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Testimony: 

Before the Budget Committee, House of Representatives: 

United States Government Accountability Office: 

GAO: 

For Release on Delivery Expected at 2:00 p.m. EST: 

Wednesday, February 15, 2006: 

21st Century: 

Addressing Long-Term Fiscal Challenges Must Include a Re-examination of 
Mandatory Spending: 

Statement of David M. Walker, Comptroller General of the United States: 

GAO-06-456T: 

GAO Highlights: 

Highlights of GAO-06-456T, a report to the Budget Committee, House of 
Representatives: 

Why GAO Did This Study: 

The House Budget Committee asked GAO to discuss mandatory programs in 
light of the nation’s long-term fiscal outlook. 

What GAO Found: 

Meeting the Nation’s long-term fiscal challenge will require a 
reexamination of discretionary spending; mandatory spending, including 
entitlements; and tax policies and compliance activities. Mandatory 
spending programs—like tax expenditures—are relatively uncontrollable 
on an annual basis because they are governed by eligibility rules and 
benefit formulas. By their very nature mandatories limit budget 
flexibility—the ability of each Congress and President to allocate 
resources. With only about one-third of the budget under the control of 
the annual appropriations process, considering ways to increase 
transparency, oversight, and control of mandatory spending programs as 
well as tax expenditures must be part of addressing the nation’s long-
term fiscal challenges. 

One approach to increasing control would use triggers. A trigger is a 
measure which, when reached or exceeded, would prompt a response. A 
response could be “soft,” prompting special consideration when the 
threshold or target is breached or “hard,” requiring predetermined, 
program-specific action. By identifying significant increases in the 
spending path of a mandatory program relatively early and acting to 
constrain it, Congress may avert larger financial challenges in the 
future. Triggers for mandatory spending programs pose challenging 
design issues and would need to be program-specific. 

Mandatory spending on federal health programs is the major driver of 
long-term fiscal imbalances that, left unchecked, will put our Nation’s 
economy, security, and standard of living at risk. While Social 
Security spending is large and will grow, Medicare will grow much 
faster. By 2080, Medicare spending is projected to quintuple—from 3 to 
14 percent of the economy. This growth reflects both the expected 
growth in beneficiaries and the escalation of health costs at rates 
well above inflation. Addressing federal health spending is complex 
because this will need to involve health care system change—a societal 
challenge that will affect all age groups. Accordingly, solutions to 
health care cost growth are likely to be incremental. Taking steps to 
address the health care cost dilemma systemwide, however, will put us 
on the right path to meet the long-term fiscal challenge. 

Budgets, deficits, and long-term fiscal and economic outlooks are not 
just about numbers: they are also about values. It is time for all of 
us to recognize our stewardship obligation for the future. We should 
act sooner rather than later. Difficult choices will be required to 
avoid passing an even greater burden on to future generations. 

What GAO Recommends: 

GAO makes no recommendations. 

www.gao.gov/cgi-bin/getrpt?GAO-06-456T. 

To view the full product, including the scope and methodology, click on 
the link above. For more information, contact Susan Irving at (202) 512-
9142 or irvings@gao.gov. 

[End of section] 

Mr. Chairman, Representative Spratt, and Members of the Committee: 

I appreciate this opportunity to talk with you about the need to look 
at entitlement and other mandatory spending programs in light of our 
nation's long-term fiscal outlook and the challenge it poses for the 
budget and oversight processes. 

As I have said many times before, meeting our nation's large, growing, 
and structural fiscal imbalance will require a three-pronged approach: 

* restructuring existing entitlement programs, 

* reexamining the base of discretionary and other spending, and: 

* reviewing and revising existing tax policy, including tax 
expenditures,[Footnote 1] which can operate like mandatory spending 
programs. 

Before I turn to the major driver of the long-term spending outlook-- 
rising health care costs combined with known demographic trends--I'd 
like to step back and take a broader view of the need to reexamine and 
reconsider what the federal government does, how it does it, and who 
does it. We are in the first decade of the 21st century but the basis 
and design for many of the federal government's activities date from 
before I was born. 

In our report entitled 21st Century Challenges: Reexamining the Base of 
the Federal Government,[Footnote 2] we presented illustrative questions 
for policy makers to consider as they carry out their responsibilities. 
These questions look across major areas of the budget and federal 
operations including discretionary and mandatory spending, and tax 
policies and programs. We hope that this report, among other things, 
will be used by various congressional committees as they consider which 
areas of government need particular attention and reconsideration. You 
will, of course, also receive more specific proposals, some of them 
will be presented within comprehensive agendas--the President's Budget 
released last week is just one very prominent example. 

Our report provides examples of the kinds of difficult choices the 
nation faces with regard to discretionary spending; mandatory spending, 
including entitlements; as well as tax policies and compliance 
activities. It is, I think, important to recognize that tax policies 
and programs financing the federal budget can be reviewed not only with 
an eye toward the overall level of revenue provided to fund federal 
operations and commitments, but also the mix of taxes and the extent to 
which the tax code is used to promote overall economic growth and broad-
based societal objectives. In practice, some tax expenditures are very 
similar to mandatory spending programs even though they are not subject 
to the appropriations process or selected budget control mechanisms. As 
we reported last September, tax expenditures represent a significant 
commitment and are not typically subjected to review or reexamination. 

Mandatory spending programs--like tax expenditures--are governed by 
eligibility rules and benefit formulas, which means that funds are 
spent as required to provide benefits to those who are eligible and 
wish to participate. Since Congress and the President must change 
substantive law to change the cost of these programs, they are 
relatively uncontrollable on an annual basis. Moreover, as we reported 
in a 1994 analysis, their cost cannot be controlled by the same 
"spending cap" mechanism used for discretionary spending.[Footnote 3] 

By their very nature mandatories limit budget flexibility.[Footnote 4] 
As figure 1 shows, mandatory spending has grown as a share of the total 
federal budget. For example, mandatory spending has grown from 27 
percent before the creation of Medicare and Medicaid to 42 percent in 
1985 to 54 percent last year. (Total spending not subject to annual 
appropriations--mandatory spending and net interest--has grown from 56 
percent in 1985 to 61 percent last year.) Under both the Congressional 
Budget Office baseline estimates and the President's Budget, this 
spending would grow further. 

Figure 1: Federal Spending for Mandatory and Discretionary Programs: 

[See PDF for image] 

Note: Projections assume discretionary spending grows with inflation 
after 2006. 

[End of figure] 

While the long-term fiscal outlook is driven by Medicare, Medicaid and 
Social Security, it does not mean that all other mandatory programs 
should be "given a pass." As we have noted elsewhere, reexamination of 
the "fit" between government programs and the needs and priorities of 
the nation should be an accepted practice.[Footnote 5] So in terms of 
budget flexibility--the freedom of each Congress and President to 
allocate public resources--we cannot ignore mandatory spending programs 
even if they do not drive the aggregate. 

While some might suggest that mandatory programs could be controlled by 
being converted to discretionary or annually appropriated programs, 
that seems unlikely to happen. If we look across the range of 
mandatories we see many programs have objectives and missions that 
contribute to the achievement of a range of broad-based and important 
public policy goals such as providing a floor of income security in 
retirement, fighting hunger, fostering higher education, and providing 
access to affordable health care. To these ends, these programs--and 
tax expenditures--were designed to provide benefits automatically to 
those who take the desired action or meet the specified eligibility 
criteria without subjecting them to an annual decision regarding 
spending or delay in the provision of benefits such a process might 
entail. 

Although mandatory spending is not amenable to "caps," that does not 
mean that mandatory programs should be permitted to be on autopilot and 
grow to an unlimited extent. Since the spending for any given 
entitlement or other mandatory program is a function of the interaction 
between the eligibility rules and the benefit formula--either or both 
of which may incorporate exogenous factors such as economic downturns-
--the way to change the path of spending for any of these programs is 
to change those rules or formulas. We recently issued a report on 
"triggers"--some measure which, when reached or exceeded, would prompt 
a response connected to that program.[Footnote 6] By identifying 
significant increases in the spending path of a mandatory program 
relatively early and acting to constrain it, Congress may avert much 
larger and potentially disruptive financial challenges and program 
changes in the future. 

A trigger is a measure and a signal mechanism--like an alarm clock. It 
could trigger a "soft" response--one that calls attention to the growth 
rate or the level of spending and prompts special consideration when 
the threshold or target is breached. Two examples of soft responses 
that could be triggered include requiring the relevant agency to 
prepare a report analyzing why the trigger was tripped and/or requiring 
the President to submit a proposal to change the path or explain why he 
thinks it should remain unchanged. The Medicare program already 
contains a "soft" response trigger: The President is required to submit 
a proposal for action to Congress if the Medicare Trustees determine in 
2 consecutive years that the general revenue share of Medicare spending 
is projected to exceed 45 percent during a 7-year period.[Footnote 7] 
Each year the Social Security and Medicare Trustees test for program 
financial adequacy over the next 10 years. The results of the test are 
included in the respective Trustees' reports to Congress, in which they 
note that failure to meet this test is an indication that action is 
needed. A few Social Security reform proposals have taken this further 
by including language requiring Presidential and Congressional action 
if the Social Security Board of Trustees determines that the balance 
ratio of either of the Social Security trust funds will be zero for any 
calendar year during the succeeding 75 years.[Footnote 8] Given the 
complexity and controversy associated with reforming entitlements, 
commissions might be one means to come up with possible triggers 
appropriate to the specific programs. 

Soft responses can help in alerting decision makers of potential 
problems but they do not ensure that action to decrease spending or 
increase revenue is taken. With soft responses, the fiscal path 
continues unless Congress and the President take action. In contrast, a 
trigger could lead to "hard" responses requiring a predetermined, 
program-specific action to take place, such as changes in eligibility 
criteria and benefit formulas, automatic revenue increases, or 
automatic spending cuts. With hard responses, spending is automatically 
constrained, revenue is automatically increased, or both, unless 
Congress takes action to override. For example, this year the 
President's Budget proposes to change the Medicare trigger from solely 
"soft" to providing a "hard" (automatic) response if Congress fails to 
enact the President's proposal.[Footnote 9] Figure 2 below illustrates 
the conceptual differences between hard and soft responses of a budget 
trigger. 

Figure 2: Conceptual Differences between Hard and Soft Responses: 

[See PDF for image] 

[End of figure] 

In our recent report on mandatory spending triggers, we discussed the 
kinds of responses that might be triggered and the importance of 
program-specific design. Proposed changes in underlying benefits 
structure and design of a mandatory program can be considered in the 
context both of the factors that drive the growth of that program and 
the specific goals and objectives of the program. For example, some 
mandatories are intended to have a countercyclical effect; any 
triggered response in these programs would have to be designed not to 
interfere with that function. Its design, therefore, would have to be 
sensitive to whether growth comes because the program is, in fact, 
working as an automatic stabilizer. 

Both near-and long-term perspectives should be considered in the design 
of triggers. For some programs, it might be appropriate to tie the 
trigger to historical data--for example, to see whether spending growth 
was greater than some historical average or path. For programs that 
expose the government to long-term commitments, it might be more 
appropriate to tie the trigger to projections of future spending. For 
"contributory" programs that represent a long-term commitment of future 
earmarked resources, such as Social Security, one appropriate measure 
could be the actuarial projections of the 75-year outlook. Some similar 
approach might be used for programs like pension or health insurance. 

Any discussion to create triggered responses and their design must 
recognize that unlike controls on discretionary spending, there is some 
tension between the idea of triggers and the nature of entitlement and 
other mandatory spending programs. These programs--as with tax 
provisions such as tax expenditures--were designed to provide benefits 
based on eligibility formulas or actions as opposed to an annual 
decision regarding spending. This tension makes it more challenging to 
constrain costs and to design both triggers and triggered responses. At 
the same time, with only about one-third of the budget under the 
control of the annual appropriations process, considering ways to 
increase transparency, oversight, and control of mandatory programs 
must be part of addressing the nation's long-term fiscal challenges. 

Before I turn to the largest driver of our long-term challenge--rising 
health care costs--let me note that the idea of triggers need not only 
apply to spending. The revenue side of the budget should also be 
addressed. If, for example, one option to cover the increased costs of 
a mandatory spending program was a premium increase or tax increase, it 
would serve to increase public visibility and could make the American 
people more aware of how much they are paying for services. More 
directly analogous to mandatory spending programs is the extensive use 
of tax incentives, rather than direct spending authority, to address 
various social objectives. As we reported in September 2005,[Footnote 
10] the sum of revenue loss estimates associated with tax expenditures--
such as tax exclusions, credits, and deductions--was nearly $730 
billion in 2004.[Footnote 11] Under the most recent estimates, this has 
risen to more than $775 billion in 2005. 

Let me be clear that in suggesting application of this analysis to tax 
expenditures I am not addressing the appropriate level of taxation as a 
share of GDP. Whatever level of revenue is deemed appropriate, tax 
expenditures that seek to achieve programmatic or policy goals should--
like other federal programs or activities--be reviewed to determine 
their effectiveness, continued relevance, affordability, and 
sustainability. Tax expenditures have a significant effect on overall 
tax rates--in that, for any given level of revenue, overall tax rates 
must be higher to offset the revenue forgone through tax expenditures--
as well as the budget and fiscal flexibility. They also contribute to 
the growing complexity of the federal tax system. Many tax expenditures 
operate like mandatory spending programs and generally are not subject 
to reauthorization. Such tax expenditures are embedded in the tax 
system. They are not subject to a performance test and are off the 
radar screen for the most part. This is a concern from a budgetary 
standpoint because taxpayer dollars committed to fund these 
expenditures do not compete in the annual appropriations process and 
are effectively "fully funded" before any discretionary spending is 
considered. The analysis we have applied to spending would also be 
useful in examining tax expenditures. 

Federal Health Care Spending Drives the Long-Term Fiscal Challenge: 

Among mandatory spending programs--and indeed tax expenditures--the 
health area is especially important because the long-term fiscal 
challenge is largely a health care challenge. Contrary to public 
perceptions, health care is the biggest driver of the long-term fiscal 
challenge. While Social Security is important because of its size, 
health care spending is both large and projected to grow much more 
rapidly. 

Our most recent simulation results illustrate the importance of health 
care in the long-term fiscal outlook as well as the imperative to take 
action. Simply put, our nation's fiscal policy is on an imprudent and 
unsustainable course. These long-term budget simulations show, as do 
those published last December by the Congressional Budget Office 
(CBO),[Footnote 12] that over the long term we face a large and growing 
structural deficit due primarily to known demographic trends and rising 
health care costs and lower federal revenues as a percentage of the 
economy. Continuing on this unsustainable fiscal path will gradually 
erode, if not suddenly damage, our economy, our standard of living, and 
ultimately our national security. Our current path also will 
increasingly constrain our ability to address emerging and unexpected 
budgetary needs and increase the burdens that will be faced by future 
generations. 

Figures 3 and 4 present our long-term simulations under two different 
sets of assumptions. In figure 3, we start with CBO's 10-year baseline-
-constructed according to the statutory requirements for that 
baseline.[Footnote 13] Consistent with these requirements, 
discretionary spending is assumed to grow with inflation for the first 
10 years and tax cuts scheduled to expire are assumed to expire. After 
2016, discretionary spending is assumed to grow with the economy, and 
revenue is held constant as a share of GDP at the 2016 level. In figure 
4, two assumptions are changed: (1) discretionary spending is assumed 
to grow with the economy after 2006 rather than merely with inflation, 
and (2) all expiring tax provisions are extended. For both simulations, 
Social Security and Medicare spending is based on the 2005 Trustees' 
intermediate projections, and we assume that benefits continue to be 
paid in full after the trust funds are exhausted. Medicaid spending is 
based on CBO's December 2005 long-term projections under mid-range 
assumptions. 

Figure 3: Composition of Spending as a Share of GDP under Baseline 
Extended: 

[See PDF for image] 

Note: 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 alternative minimum tax (AMT), and 
(3) increased revenue from tax-deferred retirement accounts. After 
2016, revenue as a share of GDP is held constant. 

[End of figure] 

Figure 4: 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] 

Note: This includes certain tax provisions that expired at the end of 
2005, such as the increased AMT exemption amount. 

[End of figure] 

As these simulations illustrate, absent significant policy changes on 
the spending and/or revenue side of the budget, the growth in mandatory 
spending on federal retirement and especially health entitlements will 
encumber an escalating share of the government's resources. Indeed, 
when we assume that all the temporary tax reductions are made permanent 
and discretionary spending keeps pace with the economy, our long-term 
simulations suggest that by 2040 federal revenues may be adequate to 
pay only some Social Security benefits and interest on the federal 
debt. Neither slowing the growth in discretionary spending nor allowing 
the tax provisions to expire--nor both together--would eliminate the 
imbalance. Although revenues will be part of the debate about our 
fiscal future, assuming no changes to Social Security, Medicare, 
Medicaid, and other drivers of the long-term fiscal gap would require 
at least a doubling of taxes--and that seems highly implausible. 
Economic growth is essential, but we will not be able to simply grow 
our way out of the problem. The numbers speak loudly: our projected 
fiscal gap is simply too great. Closing the current long-term fiscal 
gap would require sustained economic growth far beyond that experienced 
in U.S. economic history since World War II. Tough choices are 
inevitable, and the sooner we act the better. 

Accordingly, substantive reform of the major health programs and Social 
Security is critical to recapturing our future fiscal flexibility. 
Ultimately, the nation will have to decide what level of federal 
benefits and spending it wants and how it will pay for these benefits. 
Our current fiscal path will increasingly constrain our ability to 
address emerging and unexpected budgetary needs and increase the 
burdens that will be faced by future generations. Continuing on this 
path will mean escalating and ultimately unsustainable federal deficits 
and debt that will serve to threaten our future national security as 
well as the standard of living for the American people. 

The aging population and rising health care spending will have 
significant implications not only for the budget, but also the economy 
as a whole. Figure 5 shows the total future draw on the economy 
represented by Social Security, Medicare, and Medicaid. Under the 2005 
Trustees' intermediate estimates and CBO's 2005 long-term Medicaid 
estimates under mid-range assumptions, spending for these entitlement 
programs combined will grow to 15.7 percent of gross domestic product 
(GDP) in 2030 from today's 8.4 percent. It is clear that, taken 
together, Social Security, Medicare, and Medicaid represent an 
unsustainable burden on future generations. 

Furthermore, most of the long-term growth is in health care. While 
Social Security in its current form will grow from 4.3 percent of GDP 
today to 6.4 percent in 2080, Medicare's burden on the economy will 
quintuple--from 2.7 percent to 13.8 percent of the economy--and these 
projections assume a growth rate for Medicare spending that is below 
historical experience! As figure 5 shows, unlike Social Security which 
grows larger as a share of the economy and then levels off, within this 
projection period we do not see Medicare growth abating. Whether or not 
the President's Budget proposals on Medicare are adopted, they should 
serve to raise public awareness of the importance of health care costs 
to both today's budget and tomorrow's. This could serve to jump start a 
discussion about appropriate ways to control the major driver of our 
long-term fiscal outlook--health care spending. 

Figure 5: Social Security, Medicare, and Medicaid Spending as a Percent 
of GDP: 

[See PDF for image] 

Note: Social Security and Medicare projections are based on the 
intermediate assumptions of the 2005 Trustees' Reports. Medicaid 
projections are 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] 

As noted, unlike Social Security, Medicare spending growth rates 
reflect not only a burgeoning beneficiary population, but also the 
escalation of health care costs at rates well exceeding general rates 
of inflation. The growth of medical technology has contributed to 
increases in the number and quality of health care services. Moreover, 
the actual costs of health care consumption are not transparent. 
Consumers are largely insulated by third-party payers from the cost of 
health care decisions. 

The health care spending problem is particularly vexing for the federal 
budget, affecting not only Medicare and Medicaid but also other 
important federal health programs, such as for our military personnel 
and veterans. For example, Department of Defense health care spending 
rose from about $12 billion in 1990 to about $30.4 billion in 2004--in 
part, to meet additional demand resulting from program eligibility 
expansions for military retirees, reservists, and the dependents of 
those two groups and for the increased needs of active duty personnel 
involved in conflicts in Iraq, Bosnia, and Afghanistan. Expenditures by 
the Department of Veterans Affairs have also grown--from about $12 
billion in 1990 to about $26.8 billion in 2004--as an increasing number 
of veterans look to federal programs to supply their health care needs. 

The challenge to rein in health care spending is not limited to public 
payers, however, as the phenomenon of rising health care costs 
associated with new technology exists system-wide. This means that 
addressing the unsustainability of health care costs is also a major 
competitiveness and societal challenge that calls for us as a nation to 
fundamentally rethink how we define, deliver, and finance health care 
in both the public and the private sectors. A major difficulty is that 
our current system does little to encourage informed discussions and 
decisions about the costs and value of various health care services. 
These decisions are very important when it comes to cutting-edge drugs 
and medical technologies, which can be incredibly expensive but only 
marginally better than other alternatives. As a nation, we are going to 
need to weigh unlimited individual wants against broader societal needs 
and decide how responsibility for financing health care should be 
divided among employers, individuals, and government. Ultimately, we 
may need to define a set of basic and essential health care services to 
which every American is ensured access. Individuals wanting additional 
services, and insurance coverage to pay for them, might be required to 
allocate their own resources. Clearly, such a dramatic change would 
require a long transition period--all the more reason to act sooner 
rather than later. 

In recent years, policy analysts have discussed a number of incremental 
reforms that take aim at moderating health care spending, in part by 
unmasking health care's true costs. (See fig. 6 for a list of selected 
reforms.) Among these reforms is to devise additional cost-sharing 
provisions to make health care costs more transparent to patients. 
Currently, many insured individuals pay relatively little out of pocket 
for care at the point of delivery because of comprehensive health care 
coverage--precluding the opportunity to sensitize these patients to the 
cost of their care. 

Figure 6: Selected Reforms Aimed at Moderating Health Care Spending: 

* Develop a set of national practice standards to help avoid 
unnecessary care, improve outcomes, and reduce litigation; 
* Encourage case management approaches for people with expensive acute 
and chronic conditions to improve the quality and efficiency of care 
delivered and avoid inappropriate care; 
* Foster the use of information technology to increase consistency, 
transparency, and accountability in health care; 
* Emphasize prevention and wellness care, including nutrition; 
* Leverage the government's purchasing power to control costs for 
prescription drugs and other health care services; 
* Revise certain federal tax preferences for health care to encourage 
the more efficient use of appropriate care; 
* Create an insurance market that adequately pools risk and offers 
alternative levels of coverage; 
* Develop a core set of basic and essential services with supplemental 
coverage being available as an option but at a cost. Use the Federal 
Employees Health Benefits Program (FEHBP) model as a possible means to 
experiment and see the way forward; 
* Limit spending growth for government-sponsored health care programs 
(e.g., percentage of the budget and/or the economy). 

Source: GAO: 

[End of figure] 

Other steps include reforming the policies that give tax preferences to 
insured individuals and their employers. These policies permit the 
value of employees' health insurance premiums to be excluded from the 
calculation of their taxable earnings and exclude the value of the 
premium from the employers' calculation of payroll taxes for both 
themselves and employees. Tax preferences also exist for health savings 
accounts and other consumer-directed plans. These tax exclusions 
represent a significant source of forgone federal revenue and work at 
cross-purposes to the goal of moderating health care spending. As 
figure 7 shows, in 2005 the tax expenditure responsible for the 
greatest revenue loss was that for the exclusion of employer 
contributions for employees' insurance premiums and medical care. 

Figure 7: Health Care Was the Nation's Top Tax Expenditure in Fiscal 
Year 2005: 

[See PDF for image] 

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. 

[A] 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. 

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

[End of figure] 

Another area conducive to incremental change involves provider payment 
reforms. These reforms are intended to induce physicians, hospitals, 
and other health care providers to improve on quality and efficiency. 
For example, studies of Medicare patients in different geographic areas 
have found that despite receiving a greater volume of care, patients in 
higher use areas did not have better health outcomes or experience 
greater satisfaction with care than those living in lower use areas. 
Public and private payers are experimenting with payment reforms 
designed to foster the delivery of care that is proven to be both 
clinically and cost effective. Ideally, identifying and rewarding 
efficient providers and encouraging inefficient providers to emulate 
best practices will result in better value for the dollars spent on 
care. The development of uniform standards of practice could lead to 
ensuring that people with chronic illnesses, a small but expensive 
population, received more and cost-effective and patient-centered care 
while reducing unwarranted medical malpractice litigation. 

The problem of escalating health care costs is complex because 
addressing federal programs such as Medicare and the federal-state 
Medicaid program will need to involve change in the health care system 
of which they are a part--not just within federal programs. This will 
be a major societal challenge that will affect all age groups. Because 
our health care system is complex, with multiple interrelated pieces, 
solutions to health care cost growth are likely to be incremental and 
require a number of extensive efforts over many years. In my view, 
taking steps to address the health care cost dilemma system-wide puts 
us on the right path for correcting the long-term fiscal problems posed 
by the nation's health care entitlements. 

I have focused today on health care because it is a driver of our 
fiscal outlook. Indeed, health care is already putting a squeeze on the 
federal budget. 

Health care is the dominant but not the only driver of our long-term 
fiscal challenge. Today it is hard to think of our fiscal imbalances as 
a big problem: the economy is healthy and interest rates seem low. We, 
however, have an obligation to look beyond today. Budgets, deficits, 
and long-term fiscal and economic outlooks are not just about numbers: 
they are also about values. It is time for all of us to recognize our 
stewardship obligation for the future. We should act sooner rather than 
later. We all must make choices that may be difficult and unpleasant 
today to avoid passing an even greater burden on to future generations. 
Let us not be the generation who sent the bill for its consumption to 
its children and grandchildren. 

Thank you Mr. Chairman, Mr. Spratt, and members of the Committee for 
having me today. We at GAO, of course, stand ready to assist you and 
your colleagues as you tackle these important challenges. 

FOOTNOTES 

[1] Tax expenditures result in forgone revenue for the federal 
government due to preferential provisions in the tax code, such as 
exemptions and exclusions from taxation, deductions, credits, deferral 
of tax liability, and preferential tax rates. These tax expenditures 
are often aimed at policy goals similar to those of federal spending 
programs; existing tax expenditures, for example, are intended to 
encourage economic development in disadvantaged areas, finance 
postsecondary education, and stimulate research and development. See 
GAO, Government Performance and Accountability: Tax Expenditures 
Represent a Substantial Federal Commitment and Need to Be Reexamined, 
GAO-05-690 (Washington, D.C.: Sept. 23, 2005). 

[2] GAO, 21st Century Challenges: Reexamining the Base of the Federal 
Government, GAO-05-325SP (Washington, D.C.: February 2005). 

[3] GAO, Budget Policy: Issues in Capping Mandatory Spending, GAO/AIMD-
94-155 (Washington, D.C.: July 18, 1994). 

[4] Similarly tax expenditures may limit flexibility on the revenue 
side; there is a tradeoff between tax rates and revenue lost through 
tax expenditures. In order to raise a given amount of federal revenue, 
tax rates must be raised higher than they otherwise need to be due to 
revenue losses from tax expenditures. 

[5] GAO-05-325SP. 

[6] GAO, Mandatory Spending: Using Budget Triggers to Constrain Growth, 
GAO-06-276 (Washington, D.C.: Jan. 31, 2006). 

[7] For the purpose of the Medicare trigger, general revenue is defined 
as the difference between Medicare program outlays and dedicated 
Medicare financing sources. Dedicated Medicare financing sources are 
defined as Hospital Insurance (HI) payroll taxes, the HI share of 
income taxes on Social Security benefits, state transfers for Part D 
prescription drug benefits, premiums paid under Parts A, B, and D, and 
any gifts received by the trust funds. 

[8] Recently, this provision was included in the Bipartisan Retirement 
Security Act of 2005, H.R. 440, 109th Cong. § 14 (2005). 

[9] The response now would include a sequester if the Congress did not 
act on the President's proposal. The proposed sequester would result in 
a four-tenths of a percent reduction in all payments to providers 
beginning in the year the threshold is exceeded. Each year the 
shortfall continues to occur the reduction would grow by an additional 
four-tenths of a percent. We have not yet analyzed how this would work. 

[10] See GAO-05-690. 

[11] Summing the individual tax expenditure estimates is useful for 
gauging the general magnitude of the federal revenue involved, but it 
does not take into account possible interactions between individual 
provisions. 

[12] CBO, The Long-Term Budget Outlook (Washington, D.C.: December 
2005). 

[13] CBO, The Budget and Economic Outlook: Fiscal Years 2007 to 2016 
(Washington, D.C.: January 2006). 

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