ECON 101 Chapter Notes - Chapter all: Public Health Insurance Option, Health Care Reform, Disclose

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26 May 2018
Department
Course
Professor
Economics 101
Lori Leachman
Extra Credit Book Where does the money go? by Jean Johnson and Scott Bittle
CH1
6 points
o U.S. continues to spend more money than it makes (programs than it makes on taxes)
o Borrow money every year, and built up debt
o Large additional expenses in near future due to baby boomers who retire and health care
costs rise
o No realistic way government can lower taxes and still spend money on programs people
want
o If we keep going the same way, debt will get big enough to endanger our personal
finances
o Substantial portion of debt is held by foreign countries, foreign investors consider U.S.
bonds to be safe... they might take away soon
3 big risks
o Monster expenses in near future from baby boomers’ retirement in Social Security and
Medicare expenses (a lot of SS trust fund is in IOUs from gov - money has to come from
somewhere)
o Economy goes down as interest rates rise bc gov keeps borrowing money - becomes
harder for everyone else to borrow money - less investment, less jobs, for failing, more
debt... etc
o Foreigners hold U.S. debt as U.S. assets are considered safe rn and it is more volatile as
people can quickly move their money away and cause crisis (stock market crash)
CH2
Hypothetical situation
o Banker in Beijing says that China is holding too many U.S. Treasuries - idea spreads - no
one buys U.S. bonds, interest rates go up, commerical bank raises rates - no cash flow,
raise taxes and cutting spending, economy slumps, people draw stocks and move money
overseas - economy collapses and stock market crashes
o Bedford Falls - Pottersville and Debtville scenario - a government in crisis and an
economy in deep recession means nearly everyone suffers, except for the very rich
CH3
Debt is the accumulation of deficits (debt only goes down if there is a surplus)
o Deficit for 31 of the last 35 years (the time of book) is accumulation of 31 years of
deficits
o U.S. gov constantly runs deficits
Sometimes deficits are necessary - economic recession or wartime and needs stimulus
U.S. debt so big, spends more on interest than on education, veterans benefits, or science
U.S. continually/routinely runs deficits and adds to debt - U.S. has no plan to pay off debt
U.S. gov has worry about it tomorrow mentality
NEED
o federal deficits to fall and keep falling for a number of years
o watch expenses
o Cut expenses and raise money in ways we would rather not
CH4
Income taxes: have fallen a ton and now a lot less for the rich and the poor are almost exempt
o Tax cuts are reason that country has had big deficits (liberals)
o Tax cuts help economy by letting people keep money, deficits from gov spending
(conservative)
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Payroll taxes: comes from SS and medicare taxes, unemployment and retirement taxes
o Deductions as SS tax over a certain amount - regressive taxes
o Taxes pay for the current elderly - the working baby boomers creating surplus of payroll
tax
Corporate taxes: small percent of gov revenue
o Corporate taxes affect all businesses (even small businesses) as well as any stock owners
o Lower corporate taxes allow them to hire and pay more and invest and stay in the country
Excise taxes: smaller percent of gov revenue
o Some money goes to state and local governments
Tax burden on middle/lower income families are state/local taxes
o Federal taxes are normally progressive, rich pay more
Do tax cuts pay themselves?
o They normally do not raise enough money to cover cost of tax cut
Raising taxes hurt economy?
o No one agrees
o Diff viewpoints
Raising taxes to reduce deficit could grow economy as gov invests in education,
research... etc and buys goods/services itself
Low taxes widen wealth gap as money goes to the rich
High taxes eat away and weaken economy and can upset stock market and drive
investors overseas
No one wants to pay taxes - everything thinks someone else should be paying more - question of
fairness
Tax code is extremely complex and complicated - because a lot of benefits like tax breaks... etc
o Tax breaks incentivize people to do good things
CH5
U.S. spends a lot of money on SS, Medicare/Medicaid, national defense, and interest on money
we’ve borrowed.
Entitlements: SS & Medicare
o SS:
Paid-as-you-go, current people pay for retirees
Baby boomers retiring will run trust funds dry
o National defense:
About a fifth of budget, largest military force in world
Worry about being overstretched - wasting money
Not entitlement - decided by officials and possibility to maintaining
much larger military than needed
o Medicare: entitlement
Partially funded by payroll taxes and the rest (up to 45%) is paid by fed gov
Medical costs becoming more expensive - better tech
Medicare trust fund is being depleted fast (faster than SS)
o Health
Public health services, research and disease prevention
Health care reform
Gov gave money to help reduce health care costs and lead to information
tech and better quality of care (down payment for future improvements)
o Commerce and housing credit
Stimulus and bailout spending, tax credits, fed deposit insurance... etc
o Medicaid and CHIP
Health insurance program for the poor
o Interest on debt
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Money have to pay to banks and holders of treasury bonds for money we’ve
borrowed - to keep door open to borrow more
CH6
SS and Medicare are pay-as-you-go programs
o Current payroll taxes of those who work rn cover retirement and health care for those
who are currently old
o Problems:
Baby boomers are about to cash in on SS
People are living longer - costs more money SS and health care
Health care costs are rising
Every year there is new tech and medicine to buy - more expensive
Expanded benefits - like prescription drug coverage
o Gov uses all income - including SS and Medicare to cover ALL expenses
SS trust fund looks healthy - deceiving - gov taps into the fund to pay for other
expenses - use this surplus instead of raising taxes - but no money for future
Eventually when boomers start retiring - gov has to raise tax or slim benefits
o Choices:
Pay for everything - but 92 cents of every dollar will go to SS,
medicare/medicaid, interest on debt
Place really high taxes
Cut benefits of old people that have worked to pay for SS
CH7
Medicare problems are harder to fix than SS
Costs are linked to overall health care system and health care costs are skyrocketing
Like SS, Medicare’s costs depend on how many older people are in the country, but also how sick
they are
o Alzheimer's and dementia are expensive
o New tech will be added to covered services, but also increase costs
Medicare some parts are unnecessary - wasteful
Medicare also is subject to fraud
No clear solution - some hope on HMOs, preferred provider plans, more preventive care, and
other ideas, but costs continue to climb - some hope for comparative effectiveness research to
find what is really effective (possibly find that less expensive approaches are better)
2010 health care bill
o Cut 575 billion from medicare expenses
o Half from holding down increases in payments to doctors/hospitals - they can be more
efficient
o Reducing payments to medicare advantage plans, special plans that are alternatives to
traditional health care
o Adds coverage to annual checkups
o This does not fix a lot of problems (8tril bil - 2.5tril rev = 5.5 tril of red ink + 585 bil of
cut)
CH8
Two realities
o Americans are not gonna eliminate SS and Medicare - or transform drastically, too
popular, too many people counting on them
o SS and Medicare have to change substantially, cannot afford them the way they are right
now
o 6 useless statements
SS and medicare aren’t on table - entitlements
Life expectancy increased and health care costs are rising
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