American Academy of Emergency Medicine

Law of the Land

Dear Dr. Walker:

Reading your article in the latest edition of Common Sense I beg to differ on your claim that entitlement spending consumes almost 60% of the federal budget. figures.

I think that dubious honor goes to Military Expenditures.  If you meant discretionary spending perhaps the 60% figure is correct but do you not think it only honest and fair to so state this?

You sound like our Presidential candidates who bandy numbers and figures around without regard to what is truthful and what is misleading.

James Koss, MD FAAEM

Dr. Koss:

Thank you for responding to my column, "Law of the Land". Even though you disagree with me, I appreciate it very much. I hope the web-based "Letters to the Editor" section of Common Sense will become a popular forum for spirited, cordial debate among Academy members, and we can't have a good argument unless people argue!

The United States spends more money on defense than I can comprehend. We spend more than the rest of NATO, China, Russia, North Korea, South Korea, Iran, and Israel -- combined. In fact, we spend roughly as much on defense as every other nation in the world -- combined. Does that mean military spending is the largest category in the federal budget? Not at all. We spend so much on entitlements (mainly Medicare, Medicaid, and Social Security) that military spending isn't even close. As you can see from this chart from The Washington Post, which is hardly known for conservative bias, in 2010 entitlements consumed 57% of the federal budget (http://www.washingtonpost.com/wp-srv/special/politics/budget-2010/). Defense spending accounted for 19%, interest on the federal debt accounted for 5%, and discretionary spending took the remaining 19%.

I have found that most budget analysts don't include veterans' benefits in defense spending, which I regard as a mistake. If that is included in defense spending the percentage of the budget going to defense goes up by about 3%. That still pales in comparison to entitlement spending, and entitlements will explode over the next few years as the population ages -- and as Medicaid expands under Obamacare. Interest on the debt has already started rising, and like entitlement spending will explode in the near future.

Since the federal government currently borrows about 40% of every dollar it spends, both military and discretionary spending (everything else the government does -- such as environmental protection, law enforcement, interstate highways, national parks and forests, food and drug regulation -- everything) could be totally eliminated without balancing the budget. Although other analysts come up with slightly different figures, the numbers are close no matter who you trust to accurately analyze the federal budget. Here are other websites you can check for verification: http://www.factcheck.org/2011/07/fiscal-factcheck/, http://www.cbpp.org/cms/index.cfm?fa=view&id=1258, http://www.fas.org/sgp/crs/misc/RL33074.pdf, and http://www.cato.org/pubs/handbook/hb111/hb111-4.pdf (see figure 4.1).

While politicians frequently "bandy numbers and figures around without regard to what is truthful and what is misleading", I do not. Any American who loves his country should be frightened by these facts -- especially any American who pays income taxes.

The Editor

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