One has to ask if there is anytime where it is okay to balance the budget. Mark comments that there are no easy Solutions for reducing the national debt, but there are! Martin Feldstein would concentrate on tax expenditures; a concept which would immerse all discussion into minutiae, a Hall of Mirrors from which no exit will be found. Mark states that the real problem is the Spending on Social Security and Medicare. The first Statement must say that Social Security is not really a problem at all, and requires only minor tweaks to put it on a sustainable path. The real problem is Health Care, and here the approach is all wrong! We must discuss the real factors prior to a resort to legislation, or else We only get printed Words whose enactment mean only further confusion.
We need a simple, canopy Tax law which supercedes all previous legislation. We try to take the Watch apart like children, having absolutely no idea of how to put it back together and make it work. We build a new Watch which worked, and throw away the Parts of the old Watch which conflict with the operation of the new Watch. I shall not go into the directions which We could take, but establish that the primary policy must be to raise sufficient tax revenues to constrain the national debt. Once We set an acceptable debt level, then We can understand what degree of tax change must come.
Health Care is also much easier if We target the expenditures, and not the Patients. I would first set out medical districts based upon geography, then set expenditure budgets for health care based on number of applicable Patients. I would then set the budget for the district, and tell all medical facilities they are responsible for the medical care of all people covered; it is here I would advocate universal health care, because anything less will only incite greater health care Costs in the long-run. I would be nasty, and tell all medical personnel that they will get only $2000 per Patient; with themselves distributing the health care to greatest advantage. The above distribution will be constrained by a national program of stated necessary services which must be provided; which will include Emergency Room care, Pain Suppression, necessary surgeries, and correction of the effects of Injuries. The Pay of medical professionals, publicly announced and maintained, will be dependent on the efficiency and quality of treatment directed at the permanent health of the Patients. I would get even nastier, and provision a limitation of Drug proscriptions to 3 per Patient over a year, though Proscriptions can be of a permanent nature until reversed by Doctors’ order. This is the way, I believe, that real change will come to the expenditure position of Government. lgl