By Judd Gregg - 06/27/11 09:50 AM EDT
Someone needs to explain to the American people why our government is hiding. We know the crisis is headed our way.
We know Greece is not an aberration but a harbinger. We know that, like Ireland, we are a nation living way beyond our means. We hear the Chinese mock us as they note with smugness that we have lost our ability to address our spendthrift nature.
We watch as national rating agencies give us the bad news that we are headed towards debt problems that will downgrade our status as a world economic power.
Conservatives rally to the banner of a constitutional amendment to balance the budget. It is a straw dog of the first order, giving conservatives political cover to say they are for something that has no chance of being enacted quickly enough to address the current problem.
Fiscal responsibility does not involve either class warfare or political misdirection, it involves acknowledging and acting on the problems of intolerable deficits and crushing debt with real, workable solutions.
Let’s start with the fact that you cannot solve a problem if you are not willing to address it. The problem is the exploding cost of Medicare caused by the ever-expanding cost of healthcare, dramatically aggravated by a massive demographic shift.
A new baby boomer retires every 10 seconds and many do so with a lot of health issues that no one knows how to pay for.
It will only get worse as this huge generation ages and requires more expensive, intensive and longer-term care.
We need programs that reward outcomes, not utilization, and replicate successful and cost-effective delivery systems in places like Rochester, Minn.,Pittsburgh and Salt Lake City.
We need to face up to the fact that 30 percent of Medicare dollars are spent during the last six months of life and begin to build systems that allow patients and their families to make intelligent decisions during this challenging and emotional time.
Most of all, we need to stop relying on a top-down, bloated and dysfunctional bureaucracy that tries to manage the cost and delivery choices of Medicare and turn to a system that puts the Medicare recipient in a position where he or she has a stake in the cost of the service delivered and can influence that cost through market choices. All this and a great deal more, like tort and insurance market reform, needs to start now so that we can find out what works.
Why do these people run for office if they do not want to take on the critical public policy issues of the day? The problem of our debt is the critical public policy issue not only of today but of the foreseeable future. The opportunity to do something good for our nation is sitting there, ready to be picked up and carried to a successful result. Let’s combine a little “hope” with a lot of “if not now, when?” and get on with making our nation work again.
I must admit that the “hope” is Vice President Biden; who is excellent when it comes to dealing with people in both parties. And the “if not now, when” theme is appropriately carried by Speaker John Boehner (R-Ohio), who really does want to govern and understands as well as anyone the risks of allowing our nation to wander towards insolvency.
If these two dedicated and good leaders can get everyone else to give them some breathing space, to stop the games, then there may yet be a solution based on facing the real threats and addressing them with actual initiatives that move us away from the cliff. This would be a classic American approach, and it is greatly needed.
Judd Gregg is a former governor and three-term senator from New Hampshire who served as chairman and ranking member of the Senate Budget Committee and also as ranking member of the Senate Appropriations Foreign Operations Subcommittee.