did the math proving that government benefits aren’t generous enough to make people want to be poor.

But you’re just doing the legal math, said one reader. What about what goes on under the table? Surely all that welfare fraud is proof that poverty can be the good life, if only you have the gumption to bilk the taxpayer.

Food Stamp Error RateFirst of all, the government has conducted investigations of fraud in programs like welfare and food stamps, and they’ve found it to be shockingly low. Less than 2 percent of the programs’ budgets get ripped off. That’s lower than the private sector, where the average business loses 5 percent of its annual revenue to fraud.

Second, and perhaps more surprising, investigators have found that the majority of government fraud is committed by the middle class and the rich, not the poor!

After Hurricane Katrina, for example, the investigative reporter Eric Schnurer discovered that most of the $500 million lost to fraud did not go into the pockets of the poor people who lost their homes but rather to the “shifty contractors” who were supposed to be rebuilding the homes.

Similarly, reports Schnurer, “Medicare and Medicaid fraud is largely committed not by patients — very few people are trying to rip off taxpayers to obtain unneeded spinal taps or root canals — but by providers: unscrupulous (or sometimes just incompetent) doctors and hospitals billing for procedures the patient didn’t need or didn’t receive.”

Throw in another $100 billion a year in defense contractor fraud, and you quickly find that fraud is more likely to make the rich richer than it is to make the poor want to be poor. It’s redistribution alright, but the wealth is moving up, not down, the ladder.

Once upon a time, I might have been surprised by these findings, but in writing my new book Letter to the One Percent, I found a consistent pattern in the research literature. Psychologists have conducted many experiments on the rich and the poor, and they’ve found that the rich are less likely to have empathy for other human beings. They’re more likely to break the rules and feel that they’ve earned the right to do so. They’re less likely to think of the moral consequences of their actions, especially when money is involved, and they’re more likely to put their own needs ahead of others’.

The notion that the poor are uniquely morally deficient, it turns out, is completely backward. They’re actually more virtuous, on average, than the rich.

And yet, we have politicians who assume that the poor are less trustworthy and therefore less deserving of our help. On the 50th anniversary of the War on Poverty, they took to the floor of Congress and criticized “single mothers” and “deadbeat dads” for dropping out of school and having babies and cheating the system. Then they proposed a budget that would cut government benefits for tens of millions of Americans.

Meanwhile, in Florida, they’re fighting a recent court decision that struck down a law requiring drug testing of all welfare applicants. But they don’t seem concerned about corporate executives who apply for billion-dollar subsidies. They’re not clamoring for drug testing doctors who receive Medicare payments or retirees who receive Social Security checks or Congress members who receive six-figure salaries.

Why? Because they assume that the poor are more likely to waste taxpayers’ money on drugs. Well, I’ve got news for them: The rate of illicit drug use is no higher among the poor than it is among the rest of us, and the rate of alcohol addiction is actually lower.

Human nature is human nature. There are liars and cheaters in every walk of life. But the facts are irrefutable: The poor are not poor because they lie and cheat, nor are they responsible for high taxes and mounting debt. If anything, they have contributed less to fraud and waste than the rest of us. The next time you hear Senator Marco Rubio and his Republican colleagues say otherwise, remember: That’s a stereotype, and it’s wrong.

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This op-ed was published in today’s South Florida Sun-Sentinel and Huffington Post.