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The Price of Civilization_ Reawakening American Virtue and Prosperity - Jeffrey D. Sachs [92]

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Medicare, Medicaid, veterans’ benefits, or food stamps to the bone, we have to look elsewhere to close the deficit.

What about waste, fraud, and abuse in civilian discretionary programs? Once again, there is much less than meets the eye. Civilian discretionary spending constitutes everything the government does aside from retirement, health care, social insurance, income support, and the military, yet the total is only around 4 percent of GDP. That modest level of spending is spread out over many areas, including general science, space science (NASA), health science, agriculture, commerce, transportation (including highways), environment (including water resources), energy, regional development, education, training, housing, the justice system (including the judiciary and penal system), public administration, international diplomacy, and international development assistance. Each of these areas of spending constitutes less than 1 percent of GDP. There are no areas of obvious massive waste. A few billion dollars of savings can surely be achieved by ending wasteful agriculture subsidies, but that would barely dent the overall budget deficit. Total spending on public administration—the much-derided “federal bureaucracy”—amounted to just $20 billion, or 0.13 percent of GDP, in fiscal year 2010.17 When it comes to saving vast budgetary resources through cuts in waste, there is simply not vast waste to cut in civilian outlays.

Here is another way to show the falsity of the idea of vast waste hidden in the civilian budget. Obama established the National Commission on Fiscal Responsibility and Reform with a mandate to find a path to budget balance. The commission was charged with identifying specific areas of budget cutting, yet it couldn’t find large waste to trim. Here is the list that the commission proposed and the estimated dollar savings for the year 2015, when GDP is expected to be $18.6 trillion:18

Reduce congressional and White House budgets, $800 million.

Impose a three-year wage freeze on federal workers, $20 billion.

Reduce the size of the federal workforce, $13 billion.

Reduce federal travel, printing, and vehicle budgets, $1 billion.

Sell excess federal real estate, $100 million.

Eliminate all earmarks, $16 billion.

Reform Medicare sustainable growth, $3 billion.

Repeal support for long-term affordable care (the CLASS Act), $11 billion.

Reduce Medicare fraud, $1 billion.

Reform Medicare cost sharing, $10 billion.

Restrict Medicare supplemental insurance, $4 billion.

Extend Medicaid rebates to “dual eligibles,” $7 billion.

Reduce excess payments to hospitals for medical education, $6 billion.

Cut Medicare payments for bad debts, $3 billion.

Accelerate savings for home health care providers, $2 billion.

Medicaid savings, $6.3 billion.

Medical malpractice reform, $2 billion.

Reform health benefits for federal employees, $2 billion.

Reduce agriculture spending, $1 billion.

Eliminate in-school subsidies in student loan programs, $5 billion.

Other specified saving, $1 billion.

This is a long list, to be sure, but it is not an impressive one in terms of budget savings as a percent of GDP. It sums to a mere $115 billion, or roughly 0.6 percent of GDP in 2015. And that’s an optimistic assessment. Many of the supposed savings would not really materialize. Others may be ill advised, such as cutting support for long-term health care. The commission also called for other large savings by way of limiting cost-of-living adjustments and other gimmicks, rather than through specified cuts.

This is all pretty thin gruel. The supposition that there is massive waste to be cut in the civilian budget is simply a myth. To recapitulate: ending all earmarks and foreign aid and achieving all of the specific cuts on civilian programs proposed by the deficit commission, even if such choices were meritorious, would amount to less than 1 percent of GDP.

True health care reform, the kind that not only expands coverage but actually reduces America’s bloated costs, could probably save as much as 1 percent of GDP per year

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