the Federal Budget To Prevent U.S. Bankruptcy, Part IX:
Trimming Health and Human Services
Jim Grichar (aka Exx-Gman)
by Jim Grichar
note: I ask readers for their indulgence because of my extensive
use of the b-lingo bureaucrat-lingo and the detail I used in
presenting my arguments. I do this to reduce bureaucratic counter-arguments
which I expect to receive to the absurdity that they invariably
those who did not read Parts IVIII of this series, total actual
cuts in proposed spending (what I call the "Cut-o-meter")
now amount to $380 billion. Those cuts came from Defense, NASA,
HUD, the Education Department, the Agriculture Department, Transportation
Department, Interior, Commerce, Energy and other agencies.
Department of Health and Human Services (HHS), even without the
Social Security Administration, is a behemoth that staggers the
imagination. With a proposed budget of $579.9 billion for fiscal
year (fy) 2005, HHS almost approaches the Defense Department budget
(after you include all those items that are conveniently parked
in other budgets to deceive the public regarding the true costs
of defense). The big items in the HHS budget are Medicare and Medicaid
which account for about $454 billion and are growing at astronomical
rates because of the expansion of programs like the recent
addition of a prescription drug benefit plan for Medicare. More
spending on Medicaid which is even being funneled to illegal
aliens is also making the HHS budget grow even more. The
anticipated retirement of baby boomers in the next ten years will
bankrupt Medicare. Projections given out by the Bush Administrationís
Office of Management and Budget show that by fy 2009, HHSís total
budget will grow to almost $773 billion, nearly $200 billion more
than the fy 2005 budget.
Bit Here, a Bit There, and Soon Youíre Talking about Real Cuts!
is the epitome of welfare state "cradle to grave care,"
meaning that someone in Washington thinks they know better than
you how to run your life. And this comes at a staggering cost, not
only in financial terms but also in terms of gross infringements
on your individual freedom. Taking care of oneís own health is an
individual responsibility, not the responsibility of the government,
whether federal or state.
the lobbying efforts of representatives of the poor and senior citizens,
it might seem impossible to cut this budget. But the fact is that
the growth in this spending will eventually bankrupt the nation,
even if other government departments are eliminated or cut to the
area that needs to be cut and privatized is the Food and Drug Administration
(FDA). As I argued in a past article for LRC, multiple private drug
testing services would spring up in FDAís absence, leading to a
faster approval of drugs and a lower drug price. Eliminating the
FDA a hangover from the early 20th century
would save taxpayers gross outlays of $1.8 billion (the net outlays
are nearly $1.5 billion, as FDA charges fees for its drug approval
organization called the Health Resources and Services Administration
(HRSA) within HHS proposes to spend almost $6.4 billion in fy 2005
on such things as HIV/AIDS ($2.07 billion), family planning ($0.28
billion for birth control and abortion hereís where
Planned Parenthood gets big subsidies for its abortion clinics),
maternal and child health block grants (to states $0.73 billion),
childrenís medical exams ($0.303 billion), and other programs. Where
the federal government gets the authority to spend on such programs
is a mystery; it certainly cannot be found anywhere in the Constitution.
Eliminate the HRSA.
and Human Services proposes to spend a net of $2.8 billion on Indian
Health Services in fy 2005 (gross outlays $3.619 billion, with an
estimated $0.378 billion collected in fees). Eliminate this program
as Indians will be responsible for their own health care. Given
the tax-exempt status of their on-reservation businesses, there
is no reason to extend welfare to them.
Centers for Disease Control and Prevention (CDCP) wants to spend
nearly $4.5 billion in 2005. In the short term, given the worries
over terrorism and many infectious diseases brought here by legal
and illegal immigrants, drastically downsizing or abolishing CDCP
is unlikely. However, goofy projects such as the one in which CDCP
labeled guns as a dangerous health hazard (during the Clinton years)
need to be eliminated.
National Institutes of Health (NIH) is a very large organization
that conducts medical research. You name the disease or malady,
and it is likely covered under one of the more than 20 separate
institutes (e.g., cancer; heart, lung, and blood; aging; alcohol
abuse; mental health; etc.). NIHís proposed budget for fy 2005 hits
$28 billion. A lot of this goes for research grants. With lower
federal spending and lower taxes, citizens would have much more
money available to contribute to not-for-profit foundations that
would conduct advanced medical research, with more positive results
than obtained by grants determined by medical bureaucrats in Washington.
As this would be a controversial area to cut, letís chop off $9
billion per year from the current proposal. Further cuts in the
future should be made to eliminate NIH.
Administration for Children and Families is another hangover from
the days of welfare, still continued despite the phony welfare reform
of the late 1990's for which the Republicans claim credit. Proposed
spending for fy 2005 includes: 1) almost $18.4 billion for "temporary"
assistance for needy families; 2) $4.3 billion payments to states
for child support enforcement; 3) $2 billion for low-income energy
assistance; 4) $0.47 billion for refugee and entrant (huh?) assistance;
5) $2.7 billion for child care entitlements to states; 6) another
$2.2 billion in child care block grants to states; 7) $1.8 billion
in social service block grants to states; 8) nearly $8.8 billion
for child and family service programs; 9) $6.8 billion in payments
to states; and, a host of others. Abolish all of this and save $47.8
smaller (can you believe it, HHS has smaller programs) expenditure
categories include almost $1.4 billion for aging services, $2.6
billion for managing this monster of a department, $3.3 billion
for substance abuse and mental health services, and $0.3 billion
for healthcare research and quality. All these should be axed or
reduced. Departmental management should be cut in half.
leaves the big budget busters, Medicaid and Medicare. Medicaid is
especially pernicious in that it requires states to pony up matching
funds for a business that they too have no business being in. If
you wondered why your state wants to raise taxes, look at what it
spends on Medicaid. That is one of the categories that has nearly
bankrupted California, and it is doing so in other states, particularly
because they have to pick up the tab for visits to emergency rooms
by illegal aliens. For fy 2005, Medicaid proposes to spend almost
$183.5 billion. This needs to be abolished over the next three years.
Doing this will free up medical resources, bringing down the cost
of treatment to everyone. Let doctors and other health care workers
do what they did before the advent of this federal monster, give
free or lower cost treatment and take it off their incomes as a
charitable deduction. I know that in my area doctors have set up
such a program (to which I contribute), and it treats illegal aliens
as well as those who cannot afford health insurance. And it gets
the whole thing off the taxpayers back!
still leaves Medicare proposed spending of $270 billion. The previous
cuts will give Congress time to fashion a program to let those not
already in Medicare opt out and/or abolish it totally. Those wanting
to stay in it should accept benefit cuts. And the latest fiasco,
the prescription drug benefit plan, needs to be ended in the next
together, proposed cuts amount to a whopping $255 billion.
the Cut-o-meter Total is .... $600 billion
folks, we have now reduced spending by about $635 billion over proposed
fy 2005 levels and probably more than $600 billion over actual current
levels. Being conservative by nature, I only put the $600 billion
total into the Cut-o-meter. If the cuts are actually larger, so
much the better.
we finished yet? Of course not! Stay tuned for more proposals to
chop federal programs in our initial round of cuts!
Grichar (aka Exx-Gman) [send
him mail], formerly an economist with the federal government,
writes to "un-spin" the federal government's attempt to con the
teaches economics part-time at a community college and provides
economic consulting services to the private sector.
© 2004 LewRockwell.com