WASHINGTON -- On Day One of his vow to take "meaningful steps to rein in our debt," Barack Obama asked Congress to freeze portions of discretionary domestic spending. This would follow an astonishing permanent expansion: Republicans on the House Budget Committee say appropriations bills Obama has signed, along with his stimulus spending, have increased discretionary domestic spending 84 percent. He almost certainly will not keep his promise to veto spending bills when Congress, as it almost certainly will, largely disregards his request.
On Day Two, taking a break from the rigors of austerity, he was in Tampa, Fla., promising $8 billion for high-speed rail projects there and in a dozen other places. Four days later, he released a $3.8 trillion fiscal year 2011 budget that would add another $1.3 trillion to the national debt. The budget reveals that the deficit emergency is not so great as to preclude another stimulus, aka "jobs bill."
Or to require that middle-class tax cuts enacted under The Great Alibi (George W. Bush) be allowed to expire. Or even to scrub from the budget such filigrees from olden days as $430 million for the Corporation for Public Broadcasting, which perhaps made some sense 42 years and 500 channels ago, when public television meant for some Americans a 33 percent increase in channels, from three to four.
The depressing minutiae of the moment pale next to two large possibilities anticipated by Robert Fogel, a Nobel Prize-winning economist. They concern the rise of American health spending and the even more dramatic rise of China's economy.
Writing last September for the online journal The American, published by the American Enterprise Institute, Fogel warned that spending on health care is going to surge, for two reasons: By living longer, Americans will become susceptible to more health problems. By becoming richer they will be able to purchase more biotechnologies that make health interventions more effective.
"The financial per capita (health care) burden at age 85 and older," Fogel wrote, "is nearly six times as high as the burden at ages 50-54" and "the financial burden of health care for ages 85 and older is over 75 percent higher per capita than at ages 75-79." A century ago, "the burden of chronic diseases among elderly Americans was not only of greater severity but began more than 10 years earlier in the life cycle than it does today."
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