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Social Security fix must include Medicare

"We have a problem, and the problem is America is getting older and that there are fewer people to pay into the system to support a baby boomer generation which is about to retire. Therefore, the question is, does this country have the will to address the problem?"

_ PRESIDENT BUSH, Dec. 9, 2004

WASHINGTON _ The answer seems to be "no," starting with the president. Language matters. How we discuss something _ the words and phrases we select _ determines whether what we say makes sense. The fact that both Bush and his opponents have chosen to debate only Social Security, highlighted by the president's "personal accounts" proposal, betrays a lack of seriousness that promises failure. The nation's problem is not Social Security. It is all federal programs for retirees, of which Social Security is a shrinking part. Admit that and the debate becomes harder; but it also becomes more honest and meaningful.

Our national government is increasingly a transfer mechanism from younger workers (i.e. taxpayers) to older retirees. In fiscal 2004, Social Security ($488-billion), Medicare ($300-billion) and Medicaid ($176-billion) represented 42 percent of federal outlays. Excluding spending that doesn't go to the elderly, the Congressional Budget Office crudely estimates that these programs pay almost $17,800 to each American 65 and over.

It makes no sense to separate Social Security from Medicare. Most Social Security retirees receive Medicare. Similarly, it is the total cost of these programs that matters. By itself, Social Security is almost irrelevant. Indeed, the big increases in future spending occur in health care. The actuaries of Social Security and Medicare project that Medicare's costs will exceed Social Security's in 2024 _ and then the gap only widens.

Look at the numbers. From 2004 to 2030, the combined spending on Social Security and Medicare is expected to rise from 7 percent of national income (gross domestic product) to 13 percent. Two-thirds of the increase occurs in Medicare. Even if the budget were now balanced (dispensing with the issue of Bush's tax cuts), the required tax increases _ to cover promised benefits _ would ultimately be about 30 percent.

The central budget issue of our time is how much younger taxpayers should be forced to support older retirees _ and both political parties and the public refuse to face it. What's fair to workers and retirees? How much of a tax increase could the economy stand before growth suffers badly? How much do today's programs provide a safety net for the dependent elderly and how much do they subsidize the leisure of the fit or well-to-do? How long should people work?

We need a new generational compact to reflect new realities. In 1935, when Congress passed Social Security, life expectancy at birth was 62; now it's 77. In 1965, when Congress passed Medicare, the 65-and-over population was 9 percent of the total; by 2030, it's expected to be 20 percent. If this year's debate focuses only on Social Security, it will be an exercise in deception. Unfortunately, both the White House and congressional Democrats have a stake in deception.

Democrats argue that "the Social Security problem" can be fixed with tolerable tax increases and benefit cuts, imposed mostly on the upper-middle class and rich. True. The long-term gap between promised benefits and present taxes equals 1 to 2 percent of GDP. Though large, the needed changes in taxes and benefits probably wouldn't be crippling. There's no "crisis," say Democrats and supporting pundits. What they omit is Medicare. Adding that, tax increases would be huge _ and hard to limit to the wealthy.

The focus on Social Security also suits the White House. For starters, it avoids the reality that, until now, many Bush policies have favored the old over the young. In 2030, the new drug benefit raises Medicare spending by an estimated 36 percent. Personal accounts would involve immense practical problems. Why run the risks if, because Medicare has been ignored, the real problem of federal retirement spending remains largely unaddressed?

What's discouraging is that, along with most Republicans and Democrats, many "experts" and pundits also evade the hard questions. Their purpose is mainly to condemn or cheer George Bush. The debate we need involves generational responsibility and obligation. Anyone who examines the outlook must conclude that, even allowing for uncertainties, both Social Security and Medicare benefits will have to be cut. We can either make future cuts now, with warnings to beneficiaries; or we can wait for budgetary pressures to force abrupt cuts later, with little warning. That's the problem, and to answer Bush, no one wants to address it.

Robert J. Samuelson is a columnist for Newsweek.

Washington Post Writers Group