Comment by Aloisius | Hacker News Reader

Comment by Aloisius | Hacker News Reader

I find most of her slides interesting, but she circled the area from around 2002 to 2011 on slide 96 as "the biggest peacetime gap between revenue and expenses in USA history."

I'm not sure Ms. Meeker is aware, but we are _at war_ right now. For most of that period, we were fighting multiple wars at once.

Further, she used the 2010 budget outlook report from the CBO which takes the most pessimistic view that the Bush Tax Cuts are kept indefinitely in the heart of a deep recession. The CBO has released a 2011 budget outlook report (2012 is due next week). Even under the pessimistic alternative fiscal scenario, that 2025 date now doesn't happen until well after 2035 (the last date they try to estimate for)

That's not to say thing aren't out of control, but most of those problems are related to healthcare not "entitlements." Social security has only an extremely modest increase in cost. Healthcare is where the big hit comes from caused by and large by baby boomers aging and the restriction placed on the federal government to really negotiate rates.

If Obama had had support to implement single payer and got rid of the restrictions about negotiating rates, we'd live in a far more fiscally sound place today.

> I'm not sure Ms. Meeker is aware, but we are at war right now. For most of that period, we were fighting multiple wars at once.

This speaks to how little the wars have affected Americans as a whole. No significant cuts in programs, no higher taxes to pay for the outlay, no draft of young men and women.

For probably 99% of the population, the only effect the wars have had is something extra to hear about on the TV. So little an effect that it makes people think we're in peacetime.

Well that's the mass media and government line, but the reality is that war spending has affected everything from state budgets to employment.

Ms. Meeker and I must be reading a different budget (or reading the same budget very differently). Most of the spending budget and budgetary issues fall squarely in the lap of military spending -- which has consistently been the biggest-ticket item for many decades.

A full 20% of federal healthcare related spending goes towards veteran benefits. That's one dollar in five. This is military spending that used to be counted under the DoD budget, but now creates the false appearance that non-military aspects of government are to blame for much of the increased costs. We see ridiculous slides like this, which rank health care for injured soldiers, military pensions and so on as "entitlements" rather than "defense." Other items excluded from the defense/military "20%" figure include (next paragraph quoted from http://en.wikipedia.org/wiki/Military_budget_of_the_United_S... ):

"Nuclear weapons research, maintenance, cleanup, and production, which is in the Department of Energy budget, Veterans Affairs, the Treasury Department's payments in pensions to military retirees and widows and their families, interest on debt incurred in past wars, or State Department financing of foreign arms sales and militarily-related development assistance. Neither does it include defense spending that is not military in nature, such as the Department of Homeland Security, counter-terrorism spending by the FBI, and intelligence-gathering spending by NASA."

I would suggest that military spending is out of control, has been out of control for a very, very long time. An honest appraisal of federal military expenditures will place it at somewhere near 50% of the entire federal budget.

We've been at war since 1898, usually fighting more than one at once.

Healthcare costs are 120% of the problem.

That's sarcasm, right? Military spending outstrips healthcare costs by nearly 2:1, and has for decades.

I guess you guys are fucked, 360%!

That's true but irrelevant. Military spending as a percentage of GDP has decreased significantly over the last 50 years. Government healthcare spending as a percentage of GDP has grown unabated over the same time and shows no signs of stopping. It's this trend that makes healthcare spending a priority to solve today instead defense.

Military spending as a percentage of GDP only decreases if you don't count military spending outside the DoD's official budget -- which is why it appears to have shrunken when it actually has not.

For example, 50 years ago veteran's benefits were part of the DoD budget. Today, they're part of the healthcare budgets. VA spending accounts for 20% of all government health spending -- and has grown astronomically over the last decade. It's huge.

I urge you to take a second look at the numbers you're quoting. Specifically, consider how much of the "healthcare spending" increase is actually a hidden increase in military spending which has been quietly shifted into a non-military budget.

US public spending on healthcare is larger per capita than many other western countries with universally inclusive healthcare systems that also have better health outcomes.

As a bonus, public spending on healthcare in the US is matched by massive private spending, being responsible for most bankruptcies and foreclosures and tying many people to wage labor who would rather be entrepreneurs.

We know that healthcare with better outcomes than current ones doesn't have to be expensive. That money has been wasted. There's no established cost for endless multifront war other than our own historical experience, so it's hard to know if money is being wasted there.

We do know that we would have been running surpluses through the recession and into the foreseeable future if our healthcare system had the same costs as other systems, and wasn't a pile of rent-seeking, kickbacks, monopoly and artificial scarcity, and rats.

It's true that US public spending is larger per capita. Several times bigger than many successful european countries. It's a problem and deserves recognition.

However, it is not "120%" of the problem as you suggest. Military spending is similarly out of proportion (arguably much moreso) and military spending consumes much, much more of our federal budget than healthcare.

I'm not objecting to the idea that we need to fix our health care system -- you are right on. I'm saying that it's not "120%" of the problem; defense is, and has always been.

Healthcare falls under entitlements.

That is correct, the two fastest growing entitlements are Medicare and Medicaid.

Yes, but people like to rally against "entitlements" when they really mean a very specific part of entitlements: healthcare. It is politically dangerous for anyone who swings conservative to use accurate terminology because they've demonized healthcare reform so much.

The answer to runaway health care costs is less government, and more innovation and competition.

Because that's worked so well in which countries?

Do you often shop around for who can give you the best deal on your hip surgery? Would you like it if your insurance agent did?

I would LOVE to have information to do that. Sadly, it's almost impossible to actually know how much a procedure will cost. Which is one of the big reasons why things cost soooo much!

I could take this more seriously if I didn't strongly suspect that's your answer to everything.

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