5. Debt Held by the Public as a Percent of GDP 1940-2010 Source: OMB Historical Tables 2009. As a Percentage of GDP
6. Debt Held by the Public as a Percent of GDP 1940-2040 Source: GAO Analysis, 2010 and OMB Historical Tables 2010. As a Percentage of GDP Actual Projected World War II 108.6% 2010 63.6%
7. National Saving Is Very Low by Historical Standards Source: BEA, NIPA Tables 1.1.5 and 5.1 (2010).
8. Composition of Projected FY 2010 Federal Government Revenues and Outlays (Deficit: $1.34 Trillion) Estate & Gift Taxes ($21 billion) Other Taxes Corporate Taxes Social Insurance Taxes Individual Income Taxes Outlays: $3.49 trillion Revenue: $2.14 trillion *Includes all appropriated domestic spending such as education, transportation, homeland security, housing assistance, and foreign aid. Source: CBO August 2010. Interest Domestic* Social Security Medicare & Medicaid Other Entitlements Defense
9. Federal Spending vs. Revenues as a Percent of GDP (FY 1980-2020) CBO August Baseline Compared to the President’s Budget CBO August 2010 Baseline CBO’s Estimate of the President’s Budget Source: Congressional Budget Office, August 2010.. Average outlays: 21.0% Average revenues: 18.3% Percentage of GDP Actual Projected
10. Percent of Debt Held by the Public Owned by Foreigners (1987-2010) Source: United States Treasury Department, Treasury Bulletin, September 2010. Percentage of Ownership of Publicly-Held Debt
11. Interest Costs Go Through The Roof Source: Congressional Budget Office August 2010 and CBO’s Analysis of the President’s Budget, March 2010. Billions of Dollars
12. Without reforms, by 2022, future revenues will only cover Social Security, Medicare, Medicaid, and interest on the debt. By 2046, revenues won’t even cover interest costs. 5
13. Social Security, Medicare, & Medicaid as a Percentage of the Federal Budget All other Federal Spending $2.07 Trillion 59% Social Security, Medicare and Medicaid $1.42 Trillion 41% Source: Congressional Budget Office, August 2010.
14. Mandatory spending is consuming a growing share of the budget 62% 31% 7% 40% 15% 45% 39% 6% 55% Source: Congressional Budget Office, January 2010. 1970 1990 2010 Mandatory Discretionary Net Interest
15. Outlays of Select Mandatory Spending Programs (FY 2010 Projected) Source: Congressional Budget Office, January 2010.
16. Change in Composition of Discretionary Spending 68% 32% 60% 40% 50% 50% Defense Non-defense Source: Congressional Budget Office, January 2010.
17. Defense Discretionary Spending as a Percentage of GDP Source: Congressional Budget Office, August 2010. As a Percentage of GDP
18. Projected Growth in Entitlement Spending far Greater than Defense Spending Source: Government Accountability Office and Congressional Budget Office. 2010.
20. Outlays of Select Non-Defense Discretionary Programs (FY 2010 Projected) Source: Congressional Budget Office, January 2010. *includes ground, air, and water Education Transportation Housing, Natural Veterans Foreign Aid General Science, Energy & Resources Government Space & Nutrition Asst. Technology
21. Automatic Growth Rate in the Big Three Entitlements Swamps Growth of Appropriations Projected Annual Growth Rate in Social Security, Medicare and Medicaid Annual Growth Rate in Social Security, Medicare and Medicaid outlays Plausible Annual Growth Rate in Discretionary Spending Source: Congressional Budget Office, January 2010.
22. Americans Want to Cut Spending – But Not on the Programs That Cost the Most Source: The Economist/YouGov Poll, April 2010 and Congressional Budget Office, January 2010.
23. America’s Population is Aging Population age 65 and Over Source: Social Security and Medicare Trustees’ Report, 2010. Year Percentage of Population Aged 65 and Over
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25. Since its inception, the Social Security program has experienced more surpluses than deficits 7
26. In the future, persistent cash deficits are projected for Social Security In 2015, OASDI will begin operating with a permanent cash flow deficit. 8
27. Health Care Costs are Rising Faster Than the Economy Source: Congressional Budget Office, June 2009. Percentage of GDP Historic Level of Federal Revenues Historic Level of Federal Spending Assumes that health care cost growth will not exceed GDP growth. Assumes that health care cost growth continues at the average rate for the past 40 years (2.5 percentage points greater than GDP growth.) Assumes that health care cost growth rate declines to 1.0 percentage point greater than GDP growth—consistent with the assumption used by the Medicare Trustees.
29. U.S. spends much more, doesn’t get more Source: UC Atlas of Global Inequality
30. Medicare Costs Soar in the Coming Decades Calendar Year As a Percentage of GDP General Revenues required to fund the program Income from dedicated taxes, premiums, and state transfers Source: Medicare Trustees’ Report, May 2009.
31. Health Expenditures as a Percent of GDP (1960-2019) *Projected Source: Centers for Medicare and Medicaid Services, September 2010.
32. How Paying for Health Care Has Changed (1960-2008) Source: Centers for Medicare and Medicaid Services.
33. Almost three out of every ten Medicare dollars is spent for people who are in the last year of life SOURCE: Data from the Center for Medicare & Medicaid Services, Office of the Actuary Last Year of Life Study . Compiled by PGPF. NOTE: Data estimated for 2009, the most recent available. *Decedents. **Survivors. 17
34. Current fiscal policy is on an unsustainable path Federal Outlays as a Percentage of GDP Social Security Medicaid Medicare All Other Interest Source: Government Accountability Office, 2010. Average tax revenue
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41. Federal Revenue and Spending (FY2009) Revenues $ Bil % Spending $ Bil % Individual Income Taxes Health Care Payroll Taxes (SI, Medicare, & FICA) Social Security Other Taxes National Defense Corporate Income Taxes Income Security Total Revenue Other Interest Education Environmental International Affairs Total Outlays
42. Federal Revenue and Spending (FY2009) Revenues $ Bil % Spending $ Bil % Individual Income Taxes 915 26 Health Care 764 22 Payroll Taxes (SI, Medicare, & FICA) 891 25 Social Security 683 19 Other Taxes 161 5 National Defense 663 19 Corporate Income Taxes 138 4 Income Security 534 15 Total Revenue 2105 60 Other 526 15 DEFICIT 1417 40 Interest 191 6 Education 78 2 Environmental 46 1 International Affairs 37 1 Total Outlays 3522 100
43. Current Policy Trends Lead to Large Sustained Deficits Fiscal Years 2011-2020 CBO August 2010 Baseline The Concord Coalition Plausible Baseline assumes that discretionary spending grows at the rate of nominal GDP, that war costs slow gradually, that Medicare physician payment cuts are postponed, and that all expiring tax provisions (including those from the 2009 stimulus package) are extended with AMT relief. Source: Congressional Budget Office, August 2010 and Concord Coalition analysis. Billions of Dollars -$15.2 Trillion Deficit -$6.2 Trillion Deficit
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Editor's Notes
What Does National Savings Rate Mean? An estimate from the U.S. Commerce Department's Bureau of Economic Analysis (BEA) of the amount of income left over after subtracting consumption costs and expenditures. The National Savings Rate , though it is referred to as a "savings rate," does not actually measure the amount of money Americans are saving or investing for the long-term. National savings include savings left over from personal, business and government. Investopedia explains National Savings Rate The National Savings Rate is confusing at first glance, due to the fact that it is often substantially less than what the typical American reports contributing to their employer-sponsored retirement plans and IRAs. This difference is because the national savings rate includes government savings, and they are usually reporting deficits which lowers the national savings rate.
We all have a stake in this…. This graphic just serves to explain where the money comes from to pay for Medicare (note: all the blue bars are your taxes)….as you will note: greater than 70% of Part’s B (outpatient and MD services) and D (Rx drugs) come from general revenues (recall previous slide on Medicare costs, the red part of the graphic that explodes in the future), or your income taxes ; and 85% of Part A (hospital insurance) comes from payroll taxes . Seniors are paying beneficiary premiums for these services…. To wrap up my remarks on health care, specifically, I leave you with this…. The Medicare entitlement program provides essential coverage for its beneficiaries and enjoys broad public support. It’s fiscal sustainability and stability is an issue that touches all of us in one or many ways: young and middle-aged workers via payroll and income taxes, all of us who have aging parents or other family members who receive services, and seniors themselves who are enrolled and pay premiums. We ALL should and ALL can play a role in working together to decide how to make fiscally responsible choices moving forward….for the solvency of our entitlement programs – and to ensure that the resources entrusted to the program by taxpayers and beneficiaries are used wisely. Segue : a lot has been happening in DC with regards to health care changes and reform….
Have the students guess at these numbers (easier to ask for the % not actual $ amounts)….. Turn to p. 3 in workbook to fill these out.
Here are the numbers…. Things to note: large numbers associated with health care; SS and defense, too. On Revenue side: $2.1 trillion revenue budget vs. $3.5 trillion spending budget….= $1.4 trillion deficit.