When it comes to financial matters, we have entered the era of the Big Lie. While Washington decries the accounting yarns spun by Enron, Global Crossing, WorldCom, Adelphia Communications Corp., Halliburton Co., etc., the corporate evildoers have nothing on our government. The White House and Congress have a form of fiscal insanity so profound it should qualify for its own diagnosis code.
In the past year we have watched as the hard-won budget surpluses of the 1990s have disappeared. After decades of hearing from Republicans and moderate Democrats about the perils of deficit spending, we have replaced fiscal accountability with a fiscal rabbit hole-accounting by sleight of hand. And we are fools for believing in it.
Amid economic stagnation, a 10-year, $1.6 trillion tax cut that is just kicking into gear and preparations for war with Iraq, the administration thinks that this year's $165 billion deficit will somehow turn into a balanced budget by fiscal 2005. Remember, two years ago we had projections of a $5.6 trillion, 10-year surplus. And there's the point. Fiscal planning should be based on current economic reality, not some idea of what the picture will look like five or 10 years out. By now we should know the 10-year projections are political, not accounting, statements.
Congress, meanwhile, is happy to go along with the fiction. The Senate overwhelmingly passed a record $355 billion military budget late last month that actually went beyond the Pentagon requests in some areas. Once we go to war, you know that budget will be blown.
The new farm bill-you know, the one where we pay people not to plant and to pour milk away-increases subsidies by $80 billion per year.
Ohio Republican Sen. George Voinovich, not exactly a wild-eyed liberal, says this about this situation: "The country's finances are in dire condition. We face a sea of red ink as far as the eye can see. We are on the edge of an abyss and we must stop before we commit fiscal suicide." He wanted to divert $45 billion from the military bill for legitimate domestic needs.
The implications for healthcare of this fiscal plight are ominous. Hospitals want Medicare relief. Seniors need a prescription-drug benefit. The Medicaid program is being decimated as governors win waivers to cut benefits. And the biggest healthcare spending need, help for the 40 million uninsured Americans, is if anything becoming more pressing.
All of those are worthy goals. But as I watched the debate over a Medicare prescription-drug benefit unfold two weeks ago, I couldn't help but marvel at the lack of discussion about how it would be paid for. The tripartisan plan would cost $370 billion over 10 years, while the most liberal plan would cost $800 billion.
A bill may pass this fall, but when we begin to awaken from this fiscal dreamland we are living in, there are going to be some serious decisions to make. And yes, we will wake up, just as we did after the end of the Reagan era. And then, tax cuts may have to be repealed and spending controlled.
Now ask yourself this question: When was the last time healthcare took precedence when difficult fiscal decisions had to be made? Unfortunately, healthcare always takes a back seat to defense and other issues.
Perhaps instead of simply lobbying for provider relief, people in the healthcare industry ought to join the few lonely voices advocating a repeal of the tax cuts and a reduction in out-of-control spending. Only when we have restored some fiscal sanity can we find the money to pay for the nation's very real healthcare needs.