The case for performing bariatric surgery on government

According to my American Heritage dictionary, bariatrics is “… [t]he branch of medicine that deals with the causes, prevention, and treatment of obesity.” A recent study from Cornell University found that obesity among both children and adults is a national crisis, accounting for more than 20 percent of all U.S. health-care spending, twice the amount previously acknowledged. Bariatric surgery is a last resort considered only after obese candidates have tried and failed to lose weight through diet and exercise.

Obesity in government has paralleled the rise of obesity in the U.S. population. The only difference is that the unit of measure — pounds — is replaced by dollars and people.

How do I define government obesity? Using 2011 dollars as the constant, the federal government in 1960 spent $712 billion, or 18 percent of GDP. In 1970, the federal budget tipped the scales at $1.2 trillion before rising to $1.7 trillion in 1980, 21 percent of GDP. In 1990, the numbers rose to $2.3 trillion, in 2000, $2.5 trillion, and in 2007, $3.3 trillion. By 2010, federal expenditures approached $4 trillion dollars, or a whopping 25 percent of GDP.

The federal government, however, was not the only branch adding avoirdupois. State and local governments, collectively, in 1960 spent $384 billion, rising to $2.3 trillion by 2009. The percent of GDP consumed by the states rose from around 9 percent to 15 percent during that period. Adding federal, state, and local spending together, government expenditures jumped from 27 percent of GDP to 42 percent. That’s a 56 percent “weight” increase.

Hard to get your arms around measurements in the trillions? Converting total expenditures to the personal means that government at all levels annually spends $20,000 for every American man, woman, and child. While you are trying to digest that tidbit, let me present you with another weighty figure: the federal debt currently on the books. Each resident of our country carries $49,000 as his/her share, which combined with the annual operating expense, makes each of us liable on the Poltenson bariatric index for around $70,000. (I won’t burden you with the official state debt obligation or the multiple government promises carried off the books.)

The rate of government obesity is rising rapidly, another worrying sign. In 2008, the federal debt stood at $10.7 trillion; in 2012, it reached $15.6 trillion. The spike in just four years exceeded all the debt accumulated in the first 200 years of the Republic. Our per-capita spending and borrowing binge has not only placed us ahead of advanced, European “socialist” countries like Germany, France, and the United Kingdom but also ahead of most Latin American countries, which we used to deride as banana republics.

There is another bariatric unit of measure to consider besides dollars — people, both as employees and as beneficiaries. Today, there are 20 million Americans who work either full time or part time for the government. Of these, only 2 million are on the federal payroll. The rest work for state and local governments and for businesses dependent on government contracts or which administer programs supported by government grants and contracts. According to a 2009 Internal Revenue Service report, 

13.5 million Americans are employed in nonprofit corporations. This sector spent $1.9 trillion that year with one-third of the funds originating from government. Over the last quarter century, government grants to nonprofit corporations have tripled, adjusting for inflation.

People are also beneficiaries of government largesse. Today, 60 million Americans receive Medicaid benefits, 54 million collect Social Security (projected to rise to 90 million in 2035), 48 million are covered by Medicare, 45 million depend on food stamps, and 7 million are either in prison, on probation, or on parole. Clearly, millions have become dependent on the intake of government calories, including more than half of all Americans over 65 who receive a majority of their income from Social Security.

We’ve been here before. When the U.S. entered World War II, the country’s national debt stood at $49 billion or 43.8 percent of GDP. At the end of the war in 1945, the debt ballooned to $258 billion, 116 percent of GDP. Ten years later, the national debt stood at 59.5 percent of GDP, a result of economic growth and fiscal restraint. Our neighbor to the north wrestled with government obesity in the 1990s and brought Canada back to a path of financial sustainability. More recently, state governments like Indiana have shed pounds in order to grow their economies and live within their income.

What’s different today is that much of government is “hidden” in plain sight. While government employment rolls may not be expanding, government’s reach is everywhere in terms of those it’s employing and those who receive direct benefits. Turning off the spigot is never easy, but don’t underestimate the difficulty. The Bowles-Simpson committee told us to be bold and cut $4 trillion from the federal budget over 10 years. Four trillion seems to be the accepted marker to put the brakes on big government. Yet a 2010 report by the National Research Council and the National Academy of Public Administration says that reining in our obesity requires cutting Social Security for 70 percent of retirees, cutting spending on Medicare and Medicaid by 20 percent each, and trimming all federal programs by another 20 percent. This effort would only bring federal spending back to the 21 percent-of-GDP level.

The nation has tried fiscal dieting and exercise for half a century. It hasn’t worked. It’s time for the citizenry to accept that only a painful, gastric operation will correct our government corpulence. James Madison reminded us two centuries ago that enlightened statesmen will not always be at the helm. There is no better reminder that the electorate has the power to put enlightened statesmen at the helm who can suppress our insatiable appetite for big government.

We know the causes of government obesity, and we know how to treat it. Now we need the scalpel and those with the will and knowledge to wield it.       

Norman Poltenson is publisher of The Central New York Business Journal. Contact him at npoltenson@cnybj.com