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entitled '21st Century Accountability Challenges' which was released on 
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United States Government Accountability Office: 

21st Century Accountability Challenges: 

AICPA GAAC Annual Conference: 

The Honorable David M. Walker: Comptroller General of the United 
States: 

August 21, 2006: 

GAO-06-1078CG: 

The Case for Change: 

The federal government is on a "burning platform," and the status quo 
way of doing business is unacceptable for a variety of reasons, 
including: 

Past fiscal trends and significant long-range challenges: 

Rising public expectations for demonstrable results and enhanced 
responsiveness: 

Selected trends and challenges having no boundaries: 

Additional resource demands due to Iraq, Afghanistan, incremental 
homeland security needs, and recent natural disasters in the United 
States: 

Numerous government performance/accountability and high risk 
challenges: 

Outdated federal organizational structures, policies, and practices: 

Composition of Federal Spending: 

[See PDF for image] - graphic text 

3 pie charts with 5 items each except the year 1965. 

1965: 
Defense: 43.0%. 
Social Security: 15.0%. 
Medicare & Medicaid: 0%. 
Net interest: 7.0%. 
All other spending: 35.0%. 

1985: 
Defense: 27.0%. 
Social Security: 20.0%. 
Medicare & Medicaid: 9.0%. 
Net interest: 14.0%. 
All other spending: 30.0%. 

2005: 
Defense: 20.0%. 
Social Security: 21.0%. 
Medicare & Medicaid: 19.0%. 
Net interest: 7.0%. 
All other spending: 32.0%. 

Source: Office of Management and Budget. 

Federal Spending for Mandatory and Discretionary Programs: 

[See PDF for image] - graphic text 

3 pie charts with 3 items each. 

1965: 
Discretionary: 66%; 
Mandatory: 27%; 
Net Interest: 7%. 

1985: 
Discretionary: 44%; 
Mandatory: 42%; 
Net Interest: 14%. 

2005: 
Discretionary: 39%; 
Mandatory: 54%; 
Net Interest: 7%. 

Source:Office of Management and Budget.

Surplus or Deficit as a Share of GDP Fiscal Years 1962-2005: 

[See PDF for image] - graphic text: 

Line/Stacked Bar combo chart with 1 line (Unified) and 43 bars. 

Fiscal year: 1962; 
On-budget: -1%; 
Off-budget: -0.2%; 
Unified: -1.3%. 

Fiscal year: 1963; 
On-budget: -0.7%; 
Off-budget: -0.1%; 
Unified: -0.8%. 

Fiscal year: 1964; 
On-budget: -1%; 
Off-budget: 0.1%; 
Unified: -0.9%. 

Fiscal year: 1965; 
On-budget: -0.2%; 
Off-budget: No data; 
Unified: -0.2%. 

Fiscal year: 1966; 
On-budget: -0.4%; 
Off-budget: -0.1%; 
Unified: -0.5%. 

Fiscal year: 1967; 
On-budget: -1.6%; 
Off-budget: 0.5%; 
Unified: -1.1%. 

Fiscal year: 1968; 
On-budget: -3.2%; 
Off-budget: 0.3%; 
Unified: -2.9%. 

Fiscal year: 1969; 
On-budget: -0.1%; 
Off-budget: 0.4%; 
Unified: 0.3%. 

Fiscal year: 1970; 
On-budget: -0.9%; 
Off-budget: 0.6%; 
Unified: -0.3%. 

Fiscal year: 1971; 
On-budget: -2.4%; 
Off-budget: 0.3%; 
Unified: -2.1%. 

Fiscal year: 1972; 
On-budget: -2.2%; 
Off-budget: 0.3%; 
Unified: -2%. 

Fiscal year: 1973; 
On-budget: -1.2%; 
Off-budget: No data; 
Unified: -1.1%. 

Fiscal year: 1974; 
On-budget: -0.6%; 
Off-budget: 0.1%; 
Unified: -0.4%. 

Fiscal year: 1975; 
On-budget: -3.5%; 
Off-budget: 0.1%; 
Unified: -3.4%. 

Fiscal year: 1976; 
On-budget: -4.1%; 
Off-budget: -0.2%; 
Unified: -4.2%. 

Fiscal year: 1977; 
On-budget: -2.5%; 
Off-budget: -0.2%; 
Unified: -2.7%. 

Fiscal year: 1978; 
On-budget: -2.5%; 
Off-budget: -0.2%; 
Unified: -2.7%. 

Fiscal year: 1979; 
On-budget: -1.5%; 
Off-budget: -0.1%; 
Unified: -1.6%. 

Fiscal year: 1980; 
On-budget: -2.7%; 
Off-budget: No data; 
Unified: -2.7%. 

Fiscal year: 1981; 
On-budget: -2.4%; 
Off-budget: -0.2%; 
Unified: -2.6%. 

Fiscal year: 1982; 
On-budget: -3.7%; 
Off-budget: -0.2%; 
Unified: -4%. 

Fiscal year: 1983; 
On-budget: -6%; 
Off-budget: No data; 
Unified: -6%. 

Fiscal year: 1984; 
On-budget: -4.8%; 
Off-budget: No data; 
Unified: -4.8%. 

Fiscal year: 1985; 
On-budget: -5.3%; 
Off-budget: 0.2%; 
Unified: -5.1%. 

Fiscal year: 1986; 
On-budget: -5.4%; 
Off-budget: 0.4%; 
Unified: -5%. 

Fiscal year: 1987; 
On-budget: -3.6%; 
Off-budget: 0.4%; 
Unified: -3.2%. 

Fiscal year: 1988; 
On-budget: -3.9%; 
Off-budget: 0.8%; 
Unified: -3.1%. 

Fiscal year: 1989; 
On-budget: -3.8%; 
Off-budget: 1%; 
Unified: -2.8%. 

Fiscal year: 1990; 
On-budget: -4.8%; 
Off-budget: 1%; 
Unified: -3.9%. 

Fiscal year: 1991; 
On-budget: -5.4%; 
Off-budget: 0.9%; 
Unified: -4.5%. 

Fiscal year: 1992; 
On-budget: -5.5%; 
Off-budget: 0.8%; 
Unified: -4.7%. 

Fiscal year: 1993; 
On-budget: -4.6%; 
Off-budget: 0.7%; 
Unified: -3.9%. 

Fiscal year: 1994; 
On-budget: -3.7%; 
Off-budget: 0.8%; 
Unified: -2.9%. 

Fiscal year: 1995; 
On-budget: -3.1%; 
Off-budget: 0.9%; 
Unified: -2.2%. 

Fiscal year: 1996; 
On-budget: -2.3%; 
Off-budget: 0.9%; 
Unified: -1.4%. 

Fiscal year: 1997; 
On-budget: -1.3%; 
Off-budget: 1%; 
Unified: -0.3%. 

Fiscal year: 1998; 
On-budget: -0.3%; 
Off-budget: 1.1%; 
Unified: 0.8%. 

Fiscal year: 1999; 
On-budget: No data; 
Off-budget: 1.4%; 
Unified: 1.4%. 

Fiscal year: 2000; 
On-budget: 0.9%; 
Off-budget: 1.5%; 
Unified: 2.4%. 

Fiscal year: 2001; 
On-budget: -0.3%; 
Off-budget: 1.6%; 
Unified: 1.3%. 

Fiscal year: 2002; 
On-budget: -3.1%; 
Off-budget: 1.5%; 
Unified: -1.5%. 

Fiscal year: 2003; 
On-budget: -4.9%; 
Off-budget: 1.5%; 
Unified: -3.5%. 

Fiscal year: 2004; 
On-budget: -4.9%; 
Off-budget: 1.3%; 
Unified: -3.6%. 

Fiscal Year: 2005; 
On-Budget: -4.1%; 
Off-Budget: 1.2%; 
Unified: -2.8%. 

Source: Office of Management and Budget: 

Fiscal Year 2004 and 2005 Deficits and Net Operating Costs: 

Number is parentheses means Dollars in billions 

On-Budget Deficit; 
Fiscal year 2004: (568); 
Fiscal year 2005: (494); 

Off-Budget Surplus*; 
Fiscal year 2004: 155; 
Fiscal year 2005: 175. 

Unified Deficit; 
Fiscal year 2004: (413); 
Fiscal year 2005: (318). 

Net Operating Cost; 
Fiscal year 2004: (616); 
Fiscal year 2005: (760). 

*Includes $151 billion in fiscal year 2004 and $173 billion in fiscal 
year 2005 in Social Security surpluses and $4 billion in fiscal year 
2004 and $2 billion in fiscal year 2005 in Postal Service surpluses. 

Sources: The Office of Management and Budget and the Department of the 
Treasury. 

[End of table] 

Estimated Fiscal Exposures ($ trillions): 

Explicit liabilities: 
* Publicly held debt; 
* Military & civilian pensions & retiree health; 
* Other; 
2000: $6.9; 
2005: $9.9. 

Commitments and Contingencies: E.g., PBGC, undelivered orders; 
2000: 0.5; 
2005: 0.9. 

Implicit exposures;
2000: 13.0; 
2005: 35.6. 

Implicit exposures: Future Social Security benefits; 
2000: 3.8; 
2005: 5.7. 

Implicit exposures: Future Medicare Part A benefits; 
2000: 2.7; 
2005: 8.8. 

Implicit exposures: Future medicare Part B benefits; 
2000: 6.5; 
2005: 12.4. 

Implicit exposures: Future Medicare Part D benefits; 
2000: N/A; 
2005: 8.7. 

Source: U.S. government's consolidated financial statements (CFS). 

Note: Estimates for Social Security and Medicare are at present value 
as of January 1 of each year as reported in the CFS and all other data 
are as of September 30. 

[End of table] 

How Big is Our Growing Fiscal Burden? 

Our total fiscal burden can be translated and compared as follows: 

Total Fiscal Exposures; 
$46.4 trillion. 

Total Household net worth[1]; 
$51.1 trillion. 

Total Household net worth: Burden/Net Worth ratio; 
91 percent. 

Burden[2]: Per person; 
$156,000. 

Burden: Per Full time worker; 
$375,000. 

Burden: Per household; 
$411,000. 

Income: Median Household income[3]; 
$44,389. 

Income: Disposable personal income per capita[4]; 
$30,431. 

Notes: (1) Federal Reserve Board, Flow of Funds Accounts, Table B.100, 
2005:Q3 (Dec. 8, 2005); (2) Burdens are calculated using total U.S. 
population as of 9/30/05, from the U.S. Census Bureau, full-time 
workers for 2004, reported by the Bureau of Economic Analysis, in NIPA 
table 6.5D (Aug. 4, 2005); and households for 2004, reported by the 
U.S. Census Bureau, in Income Poverty & Health Insurance Coverage in 
the US: 2004 (Aug. 2005); (3) U.S. Census Bureau, Income Poverty & 
Health Insurance Coverage in the US: 2004 (Aug. 2005); and (4) Bureau 
of Economic Analysis, Personal Income and Outlays: October 2005, table 
2, 2005:Q3, (Dec.1, 2005). 

Sources: GAO analysis. 

[End of table] 

Composition of Spending as a Share of GDP Under Baseline Extended: 

[See PDF for image] -graphic text: 

Line/Stacked Bar combo chart with 4 groups, 1 line (Revenue) and 4 bars 
per group. 

2005; 
Net interest: 1.4%; 
Social Security: 4.4%; 
Medicare & Medicaid: 3.8%; 
All other spending: 10.4%; 
Revenue: 19.5%. 

2015; 
Net interest: 1.5%; 
Social Security: 4.6%; 
Medicare & Medicaid: 5.2%; 
All other spending: 7.6%; 
Revenue: 19.6%. 

2030; 
Net interest: 1.9%; 
Social Security: 6.4%; 
Medicare & Medicaid: 8%; 
All other spending: 7.6%; 
Revenue: 19.6%. 

2040; 
Net interest: 4.3%; 
Social Security: 6.8%; 
Medicare & Medicaid: 9.7%; 
All other spending: 7.6%; 
Revenue: 19.6%. 

Notes: In addition to the expiration of tax cuts, revenue as a share of 
GDP increases through 2016 due to (1) real bracket creep, (2) more 
taxpayers becoming subject to the AMT, and (3) increased revenue from 
tax-deferred retirement accounts. After 2016, revenue as a share of GDP 
is held constant. 

Source: GAO's May 2006 analysis. 

Composition of Spending as a Share of GDP Assuming Discretionary 
Spending Grows with GDP after 2006 and All Expiring Tax Provisions are 
Extended: 

[See PDF for image] -graphic text: 

Line/Stacked Bar combo chart with 4 groups, 1 line (Revenue) and 4 bars 
per group. 

2005; 
Net interest: 1.2%; 
Social Security: 4.4%; 
Medicare & Medicaid: 3.8%; 
All other spending: 10.4%; 
Revenue: 17.4%. 

2015; 
Net interest: 2.8%; 
Social Security: 4.7%; 
Medicare & Medicaid: 5.2%; 
All other spending: 9.7%; 
Revenue: 17.4. 

2030; 
Net interest: 7.7%; 
Social Security: 6.7%; 
Medicare & Medicaid: 8%; 
All other spending: 9.7%; 
Revenue: 17.4%. 

2040; 
Net interest: 15.7%; 
Social Security: 7.9%; 
Medicare & Medicaid: 9.7%; 
All other spending: 9.7%; 
Revenue: 17.4%. 

Note: This includes certain tax provisions that expired at the end of 
2005, such as the increased AMT exemption amount. Source: GAO's May 
2006 analysis. 

Growth in Spending for Social Security, Medicare, and Medicaid Expected 
to Outpace Economic Growth: 

[See PDF for image]  graphic text: 

Bar graph with four items. 

Growth in constant dollars 2005-2030. 

GDP: 72%; 
Social Security Spending: 147%; 
Medicaid Spending: 166%; 
Medicare Spending: 331%. 

Note: Social Security and Medicare projections based on the 
intermediate assumptions of the 2005 Trustees' Reports. Medicaid 
projections based on CBO's December 2003 long-term projections for 
federal spending on Medicaid under mid-range assumptions. 

Source: GAO analysis based on data from the Office of the Chief 
Actuary, Social Security Administration, Office of the Actuary, Centers 
for Medicare and Medicaid Services, and the Congressional Budget 
Office. 

[End of figure] 

Social Security, Medicare, and Medicaid Spending as a Percent of GDP: 

[See PDF for image] - graphic text: 

Area graph with 81 Groups and 3 items per Group. 

Percent of GDP: 

Year: 2000; 
Social Security: 4.23%; 
Medicaid: 1.23%; 
Medicare: 2.29%. 

Year: 2001; 
Social Security: 4.33%; 
Medicaid: 1.32%; 
Medicare: 2.44%. 

Year: 2002; 
Social Security: 4.4%; 
Medicaid: 1.44%; 
Medicare: 2.53%. 

Year: 2003; 
Social Security: 4.35%; 
Medicaid: 1.5%; 
Medicare: 2.57%. 

Year: 2004; 
Social Security: 4.27%; 
Medicaid: 1.52%; 
Medicare: 2.63%. 

Year: 2005; 
Social Security: 4.26%; 
Medicaid: 1.51%; 
Medicare: 2.69%. 

Year: 2006; 
Social Security: 4.21%; 
Medicaid: 1.5%; 
Medicare: 3.33%. 

Year: 2007; 
Social Security: 4.19%; 
Medicaid: 1.52%; 
Medicare: 3.36%. 

Year: 2008; 
Social Security: 4.2%; 
Medicaid: 1.57%; 
Medicare: 3.41%. 

Year: 2009; 
Social Security: 4.24%; 
Medicaid: 1.62%; 
Medicare: 3.45%. 

Year: 2010; 
Social Security: 4.28%; 
Medicaid: 1.68%; 
Medicare: 3.5%. 

Year: 2011; 
Social Security: 4.34%; 
Medicaid: 1.74%; 
Medicare: 3.56%. 

Year: 2012; 
Social Security: 4.42%; 
Medicaid: 1.8%; 
Medicare: 3.67%. 

Year: 2013; 
Social Security: 4.51%; 
Medicaid: 1.87%; 
Medicare: 3.81%. 

Year: 2014; 
Social Security: 4.61%; 
Medicaid: 1.93%; 
Medicare: 3.96%. 

Year: 2015; 
Social Security: 4.71%; 
Medicaid: 1.95%; 
Medicare: 4.12%. 

Year: 2016; 
Social Security: 4.81%; 
Medicaid: 1.95%; 
Medicare: 4.29%. 

Year: 2017; 
Social Security: 4.92%; 
Medicaid: 1.95%; 
Medicare: 4.44%. 

Year: 2018; 
Social Security: 5.02%; 
Medicaid: 1.95%; 
Medicare: 4.61%. 

Year: 2019; 
Social Security: 5.13%; 
Medicaid: 1.95%; 
Medicare: 4.78%. 

Year: 2020; 
Social Security: 5.24%; 
Medicaid: 1.95%; 
Medicare: 4.96%. 

Year: 2021; 
Social Security: 5.35%; 
Medicaid: 1.99%; 
Medicare: 5.14%. 

Year: 2022; 
Social Security: 5.45%; 
Medicaid: 2.02%; 
Medicare: 5.33%. 

Year: 2023; 
Social Security: 5.55%; 
Medicaid: 2.06%; 
Medicare: 5.51%. 

Year: 2024; 
Social Security: 5.65%; 
Medicaid: 2.09%; 
Medicare: 5.71%. 

Year: 2025; 
Social Security: 5.75%; 
Medicaid: 2.13%; 
Medicare: 5.9%. 

Year: 2026; 
Social Security: 5.85%; 
Medicaid: 2.17%; 
Medicare: 6.08%. 

Year: 2027; 
Social Security: 5.93%; 
Medicaid: 2.2%; 
Medicare: 6.26%. 

Year: 2028; 
Social Security: 6.01%; 
Medicaid: 2.23%; 
Medicare: 6.43%. 

Year: 2029; 
Social Security: 6.08%; 
Medicaid: 2.27%; 
Medicare: 6.6%. 

Year: 2030; 
Social Security: 6.14%; 
Medicaid: 2.31%; 
Medicare: 6.77%. 

Year: 2031; 
Social Security: 6.19%; 
Medicaid: 2.35%; 
Medicare: 6.93%. 

Year: 2032; 
Social Security: 6.24%; 
Medicaid: 2.4%; 
Medicare: 7.08%. 

Year: 2033; 
Social Security: 6.27%; 
Medicaid: 2.45%; 
Medicare: 7.22%. 

Year: 2034; 
Social Security: 6.29%; 
Medicaid: 2.5%; 
Medicare: 7.37%. 

Year: 2035; 
Social Security: 6.31%; 
Medicaid: 2.55%; 
Medicare: 7.52%. 

Year: 2036; 
Social Security: 6.32%; 
Medicaid: 2.6%; 
Medicare: 7.67%. 

Year: 2037; 
Social Security: 6.33%; 
Medicaid: 2.65%; 
Medicare: 7.8%. 

Year: 2038; 
Social Security: 6.32%; 
Medicaid: 2.7%; 
Medicare: 7.92%. 

Year: 2039; 
Social Security: 6.32%; 
Medicaid: 2.75%; 
Medicare: 8.03%. 

Year: 2040; 
Social Security: 6.31%; 
Medicaid: 2.8%; 
Medicare: 8.14%. 

Year: 2041; 
Social Security: 6.3%; 
Medicaid: 2.85%; 
Medicare: 8.25%. 

Year: 2042; 
Social Security: 6.29%; 
Medicaid: 2.9%; 
Medicare: 8.36%. 

Year: 2043; 
Social Security: 6.28%; 
Medicaid: 2.95%; 
Medicare: 8.46%. 

Year: 2044; 
Social Security: 6.27%; 
Medicaid: 3%; 
Medicare: 8.58%. 

Year: 2045; 
Social Security: 6.26%; 
Medicaid: 3.05%; 
Medicare: 8.7%. 

Year: 2046; 
Social Security: 6.26%; 
Medicaid: 3.1%; 
Medicare: 8.82%. 

Year: 2047; 
Social Security: 6.25%; 
Medicaid: 3.14%; 
Medicare: 8.93%. 

Year: 2048; 
Social Security: 6.25%; 
Medicaid: 3.19%; 
Medicare: 9.03%. 

Year: 2049; 
Social Security: 6.24%; 
Medicaid: 3.23%; 
Medicare: 9.14%. 

Year: 2050; 
Social Security: 6.24%; 
Medicaid: 3.27%; 
Medicare: 9.25%. 

Year: 2051; 
Social Security: 6.24%; 
Medicaid: 3.31%; 
Medicare: 9.36%. 

Year: 2052; 
Social Security: 6.24%; 
Medicaid: 3.35%; 
Medicare: 9.47%. 

Year: 2053; 
Social Security: 6.24%; 
Medicaid: 3.39%; 
Medicare: 9.59%. 

Year: 2054; 
Social Security: 6.25%; 
Medicaid: 3.44%; 
Medicare: 9.71%. 

Year: 2055; 
Social Security: 6.25%; 
Medicaid: 3.48%; 
Medicare: 9.84%. 

Year: 2056; 
Social Security: 6.26%; 
Medicaid: 3.52%; 
Medicare: 9.98%. 

Year: 2057; 
Social Security: 6.27%; 
Medicaid: 3.57%; 
Medicare: 10.12%. 

Year: 2058; 
Social Security: 6.27%; 
Medicaid: 3.61%; 
Medicare: 10.26%. 

Year: 2059; 
Social Security: 6.28%; 
Medicaid: 3.66%; 
Medicare: 10.4%. 

Year: 2060; 
Social Security: 6.29%; 
Medicaid: 3.7%; 
Medicare: 10.55%. 

Year: 2061; 
Social Security: 6.29%; 
Medicaid: 3.75%; 
Medicare: 10.7%. 

Year: 2062; 
Social Security: 6.3%; 
Medicaid: 3.8%; 
Medicare: 10.84%. 

Year: 2063; 
Social Security: 6.31%; 
Medicaid: 3.84%; 
Medicare: 10.99%. 

Year: 2064; 
Social Security: 6.32%; 
Medicaid: 3.89%; 
Medicare: 11.14%. 

Year: 2065; 
Social Security: 6.33%; 
Medicaid: 3.94%; 
Medicare: 11.3%. 

Year: 2066; 
Social Security: 6.34%; 
Medicaid: 3.99%; 
Medicare: 11.47%. 

Year: 2067; 
Social Security: 6.35%; 
Medicaid: 4.04%; 
Medicare: 11.64%. 

Year: 2068; 
Social Security: 6.35%; 
Medicaid: 4.09%; 
Medicare: 11.81%. 

Year: 2069; 
Social Security: 6.36%; 
Medicaid: 4.14%; 
Medicare: 11.96%. 

Year: 2070; 
Social Security: 6.36%; 
Medicaid: 4.19%; 
Medicare: 12.12%. 

Year: 2071; 
Social Security: 6.37%; 
Medicaid: 4.25%; 
Medicare: 12.28%. 

Year: 2072; 
Social Security: 6.37%; 
Medicaid: 4.3%; 
Medicare: 12.44%. 

Year: 2073; 
Social Security: 6.37%; 
Medicaid: 4.35%; 
Medicare: 12.6%. 

Year: 2074; 
Social Security: 6.38%; 
Medicaid: 4.41%; 
Medicare: 12.75%. 

Year: 2075; 
Social Security: 6.38%; 
Medicaid: 4.46%; 
Medicare: 12.92%. 

Year: 2076; 
Social Security: 6.38%; 
Medicaid: 4.52%; 
Medicare: 13.08%. 

Year: 2077; 
Social Security: 6.39%; 
Medicaid: 4.57%; 
Medicare: 13.25%. 

Year: 2078; 
Social Security: 6.39%; 
Medicaid: 4.63%; 
Medicare: 13.41%. 

Year: 2079; 
Social Security: 6.39%; 
Medicaid: 4.69%; 
Medicare: 13.58%. 

Year: 2080; 
Social Security: 6.39%; 
Medicaid: 4.75%; 
Medicare: 13.75%.

Source: GAO analysis based on data from the Office of the Chief 
Actuary, Social Security Administration, Office of the Actuary, Centers 
for Medicare and Medicaid Services, and the Congressional Budget 
Office. 

Note: Social Security and Medicare projections based on the 
intermediate assumptions of the 2006 Trustees' Reports. Medicaid 
projections based on CBO's January 2006 short-term Medicaid estimates 
and CBO's December 2005 long-term Medicaid projections under mid-range 
assumptions. 

[End of Figure] 

Debt per Capita Could Exceed GDP Per Capita by 2030 Assuming 
Discretionary Spending Grows with GDP after 2006 and All Expiring Tax 
Provisions are Extended: 

Bar Graph. 

Per Capita 2005 dollars. 

2005; 
Debt per capita: 15,254; 
GDP per capita: 40,838. 

2030; 
Debt per Capita: 85,920; 
GDP per Capita: 56,607. 

2040; 
Debt per Capita: 170,150; 
GDP per Capita: 56,827. 

Source: GAO's January 2006 analysis. 

[End of Figure] 

Measured on an Outlay Equivalent Basis, Tax Expenditures Exceeded 
Discretionary Spending for Most Years in the Last Decade: 

[See PDF for image]  graphic text: 

Line graph with three lines with 24 items each. 

Dollars in billions (in constant 2004 dollars). 

Fiscal year: 1981; 
Mandatory spending: $687.6; 
Discretionary spending: $571.7; 
Sum of tax expenditure outlay equivalent estimates: $501.2. 

Fiscal year: 1982; 
Mandatory spending: $729.5; 
Discretionary spending: $566.5; 
Sum of tax expenditure outlay equivalent estimates: $544.1. 

Fiscal year: 1983; 
Mandatory spending: $757.3; 
Discretionary spending: $588.0; 
Sum of tax expenditure outlay equivalent estimates: $598.8. 

Fiscal year: 1984; 
Mandatory spending: $758.3; 
Discretionary spending: $609.0; 
Sum of tax expenditure outlay equivalent estimates: $618.3. 

Fiscal year: 1985; 
Mandatory spending: $824.9; 
Discretionary spending: $646.4; 
Sum of tax expenditure outlay equivalent estimates: $676.7. 

Fiscal year: 1986; 
Mandatory spending: $838.5; 
Discretionary spending: $666.2; 
Sum of tax expenditure outlay equivalent estimates: $728.6. 

Fiscal year: 1987; 
Mandatory spending: $829.0; 
Discretionary spending: $657.7; 
Sum of tax expenditure outlay equivalent estimates: $702.7. 

Fiscal year: 1988; 
Mandatory spending: $861.3; 
Discretionary spending: $666.6; 
Sum of tax expenditure outlay equivalent estimates: $524.7. 

Fiscal year: 1989; 
Mandatory spending: $905.1; 
Discretionary spending: $675.4; 
Sum of tax expenditure outlay equivalent estimates: $549.2. 

Fiscal year: 1990; 
Mandatory spending: $1,002.6; 
Discretionary spending: $667.0; 
Sum of tax expenditure outlay equivalent estimates: $534.6. 

Fiscal year: 1991; 
Mandatory spending: $1,015.7; 
Discretionary spending: $684.8; 
Sum of tax expenditure outlay equivalent estimates: $532.8. 

Fiscal year: 1992; 
Mandatory spending: $1,062.0; 
Discretionary spending: $668.6; 
Sum of tax expenditure outlay equivalent estimates: $551.2. 

Fiscal year: 1993; 
Mandatory spending: $1,065.7; 
Discretionary spending: $660.7; 
Sum of tax expenditure outlay equivalent estimates: $561.7. 

Fiscal year: 1994; 
Mandatory spending: $1,103.6; 
Discretionary spending: $649.2; 
Sum of tax expenditure outlay equivalent estimates: $600.3. 

Fiscal year: 1995; 
Mandatory spending: $1,140.3; 
Discretionary spending: $639.9; 
Sum of tax expenditure outlay equivalent estimates: $622.3. 

Fiscal year: 1996; 
Mandatory spending: $1,184.2; 
Discretionary spending: $613.8; 
Sum of tax expenditure outlay equivalent estimates: $620.0. 

Fiscal year: 1997; 
Mandatory spending: $1,193.6; 
Discretionary spending: $619.7; 
Sum of tax expenditure outlay equivalent estimates: $650.2. 

Fiscal year: 1998; 
Mandatory spending: $1,231.3; 
Discretionary spending: $617.7; 
Sum of tax expenditure outlay equivalent estimates: $738.7. 

Fiscal year: 1999; 
Mandatory spending: $1,247.8; 
Discretionary spending: $631.7; 
Sum of tax expenditure outlay equivalent estimates: $785.5. 

Fiscal year: 2000; 
Mandatory spending: $1,271.1; 
Discretionary spending: $665.5; 
Sum of tax expenditure outlay equivalent estimates: $825.0. 

Fiscal year: 2001; 
Mandatory spending: $1,283.5; 
Discretionary spending: $686.7; 
Sum of tax expenditure outlay equivalent estimates: $908.1. 

Fiscal year: 2002; 
Mandatory spending: $1,325.5; 
Discretionary spending: $762.4; 
Sum of tax expenditure outlay equivalent estimates: $944.2. 

Fiscal year: 2003; 
Mandatory spending: $1,361.0; 
Discretionary spending: $841.8; 
Sum of tax expenditure outlay equivalent estimates: $883.5. 

Fiscal year: 2004; 
Mandatory spending: $1,396.8; 
Discretionary spending: $895.4; 
Sum of tax expenditure outlay equivalent estimates: $852.5. 

Note: Outlay-equivalent estimates represent the amount of budget 
outlays that would be required if the government were to provide 
taxpayers with the same after-tax income they receive through the tax 
expenditure. Outlay-equivalent estimates are useful to compare tax 
expenditures and other parts of the federal budget. Summing tax 
expenditure estimates does not take into account interactions between 
individual provisions. 

Source: GAO Analysis of OMB's Budget Reports on Tax Expenditures, 
Fiscal Years 1976-2006. 

[End of Figure] 

Health Care Is the Nation's Top Tax Expenditure in Fiscal Year 2005: 

[See PDF for image] --graphic text: 

Bar chart with five items: 

Exclusion of employer contributions for insurance premiums and medical 
care: $118.4. 
Deductibility of mortgage interest on owner-occupied dwellings: $62.2. 
Exclusion of pension contributions and earnings: employer-sponsored 
401(K) plans: $50.6. 
Exclusion of pension contributions and earnings: employer-sponsored 
defined benefit plans: $41.8. 
Deductibility of nonbusiness state and local taxes (other than on owner-
occupied dwellings): $37.4. 

Note: `Tax expenditures" refers to the special tax provisions that are 
contained in the federal income taxes on individuals and corporations. 
OMB does not include forgone revenue from other federal taxes such as 
Social Security and Medicare payroll taxes. 

*If the payroll tax exclusion were also counted here, the total tax 
expenditure for employer contributions for health insurance premiums 
would be about 50 percent higher or $177.6 billion. 

**This is the revenue loss and does not include associated outlays of 
$14.6 billion. 

Source: Office of Management and Budget (OMB), Analytical Perspectives, 
Budget of the United States Government, Fiscal Year 2007. 

[End of Figure] 

Current Fiscal Policy Is Unsustainable: 

The "Status Quo" is Not an Option: 

* We face large and growing structural deficits largely due to known 
demographic trends and rising health care costs. 

* GAO's simulations show that balancing the budget in 2040 could 
require actions as large as: 

- Cutting total federal spending by 60 percent or: 

- Raising federal taxes to 2 times today's level: 

Faster Economic Growth Can Help, but It Cannot Solve the Problem: 

* Closing the current long-term fiscal gap based on reasonable 
assumptions would require real average annual economic growth in the 
double digit range every year for the next 75 years. 

* During the 1990s, the economy grew at an average 3.2 percent per 
year. 

* As a result, we cannot simply grow our way out of this problem. Tough 
choices will be required. 

The Way Forward: A Three-Pronged Approach: 

1. Strengthen Budget and Legislative Processes and Controls: 

2. Improve Financial Reporting and Performance Metrics: 

3. Fundamental Reexamination & Transformation for the 21St Century: 

Solutions Require Active Involvement from both the Executive and 
Legislative Branches: 

The Way Forward: Strengthen Budget and Legislative Processes and 
Controls: 

Restore discretionary spending caps & PAYGO rules on both sides of the 
ledger: 

Develop mandatory spending triggers [with specific defaults], and other 
action-forcing provisions (e.g., sunsets) for both direct spending 
programs and tax preferences: 

Develop, impose & enforce modified rules for selected items (e.g., 
earmarks, emergency designations, and use of supplementals): 

Require present value cost estimates for any legislative debate on all 
major tax and spending bills, including entitlement programs. Cost 
estimates should usually assume no sunset: 

Extend accrual budgeting to insurance & federal employee pensions; 
develop techniques for extending to retiree health & environmental 
liabilities: 

Consider bi-annual budgeting: 

Consider expedited line item rescissions from the President that would 
only require a majority vote to override the proposed rescission(s): 

The Way Forward: 

Improve Financial Reporting and Performance Metrics: 

Improve transparency & completeness of President's budget proposal: 

* Return to 10-year estimates in budget both for current policies and 
programs and for policy proposals: 

* Include in the budget estimates of long-term cost of policy proposals 
& impact on total fiscal exposures. 

* Improve transparency of tax expenditures: 

Consider requiring President's budget to specify a path to on-budget 
balance within 10-year window or explain the selection of an 
alternative deadline: 

Require annual OMB report on existing fiscal exposures [liabilities, 
obligations, explicit & implied commitments] 

Require enhanced financial statement presentation and preparation of 
summary annual report that is both useful and used: 

Develop key national (outcome-based) indicators (e.g. economic, 
security, social, environmental) to chart the nation's position, 
progress, and position relative to the other major industrial 
countries: 

The Way Forward: Fundamental Reexamination & Transformation: 

Restructure existing entitlement programs: 

Reexamine and restructure the base of all other spending: 

Review & revise existing tax policy, including tax preferences and 
enforcement programs: 

Expand scrutiny of all proposed new programs, policies, or activities: 

Reengineer internal agency structures and processes, including more 
emphasis on long-term planning, integrating federal activities, and 
partnering with others both domestically and internationally: 

Strengthen and systematize Congressional oversight processes: 

Increase transparency associated with government contracts and other 
selected items: 

Key National Indicators: 

WHAT: A portfolio of economic, social, and environmental outcome-based 
measures that could be used to help assess the nation's and other 
governmental jurisdictions' position and progress: 

WHO: Many countries and several states, regions, and localities have 
already undertaken related initiatives (e.g., Australia, New Zealand, 
Canada, United Kingdom, Oregon, Silicon Valley (California) and 
Boston). 

WHY: Development of such a portfolio of indicators could have a number 
of possible benefits, including: 

* Serving as a framework for related strategic planning efforts 

* Enhancing performance and accountability reporting: 

* Informing public policy decisions, including much needed baseline 
reviews of existing government policies, programs, functions, and 
activities: 

* Facilitating public education and debate as well as an informed 
electorate: 

WAY FORWARD: Consortium of key players housed by the National Academies 
domestically and related efforts by the OECD and others 
internationally. 

Key National Indicators: Where the United States Ranks: 

The United States may be the only superpower, but compared to most 
other OECD countries on selected key economic, social, and 
environmental indicators, on average, the U.S. ranks: 

16 0UT OF 28: 

OECD Categories for Key Indicators (2006 OECD Factbook): 

* Population/Migration; 
* Energy; 
* Environment; 
* Quality of Life
* Macroeconomic trends; 
* Labor Market; 
* Education; 
* Economic globalization;  
* Prices; 
* Science & Tech; 
* Public Finance. 

21st Century Challenges Report: 

Provides background, framework, and questions to assist in reexamining 
the base:   

Covers entitlements & other mandatory spending, discretionary spending, 
and tax policies and programs: 

Based on GAO's work for the Congress: 

Twelve Reexamination Areas: 

Mission Areas: 

* Defense 
* International Affairs: 
* Education & Employment 
* Natural Resources, Energy & Environment: 
* Financial Regulation & Housing 
* Retirement & Disability: 
* Health Care 
* Science & Technology: 
* Homeland Security 
* Transportation: 

Crosscutting Areas: 

* Improving Governance 
* Reexamining the Tax System: 

Moving the Debate Forward: 

The Sooner We Get Started, the Better: 

* The miracle of compounding is currently working against us 

* Less change would be needed, and there would be more time to make 
adjustments: 

* Our demographic changes will serve to make reform more difficult over 
time: 

Need Public Education, Discussion, and Debate 

* The role of government in the 21st Century: 

* Which programs and policies should be changed and how 

* How government should be financed: 

GAO's Work to Modernize the Accountability Profession: 

GAO is actively working to modernize and transform the accountability 
profession, both inside the government and in the private sector, and 
to lead by example in this area: 

* Strengthening the independence of the FASAB: 

* Revitalizing the JFMIP principals' efforts, including definitions of 
success, accelerated reporting, etc. 

* Creating of the U.S Auditing Standards Coordinating Forum (i.e., GAO, 
PCAOB, ASB): 

* Leading strategic planning and coordination efforts with major 
accountability organizations around the world (e.g., INTOSAI, IGAF) 
that includes oversight, insight, and foresight dimensions: 

* 2003 revision of Government Auditing Standards (2006 revision is in 
process): 

* Modernizing of the accounting/reporting and audit models (e.g. IFAC, 
IAASB, FASB, GASB, FASAB, etc. ): 

* Enhancing federal financial reporting and pursuing publication of a 
summary annual report 

* Assuring appropriate treatment of restatements by auditors and 
others: 

* Monitoring implementation of the Sarbanes-Oxley Act, including 
providing suggestions for possible actions by the PCAOB and the SEC in 
connection with the internal control reporting requirements under 
Section 404: 

* Considering whether reform elements similar to those in Sarbanes- 
Oxley make sense for the federal government: 

* Exploring additional opportunities for employing more frequent 
reporting and continuous auditing approaches: 

* Exploring revised approaches to quality assurance programs, including 
internal inspections and peer reviews: 

Selected Government: 

Accountability Issues Leading by Example: 

Definition of success in financial management: 

* Clean opinion on financial statements 

* No major control weaknesses: 

* No major compliance issues: 

* Systems that produce timely, accurate, and useful financial and 
management information: 

Scope of audit: 

* Internal controls (GAO's audit and selected others currently) 

* Compliance matters (all currently): 

* Performance and projection information (future): 

Additional issues: 

* Accelerated and enhanced financial reporting (all agencies) 

* Audit/ financial management committees (GAO and selected other 
agencies): 

The Future Accounting/Reporting and Audit Reporting Model: 

We need to review and revise the existing accounting/reporting model to 
reflect several dimensions: 

* Generic provisions: 

* Industry information: 

* Entity-specific information (i.e., value and risk): 

We need to recognize the difference between certain types of financial 
and other information: 

* Historical cost: 

* Readily marketable assets: 

* Non-readily marketable assets 

* Projection information: 

* Performance information: 

We need to review and revise the existing audit reporting model to 
accomplish at least four objectives: 

* Recognize that the opinion should address whether the financial 
statements are fairly presented in all material respects and prepared 
in accordance with authoritative accounting principles (e.g., 
promulgated by FASB, GASB, FASAB, IFAC): 

* Expand the auditor's report to include key value and risk-based 
performance and projection information over time and as appropriate: 

* Update the audit reporting model to link it with the new financial 
reporting model, and provide appropriate degrees of assurance for each 
type of information to improve value and reduce risk: 

* We need to move beyond "going concern opinions" to provide more 
timely and meaningful information to the users of financial statements 
in appropriate circumstances (e.g. US government): 

We need to ultimately go global in connection with all major accounting 
and audit matters: 

We need to coordinate domestic efforts in the interim (e.g., U.S. 
auditing standards coordinating forum): 

Social Insurance Financial Reporting: 

FASAB has made significant progress on a range of federal accounting 
and reporting issues since their creation, including progress in the 
social insurance reporting area. 

The statement of social insurance, which has been reported as Required 
Supplementary Stewardship Information (RSSI) since fiscal year 2000, 
will become a basic financial statement and be subject to a full audit 
for the first time beginning with fiscal 2006. This statement discloses 
the present value of future revenues and scheduled benefits for the 
various social insurance programs. 

We need to make additional progress on the federal financial reporting 
areas, including reporting of social insurance programs. 

Among other things, we need to consider whether the bonds in the so 
called "trust funds should be deemed to be a liability of the US 
government. We also need to consider how we can enhance the 
presentation of the federal government's rapidly growing total 
liabilities and unfunded commitments, including the fiscal 
sustainability and intergenerational equity implications of such items. 

The AICPA, AAA, FEI, and other professional organizations should be 
actively engaged in these discussions and debates, including related 
due process efforts. Your opinions are both valued and valuable: 

GAO-06-1078CG 30: 

2006 Yellow Book Revisions: 

Audit quality assurance, monitoring, inspection, peer review:  

Ethics/ professional judgment: 

Expanding and clarifying the categories of nonaudit services:  

Reporting deficiencies in internal control for financial audits:  

Auditor's responsibility for evaluating and disclosing financial 
statement restatements: 

Evidence in performance audits: 

Audit documentation: 

Use of GAGAS with other standards (PCAOB, AICPA, IIA, IAASB): 

Clarification and "clean up" 

Yellow Book Revisions: Next Steps: 

Exposure Draft of proposed revisions was disseminated mid-May 2006: 

60-90 day exposure/comment period: 

Final 2006 Revised Yellow Book - Fall, 2006: 

Yellow Book Web Page: www.gao.gov/govaud/ybk01.htm: 

The Federal Financial Audit Environment: 

The federal financial audit environment is evolving: 

Closer to an opinion on the consolidated financial statements of the 
U.S. government (CFS), but DOD is the key challenge: 

GAO, as the auditor of the CFS, needs to be able to use the work of the 
auditors of the agency financial statements: 

Agencies need to meet accelerated due dates, minimize restatements, 
maintain unqualified opinions, and address their internal control and 
financial management system deficiencies: 

Performance and projection reporting need to expand over time: 

More timely financial and performance reporting should not come at the 
price of less reliable reporting:  

Selected Reporting Challenges: 

Financial and Performance Reporting: 

* DOD assets, liabilities, and contingencies - DOD 

* Restatements - Certain Agencies: 

* Performance reporting - All Agencies: 

* "Trust funds" (e.g., restricted vs. unrestricted revenues, intra- 
governmental obligations) - OMB: 

* Long-range fiscal challenges (e.g., per capita burden, 
sustainability, intergenerational impact) - GAO: 

* Summary annual report - Treasury: 

Learning from the Past and Others while Preparing for Future: 

Roman Republic: 

British Empire: 

New Zealand vs. Argentina: 

Key Leadership Attributes Needed for These Challenging and Changing 
Times: 

Courage: 
Integrity: 
Creativity: 
Stewardship: 

On the Web: 

Web site: www.gao.gov/cghome.htm: 

Contact: 

Paul Anderson, Managing Director, Public Affairs 
AndersonP1 @gao.gov (202) 512-4800: 
U.S. Government Accountability Office 441 G Street NW, Room 7149 
Washington, D.C. 20548: 

Copyright: 

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from GAO. However, because this work may contain copyrighted images or 
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if you wish to reproduce this material separately. 

GAO-06-1078CG: 

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