Gregg: Time for truth on spending

The nation waits and waits and waits to be governed.

{mosads}It seems like forever since we had a coherent fiscal policy from either the president, from the Senate Democrats (who, by the way, control a third of the elective government) or from the House Republicans.

This side blames that side and then that side blames this side and at times people on the same side — usually, the Senate Democrats and the president — blame each other.

It gets a little confusing to know who is to blame.

But, if we are honest about it, we must return to the sage advice of the old cartoon character Pogo who famously — at least among the small group that read his thoughts — proclaimed, “We have met the enemy and he is us!”

No matter how you cut it, the American people are at the core of this failure to have a federal government that is capable of getting out of its own way and governing for the good of the nation.

At the heart of this is the Baby Boom generation. This was the generation that brought the nation unsurpassed wealth and prosperity during its most productive years, the decades of the ’70s, ’80s, ’90s and the start of this century.

It is also the generation that, in the ’60s, initiated an end to the legacy of discrimination that weighed down our culture by pushing forward the causes of civil rights and women’s rights while raising to unusual intensity the debate over the correctness of the war in Vietnam.

It is a generation that has a track record of catalyzing change, mostly positive, on our country and the world.

It may not be the “greatest generation” but it is demographically the largest and definitely one of the most impactful in our nation’s history.

Now, however, it finds itself at the center of the question of how we get the federal government and those who lead it in Washington to govern in a manner that continues our nation’s great tradition of always passing on more opportunity and prosperity to the next generation.

As most folks know, the Baby Boom generation is at the core of the largest demographic shift in our history. As it heads into its retirement years, the consequence is a doubling of the number of people who are retired from 35 million to 70 million, with all the costs that are concomitant with this shift.

It has made healthcare the central cause and primary driver of the federal deficits. Naturally, it then also becomes the biggest single influence on federal policies that react to those deficits. The reverberations from all of this of are just beginning to be felt.

Almost the entire generation now qualifies for Medicare. Even more dramatic in its cost implications for fiscal policy, this generation’s Americans will live well into their 80s on average, with many people living years beyond that point. The result will be to create an explosion in the most expensive form of healthcare — long-term care, especially as paid for by Medicaid.

There is not the slightest doubt about any of this.

Of all the issues the Baby Boom generation has affected, the cost of supplying healthcare to its members will have the deepest and most dramatic effect on the nation and our future.

Because there are so many of us, because we tend to vote and because we are being affected in a very personal way by federal retirement policies, the folks in Washington are scared to act.

This is simple politics. If you do not admit there is a problem or if you intentionally understate the scale of that problem, you should be able to get through the next election, which of course is the primary purpose of most people who are elected in the first place.

The opportunity to change this comes right now.

Not with another debt-ceiling fight, not with another government shutdown, not with a false debate over tax burden levels or even with a straw dog fight over ending ObamaCare, but with a few difficult but long lasting acts of leadership.

Among the actions that ought to be taken are the following:

Change the calculation of the Cost of Living Adjustment, or COLA, as suggested by the president but rejected by the House Republicans as too politically risky.

Change the reimbursement system under Medicare to reward market forces through capitation and end the cost-plus utilization model.

Change Medicaid by turning all the funds back to the states without any significant strings, allowing the creativity of governors and people on the ground to come up with the most effective way to benefit the most people.

Tell the Baby Boom generation the truth: the system that exists was not designed to handle so many, and needs to be changed or it will fail. They will end up with a world of rationed healthcare where their children’s and grandchildren’s futures will be put at risk.

This generation can handle the truth. The politics of telling them the truth and then acting to confront the issue may seem challenging.

But it is necessary and it is a winning course of action.

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.