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Making Tough Choices

GAO-07-1239CG Published: Sep 08, 2007. Publicly Released: Sep 08, 2007.
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Highlights

This speech was given by the Comptroller General before the AARP Life@50+ 2007 Event and Expo in Boston, Massachusetts, on September 8, 2007. As Comptroller General of the United States and head of the GAO, I and my fellow GAO colleagues are in the truth, transparency, and accountability business. Importantly, at GAO, we are professionals and not politicians. Therefore, I'm here today to tell you the truth about several important issues. Furthermore, in the past six years alone, our nation's total liabilities and unfunded commitments for Social Security and Medicare have grown from about $20 trillion to over $50 trillion, of which about $8 trillion relates to the new Medicare prescription drug bill. State and local governments also face long-range fiscal challenges due to Medicaid, unfunded retiree health plans, underfunded pension plans, and deferred maintenance costs on key infrastructure. Therefore, our real fiscal challenge is national versus just federal in nature. More recent budget trends are also telling. In 1966 Medicare and Medicaid represented only about 1 percent of the federal budget. In 2006 they represented 19 percent and their portion of the federal budget is on the rise. In addition, Medicaid represents the fastest growing cost for most states. While the Social Security, Medicare, and Medicaid programs are important and will not go away, they do not relate to functions that are expressly reserved for the federal government under the Constitution. The plain but simple truth is that a status quo path for our federal government is imprudent, unsustainable, and arguably immoral. As George Washington once said, we should avoid "ungenerously throwing upon posterity the burden that we ourselves ought to bear." These are timeless words of wisdom that more policymakers should both hear and heed. Given these facts, we need to start making tough choices sooner versus later if we want to keep America great and make sure that our future is better than our past. After all, that's what leadership and stewardship are all about.

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Balanced budgetsBudget administrationBudget deficitDeficit reductionEconomic analysisEconomic growthEconomic policiesFederal social security programsFinancial analysisFinancial managementFiscal policiesHealth care cost controlHealth care programsHealth care reformIntergovernmental fiscal relationsPerformance measuresProgram evaluationState governmentsStrategic planning