"President Obama does propose to reduce overall Medicare spending as a way to offset the cost of extending coverage..."

That sure sounds (in a mathematical sense) like what the NYT claims. In this case case "designated funds" are weasel words. It's all government money. I think this is the kind of thing you would call a paper on if this were a policy you were against.

Erik,

You might consider "designated funds" weasel words, but they also happen to be the law. Medicare has a designated trust fund that pays for a portion of the program (Part A). Under the law, if the trust fund runs out of money, then the program can't pay its bills. You may not like this method funding Medicare, but that is the law.

The idea is to have better health care early in life so fewer people develop awful (and preventable) medical conditions that are expensive to treat.

Both the Medical Care practitioners and the insurance companies know the current system is not sustainable. Journalists (with their employee paid health care) seem to have lost sight of the basics.

I'm afraid I agree with Erik: if Dean knew more about MedPAC, the people supposed to eliminate waste and inefficiency, he might be more skeptical of both their abilities and their compassion.

What disgusts me is the lack of exploration of less paternalistic ways of saving money. But Waxman et al. are in too much of a hurry.

I find the whole debate thoroughly puzzling.

The financing side of US healthcare is a mess and expensive. The provision of healthcare in the US is extremely expensive. A large part of this is due to rent-seeking through AMA, the insurance lobby and the pharma lobby.

US health care consumers, though, are hardly overconsuming. The rate of people getting hospital treatment is about half of many european countries, and stays are shorter. The US has fewer doctors per people, especially GPs, and the average US doctor does fewer consultations. (for example OECD, healthcare at a glance) And it costs twice as much per capita.

The question of who pays is a completely secondary one. No european health care system - dutch or swiss mandated private insurance, german or french social insurance, UK or spanish national health service - could bare that kind of cost.

And no change in the financing system alone can control the costs. Pharma IP rights, doctor admission process, insurance oligopolies, price discrimination and so on can and will survive that change.

So talking about financing modes without addressing the horrendous rent-seeking is like talking about Bernanke without mentioning his bubble-pumping record. The MSM are completely misshaping this debate, and I hope people like Dean Baker will throw this around their heads.

Jorge, I would be interested in "exploration of less paternalistic ways of saving money". What are some of these methods that don't involve denying care?

There would be cost-reducing functions and an overall increase in efficiency (less paperwork, no executive salaries, etc.) if we began a shift towards a democratized, public choice option, which is what 77% of the voting public wants as of 8-20-2009.

The fact that Social Security and Medicare have their own budgets, separate from the general fund, does seem to lead to some very strange distortions. The article says that "Medicare itself faces a financial crisis", but it currently has a surplus in its Trust Fund. Many claim that Social Security faces a crisis, although it has a surplus of more than $2 trillion at the moment.

There is a fiscal problem with these programs only if they are not allowed to go into deficit, or even to break even. How could a deficit in the budgets of Social Security or Medicare at some indeterminate time in the future be a crisis when the general fund is now in debt for over $10 trillion? As far as fiscal matters are concerned this bizarre convention - that the trust funds can't be negative - could be fixed by a simple act of Congress. Why shouldn't these programs go into permanent debt like the government as a whole, in the anticipation of future economic growth making these debts insignificant, or perhaps of another baby boom?

As Dean says here almost every week, the real problem is not in fiscal balances in the entitlement programs, it is in the growth of health care expenses (and also the inequality of distribution in services).

By the way, we don't need another baby boom to fix the demographic trend of a growing older population - immigration of foreign workers, with children, would take care of that. It is odd that this solution is never considered.

skeptonomist, you are usually more skeptical than that. You propose to rely on fictitious future "economic growth", when you know that limited resources and simple arithmetics exclude that "solution" for the time scales we are talking about. The claim that Medicare "is nearly broke" is BS, of course, but replacing it with the "growth will save us" mantra (and its corrolary "deficits are our friends") is not the answer.

skeptonomist, very valid points on both counts.

I think some studies probably have considered simply letting in more highly skilled immigrants.

However, it should be noted that such growth would have to be managed. I.e., we have to make sure we have enough doctors, houses, etc., for such an influx, and have to make sure the skills for which there could be job growth are the ones we bring in (or train people for).

R.W. wrote, ...horrendous rent-seeking...

That pretty much sums up the ills of the US health care system.

Erik,

Well said. Correct on both counts.

| "You might consider "designated funds" weasel words, but they also happen to be the law. Medicare has a designated trust fund that pays for a portion of the program (Part A). Under the law, if the trust fund runs out of money, then the program can't pay its bills. You may not like this method funding Medicare, but that is the law."
(-- DBaker) |

"designated funds", Federal "trust funds", and Congressional "law" are absolutely 'weasel-words'.

Medicare "trust funds" are total financial and legal charades.

Congressional legislated "trusts" vastly differ from normal private sector trusts & accounting laws. In legitimate (non-weasel) trusts, the beneficiary legally owns the income generated by the trust and usually its assets. A trustee, (fiduciary), manages trust assets for the beneficiary. Trustee MUST legally follow the the formal trust requirements -- and can NOT change them unilaterally.

In contrast, the Federal Government 'owns' the assets & income of Federal trust funds. At whim, it can raise/lower future trust fund collections & payouts, spend trust assets as it pleases, change the basic trust rules, or abolish the trust completely... simply with a stroke of the Congressional pen ("law" amendment).

Normal "balances" of Federal trust funds consist of special (non-negotiable) government securities.... phony Federal IOU's to itself. Since the government can write an unlimited amount of bogus IOU's, Medicare Trust Funds will 'never' run out of money.

Have you ever seen Congress fail to raise the 'Federal Debt Ceiling" when they wanted to spend more than they had ?

Maybe I'm wrong, but isn't the Social Security Administration entitled to draw down on the trust fund in order to pay benefits? How is that different the entitlement of any other trust fund beneficiary to draw down on the fund?

Also, I think it's a false characterization to call the firestorm-triggering legislation it would take to abolish the trust fund a "whim".

Speaking of abolishing something, can we abolish the phrase "weasel words"? I think they're borderline ad-hominem, and contain no real information.

I guess my bank claiming to have my funds in an account payable to me at any time is "weasel words", since the actual money the bank holds goes out in loans, pays their salaries and costs, etc. The "weasel words" bit was dumb when Bush used its "they're just IOUs" iteration; it's even dumber with years of education possible since.

At least substitute polecat promises or ferret fakery for weasel words. If we are going to argue at this level, be creative while staying in the same genus for consistency.

The offset between health care reform costs and Medicare trust funds that Erik L. sees as sinister is a long term issue. If the Adminstration can reduce the growth rate of Medicare costs now, it improves the trust fund finances. That, in turn, implies less need to increase revenue growth sometime during the next 10-20 years to keep it solvent. And that, in turn, gives the government more scope to levy taxes to pay for increasing costs for covering the uninsured.

Welcome to the world of income and industrial polarization. America has become a nation of morons.

Now that we're all making $12 per hour, let's go fight to keep the Bush tax cuts.

Piglet:

I don't say that future growth will save the entitlement programs, I say that future growth is at least as likely to "save" these programs as it is to save the Federal Government as a whole, since SS and Medicare are now in the black and the rest of the government owes $10 trillion and counting.

Governments and politicians put out all sorts of projections depending on their objectives. The Bush administration was in the habit of putting out absurdly optimistic projections about deficits, and the most pessimistic projections for Social Security. The growth of health-care/insurance expenses is real - projections of fiscal balances 40 years in the future are red herrings. People need to keep their eyes on things which cost real money - aside from unnecessary health-care cost growth, that would include useless wars and bailing out Wall Street.

I have a quick question for the trust fund doesn't matter crowd.

If the projections prove right, and Medicare Part A doesn't have enough money to pay benefits in 2017, is the claim that beneficiaries will go to court and say "the trust fund doesn't matter," and a judge will say "that's right, the law is irrelevant, the benefits must still be paid." ?

Michael A.Shea- I do not consider it sinister. The point of Dean's original post wasn't about whether or not it was a good idea. It was about if the NYT was giving a misleading impression of the Obama plan. It seemed to me that Dean's later statement about the plan seemed to confirm the NYT but Dean somehow thought the phrase "designated funds" meant that they were wrong.

I see now that the phrase "weasel words" got his back up. That was not my intention.

As for what the judge would say, I assume, if the law remained unchanged, and if the law specifies a certain level of benefits that he would say the benefits must be paid.

I don't think that is the point of the "trust fund doesn't matter crowd". We get that the law has created some kind of obligation. Our complaint (though I hesitate to speak for everyone) is that now matter what the accountants say, ultimately future benefits are paid through taxes that are collected from the same people who pay the taxes that fund every other government activity. We don't see this as the equivalent of a private person putting money in the bank.

Erik,

the law says that if the trust fund doesn't have the money that the scheduled benefits will not be paid. Just so I understand, are you saying that the judge would rule that the law doesn't matter, the benefits should be paid anyhow?

Erik,

I think you're right, in a sense, that ultimately future benefits will be paid from taxes on future earners. It's just that I DO see this as functionally equivalent to a private person putting money in a bank, in the following sense.

If I put money into a bank, my future drawdowns will also be paid by future earners, who will pay money into it in the form of, say, interest. So money gets transfered from future earners, to me. In a way, the bank and its accounts are a mechanism for enshrining those transfers into an obligation. I don't see that as different from the way the SS and Medicare trust funds enshrine a transfer obligation between workers and beneficiaries.

Best,
David

| "I have a quick question for the trust fund doesn't matter crowd... " ? |
[Posted by: Dean Baker]

____________

Federal "law" has long stated that Federal 'trust fund' beneficiaries have no legal right to any anticipated benefit payouts. Any government judge will say the same in 2017.

The U.S. Supreme Court (SCOTUS) ruled at least twice that Social Security "contributions" are merely an ordinary income tax and that any benefits paid are purely at the discretion {whim} of Congress... regardless of any alleged "trust fund" status --those who pay the taxes having no legally enforceable property right to benefits. Same legal status applies to Medicare and other Federal "trust funds".

(Ref: SCOTUS rulings -- Helvering v. Davis, 1937 and Fleming v. Nestor, 1960).

SCOTUS justified Social Security/Medicare taxes {FICA} as being part of the Federal government’s "general taxing power".... having absolutely nothing to do with any standard legal concept of a fiduciary "trust". Any benefits paid {or not paid} are at the complete discretion of Congress... under its "General Welfare" authority.

___________

Federal 'trust-funds' are a total scam... and certainly irrelevant to 'honest' financial accounting and policy.

Wenden,

This is not the question. The current projections show that the Medicare trust fund will be unable to pay scheduled benefits in 2017. The question then is whether Medicare beneficiaries will not get the benefits committed to them.

Several people on this list have said the trust funds don't matter. If that is true, then there must be some way that Medicare beneficiaries would get their benefits after 2017 even though the trust fund is projected to be depleted.

So, either the trust fund matters or there must be some way that they will get the benefits. I'm asking for the mechanism that allows them to get benefits after the trust fund is depleted.

As a technical matter, both the HR II bill and the agreement reached by the White House and the AHA call for certain Medicare payments to hospitals to be reduced and are thus scored as savings by the CBO.

The payments are Disproportionate Share Hospital (DSH) payments and have been part of the Medicare payments to hospitals for inpatient services since 1983. Each hospital is paid differently based on the share of indigent care provided. (Medicaid has a similar concept with different payment structures in each state.) It makes sense that as the uninsured burden falls for hospitals as coverage is expanded, that DSH payments to hospitals would fall.

What makes no sense is that this reduction would limit access for any Medicare beneficiary.

Dean Baker: Wenden is quite correct, BUT should a decision go the other way, may I point out, Any action or transaction concerning a Social Security Number BINDS that action and person to the Social Security Trust Fund.

Mike,

Wendon may be correct, but it has nothing to do with the question. The question is if the trust fund does not have the money to pay benefits, then will the benefits be paid?

If the answer is "no," then the trust fund matters. If the answer is "yes," then tell me the mechanism.

[ "I'm asking for the mechanism that allows them to get benefits after the trust fund is depleted."
(Posted by: Dean Baker) ]

_______________________

The 'mechanism' is normal "U.S. Treasury Dept checks" issued thru the Federal 'Centers for Medicare and Medicaid Services' (CMS) from general Treasury funds. That's how Medicare always does payouts.

Medicare payment checks can be issued for as long as there is money in the U.S. Treasury... and as long as Congress wishes to make Medicare payments.

Again: THERE IS NO MONEY in the MEDICARE TRUST FUNDs !!!

Medicare 'trust-funds' are merely fictional sub-accounts carried on the U.S. Treasury ledger books; the supposed "balances" are bogus Federal government IOU's written to itself. Citizens, doctors & hospitals are not (and can not) be paid from these phantom Medicare trust-fund "balances" -- BECAUSE they are not real financial assets or money.

Medicare benefits, like all other government outlays, must be paid for each year either by general tax receipts, Medicare payroll taxes, borrowing, printing money {inflation}, or some combination of these.

Medicare now spends more than it directly takes in... but it is still fully funded by the other methods above.
If Medicare goes completely broke, the U.S. Treasury could still pick up the entire cost... if Congress wishes.

Future Medicare benefit payments MUST be paid for with future taxes/borrowing/inflation -- Federal politicians do NOT salt away real economic assets to pay for future Medicare outlays.

The key lesson is that Medicare "trust fund balances" are irrelevant, both financially and legally. Until one understands that point... one can not possibly understand the Medicare "system".

Wendon,

First, how do Supreme Court decisions in 1937 and 1960 render non-existent a trust fund created in (say, in the case of Social Security), circa 1983?

Second, you repeat claims like, "there is no money in the...trust fund", "[the trust funds contain] no real financial assets or money", and "politicians do not salt away real economic assets to pay for future...outlays." If there WERE money in the trust fund, if it DID contain real financial assets or money, and if politicians HAD salted away real economic assets, WHAT would those "real economic assets" or "money" be? What form would they take? Would they be bundles of dollar bills? God ingots? Stock certificates? What?

I sometimes think that we are speaking a different language here.

Let me try to put this as simply as possible to see if I can get a straightforward answer from our "trust funds don't matter" folks.

Current projections show that the Medicare trust fund will have no money in 2017. It will be broke. That means that under the law as now written, Medicare beneficiaries will not receive their benefits.

So, if the trust fund does not matter, by what mechanism (i.e. what will happen) to allow Medicare beneficiaries to get their benefits.

Just to repeat, the law says that Medicare cannot pay full benefits, because there is no money in the trust fund, so how will these benefits be paid?

(I know that Congress can change the law. But Congress can change any law. I want to know how given the law as it stands, how will Medicare beneficiaries get their benefits if the trust fund has no money? That should be a simple question.

Dean Baker: If a Social Security Number is REQUIRED anywhere in the transaction then YES the main Social Security Trust Fund Could be liable for ALL costs, should the Medicare account run short.

When the client signs or writes down that number on some Medicare document or contract, then THAT PERSON has AGREED to Social Security taking THEIR SS benefits toward that Medicare documented benifit.

Mike,
is there something written in law that says that the SS trust fund is liable for Medicare's obligations or is this just something that you think should happen?

Dean,

The best way to respond to your "what if the Medicare Trust Fund were depleted" question is the rhetorical "Well, if the king had t**s he'd be queen".

Yes, technically, if the only mechanism for paying Medicare benefits is through the Trust Fund, and if the Trust Fund is depleted, no further funds can be dispensed until the Trust Fund is replenished. But even assuming that premise regarding the Trust Fund being the sole mechanism for payments, the point is that we will decide, either before total depletion of the Trust Fund or upon it occurring, whether or not we want to fund benefits beyond that point, and if we do, we will make whatever adjustments in law are necessary, such as raising FICA Medicare and/or supplementing the flow into the Trust Fund from tax revenues going into the general fund (or more precisely, increasing the flow from general revenues, since "repayment" of Trust Fund surpluses are already diversion of general fund revenues to spending on that program). So the balance in the Trust Fund (for Medicare as for Social Security) is indeed irrelevant. As with all spending and all taxation, we decide what our priorities are, and we adjust accordingly. If we want to spend more on some program that has a dedicated tax and a "trust fund", we are NOT restrained by current projections of "solvency" based on projected revenues per current dedicated tax rates plus "trust funds". If we want to spend less on some such program, we can do so even if the program is projected to be fully "solvent" forever (we would just lower the ongoing tax rate of that dedicated tax to prevent perpetual surpluses).

So "trust fund" balances are just administrative mechanisms and internal bookkeeping, no more significant than how much money I have in my right pocket vs. my left. They have no bearing on how much we spend on a program. If Congress decides, as it will, that we need to continue providing full Medicare benefits without interruption, they will surely provide the funds one way or another, and if the Trust Fund is the mechanism they will supplement it from the general fund as needed, perhaps coupled with some spending cuts as part of the solution, whether the latter comes in the form of reduced rates paid to providers, reduced eligibility (means-testing; higher retirement age), reduced benefits in whatever form (covered treatements/drugs; covered providers; authorization/denial of treatments; % coinsurance or deductible; etc.).

But whatever we do, ultimately "trust fund" balances are irrelevant. We decide how much we want to spend overall and how much on which programs, and how much we want to tax overall and from whom for what, and the rest is just internal bookkeeping.

(And lest there is any confusion, yes, once a dedicated tax is collected, presumably it will be spent on that particular program, and arguably [not necessarily, but arguably] a "trust fund" balance is a minimum amount that must be spent on that program, but for practical purposes, that, too, is irrelevant, since the bulk of funding comes from ongoing revenues from the dedicated tax [plus any supplemental funding from the general fund aside from repayments to the trust fund] rather than from repayment of "trust fund" balances, and we can raise or lower those main revenue sources as we wish in accordance to how much we wish to spend on the program.

Is that answer clear enough for you? Is it really something you hadn't thought of on your own?

okay, then we all agree trust funds matter, just as I always said. Unless Congress changes the law (which it can always do in reference to anything-- for example it can tax people's individual accounts at a 90 percent rate), then if a trust fund is depleted the program is out of money.

Good to know that we are all on the same planet.

Dean,

That's a pretty dumb (or disingenuous, fake dumb) reading of what I wrote, and I find it hard to believe it was a sincere response.

No, as I clearly explained, these "trust funds" DON'T matter. The projected balances -- including projected point of depletion -- for one of these "trust funds" has essentially no bearing on our policy choice of how much to spend on the program in question. As I said, it's about as relevant as how much money I have in one pocket vs. the other.

I may have a policy, as I put money in my pockets in the morning, of designating my right pocket as my "Hamburger Money Pocket" and my left pocket as my "French Fries and Coke Pocket", but if, at the end of the day when I get to McDonalds, I don't have enough money in my right pocket for a hamburger, that doesn't mean I'm going to forgo the hamburger if I have enough money in the left pocket to make up the difference. Maybe I have enough total money to afford all three. Or maybe I only have enough for two of the three, in which case I'll prioritize and pick my top two, but the fact that I ran out of money in my Hamburger Pocket is irrelevant to that prioritization and thus that choice.

What you are saying, nonsensically, is "Ahah! So it DOES matter how much you have in your Hamburger Pocket, because if you DON'T change your policy and use some of the money from the other pocket for the hamburger (or shift it from the other to the Hamburger Pocket, then use it for the hamburger), you can't buy the hamburger!"

Don't you see how silly that is?

And by the way, lest you get away with something you may be implying, the changes that could occur when such a "trust fund" is depleted are not at all limited to sacrifices by beneficiaries (cuts in their benefits or eligibility, higher taxation of their benefits [essentially a cut in benefits]) or net increases in overall federal spending or in overall taxation. We could offset the incremental spending on Medicare (or SS) with cuts in other spending (e.g., More Medicare, less Social Security, or more of both and less discretionary spending). We can also, of course, borrow more, although that must eventually be paid for. Even if we, just to conform to the current mechanism as an administrative and bookkeeping practice, funded the incremental spending via an increase in the dedicated tax (FICA), it could still be revenue-neutral (i.e., no increase in overall taxation) if we offset it with cuts in other taxes.

The point is, the finances of these programs are simply part of the whole and have no real significance other than as administrative matters. We have overall spending and overall revenues, and we decide on the amounts of each and the allocation of each based on what we consider good economics and on our values and priorities. Our decision on to what extent to fund Medicare is one of those decisions, and the timing of projected depletion of the "trust fund" is irrelevant to that decision. Again, if we want to fund Medicare beyond point of projected depletion, we will (and we do and we will), just like if a hamburger and Coke are my top two priorities, I'll forgo the fries if I don't have enough for all three (or I'll borrow for it and pay later), and it would be silly (and disingenuous) for you to persist in implying that the "balance" of funds in my Hamburger Pocket plays a critical role in that decision just because I'd have to shift money from one pocket to the other (or just pay from a different pocket) to "fund" the hamburger.

I have to assume you get what I'm saying. Will you acknowledge at this point that these "trust funds" do not have the significance you are attaching to them? That you are making a technical point with no practical significance, and that is misleading since it defies common sense and is dependent on irrational thinking on an immense scale?

Brooks,

i really don't care how you do your accounting or how you think the government should do its accounting, I just am glad that we agree on how the government DOES its accounting.

Dean,

Oh come on. You are making implications regarding policy choices and practical effects, not representing your point as a mere bit of technical accounting minutiae without practical significance.

Are you going to address anything I've said? Are you going to answer my questions? Or are you going to just keep pointing to something that is (I assume) technically valid but practically insignificant, and continue to mislead people about its significance?

I'm saying that projected points of depletion of these "trust funds" are essentially irrelevant to our policy choices of how much to spend on those programs, since, if we want to spend more on those programs, we can shift funds from general fund revenues to these programs one way or another (directly or via shifts in taxation). Similarly, if these programs were, hypothetically, projected to be "solvent" or "fully funded" forever, we could still reduce projected spending on them (and without defaulting on any "trust fund" bonds) simply by shifting taxation away from them and more to the general fund. So the finances of these programs as matters of internal bookkeeping are irrelevant to our choice of how much (or how little) to spend on them. Will you acknowledge this simple, central fact? If not, tell me why you think it's not true.

Dean Baker: There really is NO guarantee of payment of anything in the Social Security Act. Public pressure on Congress gets the client what little they get today. Who knows what Congress will decide tomorrow?

Well, seems to be a good chance Dean is not going to respond in any meaningful way to my questions and arguments, so I'll just point out what we've learned from this post and thread.

Some people are concerned that the healthcare they receive under Medicare may be adversely affected due to healthcare "reform", and they have at least arguably (and I'd say more than just arguably) good reason for this concern, since projected cuts in Medicare spending could adversely affect the care they receive, perhaps due to cuts in projected Medicare spending and/or due to a worsening of our long-term fiscal imbalance caused by this "reform".

Dean throws out a silly, nonsensical argument that nothing in the "reform" legislation will adversely affect the Medicare Trust Fund balance, and in fact it will actually improve that balance, and therefore (he strangely contends via non sequitur) no one has reason to worry at all that "reform" will cause, directly or indirectly, an adverse effect on the healthcare they receive under Medicare.

I reveal this nonsensical and awfully misleading argument (to use the term loosely) for what it is: nonsense.

Dean has no substantive response, which isn't surprising, because he can't back up nonsense with a valid argument, and he never admits when he has made such an error (on the contrary, he sometimes, as here, responds with evasive, largely irrelevant comments that do not substantively address the point that has been made).

And that's your recap, folks. Although I'd be pleasantly surprised if Dean suddenly decides to offer some substantive, relevant response.

------

For what it's worth, as I note from time to time, at least Dean is a step above the likes of Mark Thoma, Brad Delong, the editors at Redstate.com, and others running (mostly) hyperpartisan echo chambers who engage in various forms of censorship of legitimate challenges to their posts and their "side's" talking points. I still think it's awful that Dean spins and distorts and misleads in support of policies he prefers, but at least he doesn't censor opposing arguments and tough criticism of his posts as too many bloggers do.

___________

"Brooks"-- all well said !

___________

This discussion is absurd.

"ultimately future benefits are paid through taxes that are collected from the same people who pay the taxes that fund every other government activity. We don't see this as the equivalent of a private person putting money in the bank."

The assumption here is that a bank account is something you can rely on whereas a government trust fund is not. This is crazy. Remember that without government guarantees and bailouts, most bank accounts with US banks would by now be worthless databse entries. Somebody here pointed out that government benefits are not guaranteed. Well, neither are private investments. NOTHING IS GUARANTEED. Anybody who, after the most recent financial crisis, would rather rely on private financial institutions than on Social Security to provide for their retirement, is either crazy or super-rich.

piglet,

No, you are misunderstanding completely. These "trust funds" have no practical significance -- no more than how much money I have in my right pocket as opposed to my left pocket. The balances in these "trust funds", at most (and Jim Glass has, elsewhere, made an apparently good case that even this much cannot be said), represent a minimum amount that must eventually be spent on the respective programs. For all practical purposes, that's meaningless, because it is inconceivable that we would spend anywhere near that little on those programs, and the bulk of funding will come from ongoing taxation, which we can raise or lower as we wish to adjust to however much we wish to spend on those programs.

For example, the SS Trust Funds have less than $3 trillion. Obviously, if we chose to, we could cut back drastically on projected SS spending without coming anywhere near spending that little over the next couple of decades. And if we chose to spend so little on SS that FICA SS revenues were generating perpetual surpluses, we could just reduce FICA SS taxation. Conversely, if one of these "trust funds" is on track to become depleted, we can either raise the dedicated tax (FICA) or divert more funds from the general fund to cover the additional spending. And with any of these tax changes, they could be offset by opposite changes in other taxes if we wanted to achieve revenue-neutrality and keep projected overall revenues unchanged.

If the above is too technical or for any other reason you need clarification, let me know what is unclear to you and I'll explain.