That sets up one of the recurring problems in health-care policy, which is that the more you do to control costs, the more people will hate you. Insurers found this out in the 1990s, when HMOs managed to save a lot of money without doing any measurable harm to care, but the American people loathed them for it. Various provisions in the Affordable Care Act ”” or any serious cost-control effort ”” will end up proving it again.

This will present a useful test for seeing who’s serious about controlling health-care costs. Conservative economists, for instance, almost universally hate the fact that employer-provided health benefits aren’t taxed, and that public-sector workers have bargained so aggressively for generous benefits. John McCain’s 2008 health plan relied on ending the employer deduction entirely and converting it to a capped deduction for individuals ”” which is a much more violent version of this kind of change.

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Since it is not the suffering and deaths of infants nor the lack of safeguards for the health and safety of women that Representative [Nancy] Pelosi finds reprehensible, it seems the only distinguishing factor of Dr. Gosnell’s practice to which she can object is the filthy, unsanitary environment. She is comfortable with women and children dying in a posh Maryland suburban clinic, but finds it reprehensible only when stripped of its sterile medical façade, and occurring in a vermin infested inner city office.

The Netherlands and Belgium apply similar mental gymnastics to cloak the horror of infanticide in medical terminology and procedures to allow the steady advance of infant and child euthanasia. Belgium is poised to become the first Western nation to legally allow minor children to undergo voluntary euthanasia. These children ”“ who are not considered mature enough to drink alcohol, vote, drive, or marry ”“ will be allowed to request their lives be ended by medical personnel. The fact that death will be brought to these young people by white-coated professionals bearing a sterile syringe of poison makes the procedure palatable to the Belgian legislature. The move is strongly opposed by the Belgian Catholic hierarchy and clergy, but this does not seem to be enough to sway politicians from their deadly path.

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A Southern Baptist from Spartanburg with no political experience walked the halls of Capitol Hill on Wednesday with his wife, lobbying Congress to support immigration reform as a moral issue.

Jim Goodroe, director of missions for the Spartanburg County Baptist Network, has ministered to the immigrant community of Spartanburg for the last 12 years. His wife, Nancy, teaches young children who don’t speak English as a first language.

The Goodroes are well-versed on visas and green cards and the struggles involved in migrating to a foreign country. But the political arena is a new world to them.

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Amid speculation that the Federal Reserve soon might start scaling back its stimulus efforts, the International Monetary Fund cautioned that a pullback before next year could hurt economies worldwide.

Highlighting its concern Friday, the IMF lowered its forecast for U.S. economic growth next year to 2.7% from an earlier projection of 3%.

The IMF also criticized U.S. fiscal policy, calling for the repeal of the automatic federal spending cuts, known as the sequester, and urging lawmakers to act promptly to raise the nation’s debt limit.

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News of two expansive U.S. surveillance programs has sparked a national discussion on security versus privacy and civil liberties. The issue is splitting American citizens and even politicians who normally find themselves on the same side.

Two Republicans in South Carolina’s congressional delegation are already sharply divided.

U.S. Sen. Lindsey Graham, who serves on the Senate Armed Services Committee, called the programs “very helpful for us when it comes to national security.”

U.S. Rep. Mark Sanford’s reaction was almost exactly the opposite. He said the data mining is “out of control” and has “no regard for constitutional rights.”

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A U.S. economy that was supposed to be barely hanging on is starting to look surprisingly robust.

Housing prices rose faster over the past year than they have in the past seven, according to data out Tuesday. Consumer confidence hit its highest level in five years. The stock market rallied another 0.6 percent as measured by the Standard & Poor’s 500, leaving it just short of an all-time high reached last week. And the national retail price of gasoline fell for six days straight through Monday and is down 16 cents a gallon since late February.

It adds up to this reality: In a year when tax increases and spending cuts by the federal government were expected to bleed life out of the economy, the strengthening housing and financial markets are proving to be more powerful than acts of Congress.

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Can we get real? For starters, $642 billion is serious money, and despite the modest improvements of the latest CBO report, the basic trends in federal finances remain the same. From 2014 to 2023, the government will spend $6 trillion more than it collects in taxes. The budget never comes close to balancing. Expanding spending on the elderly and health care continues to strangle the rest of government. As a share of the economy (gross domestic product), military and domestic discretionary programs (examples: drug approval, environmental regulation, Head Start, federal courts) drop about 40 percent from 2010 to 2023.

Nothing of consequence has changed. A few numbers have shifted slightly. That’s all. They moved in a favorable direction. Next time, they might go the other way. What’s also constant is the unwillingness of leaders of both parties, beginning with the president, to discuss budget choices candidly. The budget passed by the Democratic Senate barely touches entitlements for the elderly, which constitute the largest chunk of federal spending. The budget passed by the Republican House avoids a large tax increase only by making draconian and unrealistic spending cuts that would never pass Congress or be signed by the president.

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Former Gov. Mark Sanford completed the trail to political redemption Tuesday with a win over Democrat Elizabeth Colbert Busch to reclaim his old seat in Congress.

Sanford defeated Colbert Busch 54 percent to 45 percent, according to full unofficial results. Turnout was heavier than expected, with about 32 percent of the district’s 455,702 registered voters casting ballots.

Sanford, who has never lost an election, returns to the 1st District seat he held for three terms from 1995-2001. It’s a remarkable comeback for a man many pundits had written off after his highly publicized affair with an Argentine mistress made him the source of national ridicule in 2009.

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Lawmakers on both sides of the aisle reacted swiftly to the news that the Pentagon’s estimated number of sexual assaults jumped 35 percent, with several introducing legislation in the House and Senate to protect victims and improve response following report of an incident.

Sen. Kirsten Gillibrand, D-N.Y., chairwoman of the Senate Armed Services personnel panel, plans to introduce legislation next week that would eliminate a commander’s authority to overturn rulings in cases of sexual assault.

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Former South Carolina Gov. Mark Sanford has redeemed a political career sidelined by scandal by winning his old congressional seat.

Sanford defeated Elizabeth Colbert (KOHL’-buhrt) Busch Tuesday in the state’s 1st Congressional District. Colbert Busch is the sister of political satirist Stephen Colbert (kohl-BEHR’). With 71 percent of precincts reporting, Sanford has 54 percent of the vote.

Read it all. Also, a USA Today article is there.

(Yes indeed it is in my district! KSH).

Perhaps it is fitting that inclement weather could play a role in deciding the outcome of Tuesday’s special U.S. House election in South Carolina’s 1st District. After all, the race has been turbulent and unpredictable from the get-go.

Forecasts called for intermittent showers and thunderstorms around Charleston as voters head to the polls, adding a wrinkle to both sides’ turnout models, which were already steeped in guesswork.

The high-profile battle between former Republican Gov. Mark Sanford and Democrat Elizabeth Colbert Busch has seen everything from an embarrassing accusation of trespassing from Sanford’s ex-wife to rare, out-of-character appearances by Colbert Busch’s brother Stephen Colbert, the satirist best known for lampooning members of Congress rather than helping them raise money.

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[…An] important strand of the British effort is what the UK government calls the “Prevent” strategy. This involves the police and local authorities working with Muslim organisations and communities to ensure that British nationals who become radicalised are identified and encouraged to channel their anger before they resort to violence.

Professor Michael Clarke, an expert on counter-terrorism at the Royal United Services Institute, a think-tank, says the strategy has had some success. “It is about getting the Muslim community to accept responsibility for people in their midst, helping to identify those who are radicalised and working with the police and local authorities to stop them before they plan attacks,” he says….like a number of UK experts, he argues that the US has been slow to tackle “homegrown” jihadism pre-emptively. “The Americans find it hard to accept that jihadism can arise from within their own society. They still feel the phenomenon is pushed into the US by outside forces or foreign actors.”

Read it all (if needed another link is there).

To tax reform advocates, the federal tax code is a shambling behemoth, its immense girth weighing down corporations and Jane and Joe Taxpayer alike. The code is more than 4 million words long and has been tweaked 4,680 times since 2001, or more than once a day, according to the Internal Revenue Service’s National Taxpayer Advocate, whose job is to champion the poor schlubs who have to contend with the US tax system. Compliance takes more than 6 billion person-hours a year and costs $168 billion, the advocate’s office reports.

Tax expenditures ”“ the sober name for myriad loopholes, carve-outs, and incentives in the code ”“ shield almost as much in revenue, at just over $1 trillion, as the $1.4 trillion collected each year.

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On Jan. 30, the Obama administration unveiled a long list of exemptions from the ObamaCare insurance mandate. Flaws and contradictions in the law will cause millions of people to be uninsured. The administration also estimated that the cheapest family plan will cost $20,000 by 2016. This new information indicates that the Affordable Care Act is failing in both goals: making insurance affordable and covering the uninsured.

Children are the biggest victims. The hastily drafted law, passed before it was read, overlooked them.

The law says that beginning in 2014, employers with 50 or more full-time employees must offer coverage or pay a penalty. The law’s sloppy drafting left it unclear whether that meant worker’s coverage or family coverage.

Read it all from IBD.

The CBO forecast finds a persistent mismatch between tax revenue and spending over the coming decade. As the economy improves, tax revenue should rise to 19 percent of GDP for the period from 2015 through 2023, up from 15.8 percent in 2012, the report said. But federal spending, after an early-decade dip, will start rising persistently faster than revenues.

“After 2017, if current laws remain in place, outlays will start growing again as a percentage of GDP,” the CBO said. “The aging of the population, increasing health care costs, and a significant expansion of eligibility for federal subsidies for health insurance will substantially boost spending for Social Security and for major health care programs relative to the size of the economy.”

The CBO’s current-law “baseline” calls for spending to reach about 23 percent of GDP in 2023 and, more worrisome, to be “on an upward trajectory.”

Read it all.

Update: An IBD article is also available on this, entitled “CBO Report Shows We’re Still Headed Toward A Fiscal Cliff” and it may be found there.

The $1.2tn in automatic spending cuts that Barack Obama once promised to avert are looking increasingly likely to occur because of entrenched politics in Washington, threatening a shock to confidence in the US economy.

Economists have long assumed that the so-called sequester ”“ a budgetary mechanism passed in 2011 that takes effect on March 1 and slashes the Pentagon’s budget by $600bn over 10 years while cutting discretionary spending for government programmes by another $600bn ”“ would be replaced or reversed by Congress.

Many saw a recent move by Republicans on Capitol Hill to extend the US borrowing authority as a sign of greater co-operation with the White House. But conservative lawmakers have recently made it clear that they were simply gearing up for another fight, and are prepared to take a hard line on the $1.2tn in cuts even amid objections from military hawks.

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We agree with Obama that it will take a combination of tax increases and spending cuts to put the government’s fiscal house in order. Republicans swallowed hard and accepted an increase in tax rates for the highest incomes to start the year. It’s the Democrats’ turn to recognize that federal benefit programs, and particularly healthcare entitlements such as Medicare and Medicaid, are on an unsustainable path despite the savings from the 2010 healthcare law.

Obama should lead a Democratic push for reforms that preserve these programs for those who need them, while also reducing the deficit and stopping the federal debt from growing faster than the economy. He’s in the best position to lead on this issue, able to provide political cover for Democrats concerned that their constituents won’t put up with changes to the status quo, while showing Republicans that there are ways to save money without abandoning the government’s commitment to the elderly and poor. To create an opening for the rest of his agenda, he needs to step up to that role.

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A political class that botched the fiscal cliff so badly are not going to be capable of a gigantic deal on complex issues. It’s like going into a day care center and asking a bunch of infants to perform “Swan Lake.”

–David Brooks in a piece on today’s NY Times Op-ed page entitled “The Next Four Years”

Public debt as a percentage of gross domestic product was around 38 percent in 1965. It is around 74 percent now. Debt could approach a ruinous 90 percent of G.D.P. in a decade and a cataclysmic 247 percent of G.D.P. 30 years from now, according to the Congressional Budget Office and JPMorgan.

By 2025, entitlement spending and debt payments are projected to suck up all federal revenue. Obligations to the elderly are already squeezing programs for the young and the needy. Those obligations will lead to gigantic living standard declines for future generations. According to the International Monetary Fund, meeting America’s long-term obligations will require an immediate and permanent 35 percent increase in all taxes and a 35 percent cut in all benefits….

[The final ‘solution didn’t] involve a single hard decision. It did little to control spending. It abandoned all of the entitlement reform ideas that have been thrown around.
Whom should we blame for this? Again, we should not blame Obama and Boehner. In their different ways, they and a number of other people in the Congress are trying to find a politically palatable way to deal with these hard issues. They got what conditions allowed.

Ultimately, we should blame the American voters. The average Medicare couple pays $109,000 into the program and gets $343,000 in benefits out, according to the Urban Institute. This is $234,000 in free money. Many voters have decided they like spending a lot on themselves and pushing costs onto their children and grandchildren. They have decided they like borrowing up to $1 trillion a year for tax credits, disability payments, defense contracts and the rest. They have found that the original Keynesian rationale for these deficits provides a perfect cover for permanent deficit-living. They have made it clear that they will destroy any politician who tries to stop them from cost-shifting in this way.

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In the House, the majority Republican party says it won’t raise the debt limit without spending cuts of equivalent amounts. Mr. Obama has said he won’t negotiate over the matter, saying it is the responsibility of Congress to enable the government to pay bills it has incurred.

The government spends 40% more than it takes in and borrows money to cover the difference. Without an increase in the debt ceiling, the Treasury won’t be able to borrow the additional money needed to pay all its bills.

Failure to make payment on even some of its obligations could wreak havoc in the economy and financial markets and possibly trigger another financial crisis and recession, analysts have warned.

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The Congressional Budget Office projects that over the next decade Social Security’s annual cash deficit will rise by nearly $100 billion, reaching $155 billion a year. The cost of servicing the extra public debt tied to cashing in $1 trillion worth of Social Security’s intragovernmental IOUs over the 10 years would add $40 billion to the deficit in 2022 alone, an IBD analysis finds.

Overall, Social Security would account for nearly $200 billion in annual deficits or nearly 20% of the $1 trillion-plus deficit that would occur under current policies, including fiscal-cliff tax hikes.

Then, over the following decade, the retirement program’s impact on deficits would really balloon.

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There are two major reasons for Medicare’s rising costs. The first is the program’s design, often tweaked but left fundamentally intact since its creation in 1965, which basically pays doctors and hospitals fixed fees for whatever they do. At a time of rapid (and often beneficial) medical innovation, the dominant incentive has been to provide more, and more expensive, care. Hence the House Ways and Means Committee’s 1965 estimate that Medicare hospital insurance would cost $9 billion by 1990 fell short by $58 billion. The second reason costs keep going up, of course, is the rising number of elderly eligible for Medicare, which is inevitable; the 50 million beneficiaries today will be 78”‰million in 2030.

The ultimate solution is structural: to limit growth in expenditures per beneficiary. Easier said than done. Liberals would empower the Independent Payments Advisory Board (IPAB) to stop payment for treatments it deems not cost-effective. The idea hasn’t gotten very far, partly because Republicans denounce it as “rationing.” Conservatives favor “premium support,” which would subsidize seniors to shop among competing insurance plans, but Democrats, the president included, have tarred that idea as a skimpy “voucher.”

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he new, 113th Congress includes the first Buddhist to serve in the Senate, the first Hindu to serve in either chamber and the first member of Congress to describe her religion as “none,” continuing a gradual increase in religious diversity that mirrors trends in the country as a whole. While Congress remains majority Protestant, the institution is far less so today than it was 50 years ago, when nearly three-quarters of the members belonged to Protestant denominations.

Catholics have seen the biggest gains among the 533 members who are scheduled to be sworn in on Jan. 3.1 Catholics picked up seven seats, for a total of 163, raising their share to just over 30%. Protestants and Jews experienced the biggest declines in numerical terms. Jews now hold 33 seats (6%), six fewer than in the 112th Congress, where Jews held 39 seats (7%). Protestants lost eight seats, though they continue to occupy about the same proportion of seats (56%) as in the 112th Congress (57%).

In addition, the Protestant share of each political party in the new Congress is about the same as in the 112th; roughly seven-in-ten Republicans are Protestants, compared with fewer than half of Democrats.

Read it all and enjoy the charts as well.

While many in Washington are breathing a sigh of relief and some are trying to spin the outcome as a win for the president, those who characterize this bill as a genuine victory for anyone at all have clearly lost perspective. The deal brokered by Vice President Joe Biden and Senate Minority Leader Mitch McConnell does make good on President Obama’s promise to bring a little more equity to the tax code by raising rates on wealthier Americans, and it temporarily averts the most draconian “sequestration” cuts. But the list of what it does not do, and what it does wrong, is long.

By midday Tuesday, the Congressional Budget Office had concluded that the Biden-McConnell package would add nearly $4 trillion to federal deficits over the next 10 years. This was largely because it actually extends and makes permanent more than 80% of the Bush tax cuts. So much for the idea that this whole struggle was supposed to help America get its financial house in order.

Just as bad, or perhaps worse in terms of the day-to-day lives of average people, the bill only postpones the forced cuts of sequestration by two months, to precisely the moment the country will be engaged in another ruinous debate about lifting our national debt ceiling to ensure the country can pay its bills. It thus creates a new, even more dangerous fiscal cliff….

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Update: George Will has also written on this I see–Perils Of The Entitlement State And Our Decadent Democracy.

Congress’ hectic resolution of the “fiscal cliff” crisis is the latest in a long series of decisions by lawmakers and the White House to do less than promised ”” and to ask Americans for little sacrifice ”” in confronting the nation’s burgeoning debt.

The deal will generate $600 billion in new revenue over 10 years, less than half the amount President Barack Obama first called for. It will raise income tax rates only on the very rich, despite Obama’s campaign for broader increases.

It puts off the toughest decisions about spending cuts for military and domestic programs, including Medicare and Social Security. And it does nothing to mitigate the looming partisan showdown on the debt ceiling, which must rise soon to avoid default on U.S. loans.

In short, the deal reached between Obama and congressional Republicans continues to let Americans enjoy relatively high levels of government service at low levels of taxation. The only way that’s possible, of course, is through heavy borrowing, which future generations will inherit.

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The budget deal passed by the U.S. Senate [and House]… would raise taxes on 77.1 percent of U.S. households, mostly because of the expiration of a payroll tax cut, according to preliminary estimates from the nonpartisan Tax Policy Center in Washington.

More than 80 percent of households with incomes between $50,000 and $200,000 would pay higher taxes. Among the households facing higher taxes, the average increase would be $1,635, the policy center said. A 2 percent payroll tax cut, enacted during the economic slowdown, is being allowed to expire as of [December 31]

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Congress approved a plan to end Washington’s long drama over the “fiscal cliff” late Tuesday after House Republicans surrendered to President Obama’s demand to let taxes rise on the nation’s richest households.

The House voted 257 to 167 to send the measure to Obama for his signature; the vote came less than 24 hours after the Senate overwhelmingly approved the legislation.

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Update: Here are the new numbers for 2013 in Congress–Democrats control of the Senate by 55 to 45 (change of 2) and Republicans control of the House of Representatives by 234-201 (change of 8)

A US Senate-backed deal [by a vote of 89-8] to stave off a “fiscal cliff” of drastic taxation and spending measures has passed to the House of Representatives.

President Barack Obama has urged the House to pass the bill “without delay”.

However, several representatives have spoken out against it, with one calling it “bad for America”.

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Senate leaders are racing against the clock to reach a “fiscal cliff” deal the House and Senate can approve on New Year’s Eve.

Leaders in the upper chamber narrowed their differences Sunday as Republicans agreed to drop a demand to curb cost-of-living increases to entitlement benefits, while Democrats showed flexibility on taxes.

Yet after months of talks on ways to avoid the fiscal cliff of tax hikes and spending cuts at the end of 2012, House and Senate lawmakers find themselves approaching the new year without a bill to present to their members.
Significant differences remain over two key parts of a deal ”” the automatic spending cuts known as the sequester and the estate tax.

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Update: a BBC article is there.

I will take comments on this submitted by email only to at KSHarmon[at]mindspring[dot]com.

When President Obama talks about taxing the rich, he means the top 2 percent of Americans. John A. Boehner, the House speaker, talks about an even thinner slice. But the current and future fiscal imbalances are too large to exempt 98 percent or more of the public from being part of the solution.

Ultimately, unless we scale back entitlement programs far more than anyone in Washington is now seriously considering, we will have no choice but to increase taxes on a vast majority of Americans. This could involve higher tax rates or an elimination of popular deductions. Or it could mean an entirely new tax, such as a value-added tax or a carbon tax.

To be sure, the path ahead is not easy. No politician who wants to be re-elected is eager to entertain the possibility of higher taxes on the middle class. But fiscal negotiations might become a bit easier if everyone started by agreeing that the policies we choose must be constrained by the laws of arithmetic.

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