Big Government Is Here to Stay: Conversation with James Pinkerton (Part 2)
This morning, Anne Applebaum's column prompted a conversation between James Pinkerton and me. Part 1 of our conversation is here. What I was hoping to hear from James was that Anne is completely off base and that we've seen a confluence of events in a short span of time that indicate that something's about to change. No such luck.
James Pinkerton: At least three-fourths of the country likes Social Security and Medicare just the way they are. And we have the Bush Administration's experience with partial priviatization of the Social Security system in 2005 as yet another indicator. Even with a Republican Congress, the Bush folks couldn't come close to getting a bill through. Then, the next year, they lost both houses of Congress. One can't claim complete cause and effect -- there were other issues, too, such as Iraq and corruption -- but there sure wasn't any groundswell for even partial privatization.
Diane Ellis: But even if most of the country likes these programs the way they are, they're both either completely broke, or almost completely broke. They can't go on as they are forever. What do you predict will happen with them? Will their impending collapse provide a new entry point for a disucssion of privatization? Or will the American people favor increased debt and higher taxes?
James Pinkerton: What percentage of GDP is Social Security? Answer: Four percent. In 70 years, it will be six percent. What percentage of GDP are Medicare and Medicaid? Answer: About six percent. In 70 years, they will be 13 or 14 percent. The numbers now are not unmanageable, and the numbers 70 years from now, for Medicare and Medicaid -- well, we have time to figure out the answer. And the answer will surely be something different than what's being proposed. For example, if Alzheimer's is projected to quadruple in the next 40 years, what's the right way to economize on Alzheimer's? Bad answer: Cut senior citizens to two meals a day. Good answer: Cure Alzheimer's. A reminder to people that you need the x-factor of technology to solve problems. Which, of course, is exactly what politicians and pundits are too little interested in because they'd rather have the rumble than have a solution.
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May '10
Re: Big Government Is Here to Stay: Conversation with James Pinkerton (Part 2)
He is correct that the answer is technology.
But the thing that is not addressed much is the fact that the disruptive technologies that will transform medicine, and thus Medicare, will drastically affect the medical profession in ways that will be quite threatening to current practitioners, breaking the current licensing paradigm, and involving some government actions in areas thta make sense but would probably cause initial negative reactions from very traditionalist line-in-the-sand conservatives.
It will be interesting to see how long it takes 21st century modernity to do to the AMA and AAFP what MS-DOS and Intel did to Burroughs, Control Data, and IBM mainframes.