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The First $1 Trillion Agency

The opinions expressed by columnists are their own and do not necessarily represent the views of
The question is not whether America is afflicted with socialized medicine, it is whether the socialized medicine afflicting this country is curable or incurable. The inescapable diagnosis: If nothing is done, America dies.

You don't need to run an expensive test -- or commission a group of fiscal pathologists -- to see the metastatic growth of government-controlled health care. You only need to look at the data the U.S. Treasury and Office and Management Budget have released to the public.

In 1965, when President Lyndon Johnson signed legislation creating Medicare and Medicaid, all federal outlays equaled $118.23 billion, according to OMB. In fiscal 2012, according to the Monthly Treasury Statement for September, outlays for the Centers for Medicare and Medicaid (CMS) alone hit $1.05 trillion -- the third straight year they exceeded $1 trillion.

No other federal agency has ever run annual outlays in excess of $1 trillion. By comparison, total outlays for the Department of Defense in fiscal 2012 were $650.9 billion.

Adjusted for inflation, the $118.23 billion the federal government spent in 1965 to run all of its programs equals $868.53 billion in 2012 dollars. Thus, the entire federal government of 1965 cost less than CMS does today.

In 2010, when President Barack Obama signed his health care law, 67.7 million people were enrolled in Medicaid for at least one month of the year and 47.7 million people were enrolled in Medicare. The 115.4 million combined enrollment for Medicaid and Medicare exceeded the 111.9 million households the Census Bureau estimated were in the United States that year and the maximum of 112.6 million full-time workers the Bureau of Labor Statistics counted in any month that year.


Even before the implementation of Obamacare, Medicaid and Medicare enrollees outnumbered both American households and American full-time workers.

How did Obamacare plan to treat this malignancy?

As enacted, Obamacare required states to increase their Medicaid rolls by extending eligibility to virtually anybody earning less than 133 percent of the poverty level. The Supreme Court overruled this part of the law, saying states can choose to do this, but the federal government cannot force them. "Since the Supreme Court ruling, some states have stated their intention to implement the ACA Medicaid expansion, other states have asserted that they will not implement the expansion, and most states remain uncommitted," the Congressional Research Service reported in late July.

The Congressional Budget Office determined that full implementation of Obamacare's Medicaid expansions would cost an additional $931 billion over 10 years.

Obamacare also promised to subsidize federally approved health care plans for anyone earning less than 400 percent of the poverty level -- or $92,200 for a family of four.

Prescribing Obamacare for our health care system was like prescribing cigarette smoking for a lung-cancer victim.

But the ultimate questions are moral, not fiscal. Will we pay our own way or bankrupt our children? Will we remain a free peoplem, or will we let government control some of the most important decisions in our lives?


In fiscal 2012, as the outlays for the Centers for Medicare and Medicaid Services hit $1.05 trillion, the federal debt increased $1.28 trillion.

The current federal debt of about $16.07 trillion is more than $143,600 for each of the 111.9 million households that were in the country in 2010.

When the government controls health care it does more than bankrupt our finances, it bankrupts our souls. Some of the earliest Obamacare regulations the administration released require some Americans to help other Americans pay for sterilizations, contraceptives and abortions.

Will a government that forces one American to help another take the life of a third make morally sound decisions about the practice of medicine when innocent lives are at stake? Will it respect individual liberty in lesser matters?

Of course not.

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