There are substantial amounts of money to be saved by cutting federal spending in ways that are good policy:
- Reducing the ample fat in the military budget--i.e., getting us a more useful and less expensive military.
- Strengthening the IPAB's ability to rationalize the relative reimbursements received by primary-care physicians (i.e., raise them) and specialists (i.e., lower them) seeing Medicare patients.
- Giving Medicare the power to bargain with drug companies over prescription drug prices.
- Further pruning failed health-care experiments and health-care waste--further cutting back on things like Medicare advantage.
But the semi-concrete steps offered by Republicans I have heard are (i) raising the Medicare qualifying age (which wastes a lot of money and adds a lot to health-system inefficiency) and (ii) changing Social Security indexation (which mostly beats the crap out of old widows). Both are really lousy policy.
Can we please, please, please require that the Obama administration will only propose or accept entitlement cuts that are actually good policy?
Why Republicans Can’t Propose Spending Cuts: The Bowles-Simpson “plan” was an earnest and badly needed attempt to reconcile the GOP’s hazy belief that government is enormous with reality. They did everything they could possibly do: They brought in representatives from all sides for long meetings with budget experts, going through all aspects of federal policy in detail, in the hope of reaching an agreement on the proper scope of government and how to pay for it. It failed. The Bowles-Simpson plan wound up punting on all the major questions because it simply couldn’t bridge that gulf between perception and reality. That’s why, in lieu of any ability to identify government functions to eliminate, the plan simply pretended the federal government could have everybody do a lot more work for less pay.
The real domestic savings in Bowles-Simpson came from building on Obamacare’s steps to save money by holding down the growth of health-care costs and to cut defense spending by pretty steep levels. But these turned out to be an idea that alienated rather than satisfied Republicans. So basically it turned out to be impossible to find real spending cuts that Republicans wanted.
It’s true that Paul Ryan’s budget plan had some deep cuts. But none of those cuts touched Medicare for the next decade or Social Security at all. Ryan just kicked the crap out of the poor. So, that provision aside, if you’re not willing to inflict epic levels of suffering on the very poor, there just aren’t a lot of cuts to be had out there….
When the only cuts on the table would inflict real harm on people with modest incomes and save small amounts of money, that is a sign that there’s just not much money to save. It’s not just that Republicans disagree with this; they don’t seem to understand it. The absence of a Republican spending proposal is not just a negotiating tactic but a howling void where a specific grasp of the role of government ought to be. And negotiating around that void is extremely hard to do. The spending cuts aren’t there because they can’t be found.