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This report by C. Eugene Steuerle outlines the significant budgetary pressures and shifts impacting various sectors such as retirement, health, and labor force growth since 2000. It explores the implications of these trends on public policy and the restructuring of labor markets towards more sustainable practices.
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The Budget Squeeze C. Eugene Steuerle The Urban Institute September 10 Stanford Institute for Economic Policy Research
OUTLINE • WHERE WE WERE IN 2000 • Sources of Pressure: Revenues, Health, Retirement Programs, Future Labor Force Growth Slowdown • Retirement & Health: Not Well Targeted • Everything Else in Budget Squeezed • Impact on Democracy: Dead Men Ruling • TRENDS SINCE 2000 • Tax Cuts, Drug Benefits, Defense & International, Other Revenue Shortfall • $800 Billion Annual Shift from Surplus to Deficit • The Squeeze Tightens • THE IMPLICATIONS • Private: Restructuring of Labor Market • Public: Fundamental (Trillion Dollar) Shifts in Policy
Social Security, Medicare, and Medicaid Outlays as a Percentage of GDP, Fiscal Years 1950-2075
Pressures from Elderly Programs • People have been retiring earlier • People are living longer • Birth rates have fallen • Annual/lifetime benefits continue to rise • Health services grow & expand (quantity) • Healthcare insurance system reduces downward price pressures normal for a growing industry (price)
Social vs. Legal Pressures • Only the change in birth rates indicates a growing need in society. • The other five are signs of increased well-being or legal promises to pay out more.
Quantity Indices Over Time: Medical Care vs. Other Consumption Categories
Price Indices Over Time: Medical Care vs. Other Consumption Categories
Social Security and Expected* Medicare Benefits for Average-Wage, Two-Earner Couple
Labor Force Projections(Annual Growth Rates) Labor Force Projections (Annual Growth Rates)
One Possible Reprieve • Despite debates over capital (individual accounts), the main problem is labor • Many so-called elderly are middle-aged • They still want to be productive • Government estimates may seriously understate potential labor demand for these workers
Labor Force Participation: Males Aged 55 and Older vs. the Adult Population,1948-99
Multiple Gains if Work Expands • Fewer beneficiaries • More national output, divided into: • More taxes for elderly programs • More taxes for children’s and other programs • More private wealth & income to be spread over fewer retirement years.
Constricted Choices Among Elderly Programs • Locked-in guarantees and growth rates prevent • taking better care of truly old • removing inequities among beneficiaries • switching money toward long-term care • removing elderly from poverty
Proportion of Social Security Benefits for Males Going to Those with More Than 10 Years of Life Expectancy
Some Inequities • Current system discriminates: • single heads of household • receive less than married persons who contribute no more to system • two-earner couples • receive fewer benefits for the same levels of contribution when their earnings are split • some divorced persons • receive no share of their spouses’ benefits if married fewer than 10 years
Long-term “Long-term” Care • There does remain a serious long-term care issue for the very old • By providing increasing amounts to those relatively younger, current system actually makes problem harder to solve
Reduction in Outlay Category as a Percentage of GDP, 1961-2002
Dead Men (yes, they were men) Rule • Priorities set yesterday for the needs of tomorrow • Voters left with fewer choices • Unable to switch priorities (defense, education, homeland security, children)
Source: Steuerle, Carasso, Bishop, based on data from Gale, Orszag, and the Tax Policy Center..
3.3% Source: Steuerle, Carasso, Bishop, based on data from Gale, Orszag, and the Tax Policy Center..
Source: Steuerle, Carasso, Bishop based on data from Reischauer, OMB, CBO.
Source: Steuerle, Carasso, Bishop based on data from Reischauer, OMB, CBO.
Source: Steuerle, Carasso, Bishop based on data from Reischauer, OMB, CBO.
Source: Steuerle, Carasso, Bishop based on data from Reischauer, OMB, CBO.
SOON…VERY SOON • ANY spending on education, environment, welfare, community development and most domestic programs must be paid for out of: • Deficits (but this can only be temporary) • Rescinding of tax cuts or tax increases • Pared growth in retirement and health spending • A very small international and defense presence
CONCLUSION • Dead Men Rule by locking in future changes • Rest of government squeezed between lower taxes and higher retirement/health spending • Education/environment/discretionary programs get leftovers, if any • Automatic government (spending tomorrow’s money today) restricts choices among • programs in general • elderly programs as well • Fundamental restructuring of public budgets and private labor markets almost inevitable • Will it be done well?