So much for the boom...

Economist Dean Baker points out why the baby boom has already made its greatest impact on the Social Security fund

In Monday's paper, USA Today reports on a growing backlog of disability cases being processed by the Social Security administration. The article tells us that the aging of the baby boomers is a main cuplrit and the problem will get worse as the boomers continue to age.

Actually, the problem won't get worse, or at least the problem won't get worse because the boomers are aging. Disabled people of working age get disability benefits. When workers hit age 62, they qualify for retirement benefits, whether or not a disability keeps them from working. Over the last decade, most of the baby boomers entered the ages of high disability rates from 50 to 62. Beginning next year, the oldest baby boomers will have reached age 62, the earliest possible age to receive SS retirement benefits. This means the full impact of the wave of aging baby boomers on the disability program should be felt this year. In future years, the burden on the disability program is likely to increase less rapidly.

That is exactly what the Social Security trustees project. From 2002 through 2007, they project that the cost of the disability program will have increased at an average annual rate of 8.6 percent (@ 6.1 percent in real dollars). From 2007 through 2016 they project that the cost will increase at an average annual rate of 5.8 percent (@3.3 percent in real dollars). In other words, the worst effects of aging baby boomers on the disability program have already been felt.

Former head of faith-based initiatives

Op-ed on the current Schip funding question by the first director of the White House Office of Faith-Based and Community Initiatives appointed by Bush in 2001.

Eight years ago this week, on July 22, 1999, George W. Bush delivered his first presidential campaign speech, titled "The Duty of Hope." Speaking in Indianapolis, he rejected as "destructive" the idea that "if only government would get out of the way, all our problems would be solved." Rather, "from North Central Philadelphia to South Central Los Angeles," government "must act in the common good, and that good is not common until it is shared by those in need." There are "some things the government should be doing, like Medicaid for poor children."

I helped draft the speech and served in 2001 as an adviser to Bush. He has made good on some compassion pledges. For instance, he has increased funding for public schools that serve low-income children. His $150 million program for mentoring 100,000 children of prisoners has made progress. In May, he pledged an additional $30 billion in U.S. aid to combat the global HIV/AIDS epidemic and save Africa's affected children.

On the other hand, poverty rates have risen in many cities. In 2005, Washington fiddled while New Orleans flooded, and the White House has vacillated in its support for the region's recovery and rebuilding process. Most urban religious nonprofit organizations that provide social services in low-income communities still get no public support whatsoever. Several recent administration positions on social policy contradict the compassion vision Bush articulated in 1999.

In May, Bush rejected a bipartisan House bill that increased funding for Head Start, a program that benefits millions of low-income preschoolers. His spokesmen claimed the bill was bad because it did not include a provision giving faith-based preschool programs an absolute right to discriminate on religious grounds in hiring.

That reason reverses a principle Bush proclaimed in his 1999 speech: "We will keep a commitment to pluralism, not discriminating for or against Methodists or Mormons or Muslims, or good people of no faith at all." As many studies show, most urban faith-based nonprofits that serve their own needy neighbors do not discriminate against beneficiaries, volunteers or staff on religious grounds. These inner-city churches and grassroots groups would love to expand Head Start in their communities.

Last week, Bush threatened to veto a bipartisan Senate plan that would add $35 billion over five years to the State Children's Health Insurance Program (SCHIP). The decade-old program insures children in families that are not poor enough to qualify for Medicaid but are too poor to afford private insurance. The extra $7 billion a year offered by the Senate would cover a few million more children. New money for the purpose would come from raising the federal excise tax on cigarettes.

Several former Bush advisers have urged the White House to accept some such SCHIP plan. So have many governors in both parties and Republican leaders in the Senate. In 2003, Bush supported a Medicare bill that increased government spending on prescription drugs for elderly middle-income citizens by hundreds of billions of dollars. But he has pledged only $1 billion a year more for low-income children's health insurance. His spokesmen say doing any more for the "government-subsidized program" would encourage families to drop private insurance.

But the health-insurance market has already priced out working-poor families by the millions. With a growing population of low-income children, $1 billion a year more would be insufficient even to maintain current per-capita child coverage levels. Some speculate that SCHIP is now hostage to negotiations over the president's broader plan to expand health coverage via tax cuts and credits. But his plan has no chance in this Congress; besides, treating health insurance for needy children as a political bargaining chip would be wrong.

Bush threatens veto

The Senate Finance Committee approved an expansion of Children’s Health Insurance Program on Thursday. The vote was 17 to 4 with all Democrats and a majority of Republicans supporting the plan. According to the NYT's Bush has threatened a veto.

Lets look at the numbers.

$60 billion is $38.43 per-capita.

THe Bush plan costs $30 billion which is $19.21 per-capita.

The Democratic (and majoirty of Republicans) bill costs $19.22 more per-capita than Bush's proposal.

According to Republican Pat Roberts the bill would "provide health insurance coverage to approximately four million more children who would otherwise be uninsured." And Daniel E. Smith the Vice President of the American Cancer Society stated that the bill would “prevent more than 900,000 Americans from dying prematurely because of smoking,” to to the fact that most of the funding for the expansion comes from a .61 cent increase in the cigarette tax.

For $19.21 more dollars per-capita. We get 4 million more kids with insurance and 900,000 fewer premature deaths from smoking.

Hip replacement US vs. Canada

Something I did not know when discussing hip-replacement data US v. Canada, which was pointed out today by Princeton Economist Paul Krugman

On the other hand, it's true that Americans get hip replacements faster than Canadians. But there's a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That's right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that's what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it.

Which means when it comes to hip-replacements we are basicly comparing the US public system, to the Candian public system. Not some dramatic public vs. private show down. That is why I heard some people argure for the Medicare-for-all plan of someone like Kucinich (here and here and here and here).

update: Ezra Klien points out

A state-run system could decide, as Medicare does, that they'll pay for any and all necessary procedures, and do so quickly. Then there would be no rationing. There would be, as there is in Medicare, enormous spending and astonishingly fast cost growth. Instead, other systems, and their attendant societies, makes a judgment to devote relatively fewer resources to health care and relatively more to other things (like leisure!). That's a fair allocation of resources.

What we do in this society is devote relatively unlimited resources to health carefor wealthy and insured peopleand relatively fewer to health care for poor people. It isn't clear whether we think that's a useful way to spend trillions of dollars, or whether we'd prefer some alternate ordering of expenditures, with more going to preventive medicine and paid maternal leave.

good question on health care...

Ezra Klien has a good point to make on the question of health care wait times in other countries...

It's fascinating how much more concerned conservative types are with a Canadian who had to wait 3 months for a hip replacement than with the 18,000 Americans who die each year because they lack access to quality medical care

I think its a great point but I'm going to reframe it without dragging conservatism as a philosophy into the picture--since I'll assume many conservatives don't want to be included in a group that does believe wait times are more important than deaths from inadequate health coverage, which a study by the National Academies’ Institute of Medicine estimated to be at least 18,000 deaths per year.

Anytime questions of wait times come up, an obvious question becomes: Are long wait times a more important issue to be addressed than the 18,000 deaths from inadequate health care per year?