“contrary to what Musk claimed, tackling “waste, fraud, and abuse” cannot possibly generate enough savings to eliminate the annual budget deficit, which was nearly $2 trillion in fiscal year 2024, let alone reduce the ever-climbing national debt, which currently exceeds $36 trillion, including $29 trillion in debt held by the public.”
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“Even if Musk succeeds in curtailing “waste, fraud, and abuse,” there is only so much he can accomplish by focusing on “driving change through executive action based on existing legislation,” which is how he described his agenda last November. Any serious attempt to reduce federal borrowing will require new legislation that addresses the main drivers of federal spending, including Social Security, Medicare, and the military budget. But the platform on which Trump ran takes all those things off the table while promising pricey policies that will only exacerbate the problem that Musk decries.”
A main point to having private versions of Medicare ran by for-profit health insurance companies as an alternative option to Traditional Medicare is to save the taxpayer money by taking advantage of efficiencies gained in private competition and private flexibility while also
“First, it’s not as if there is some secret knowledge to be uncovered by the DOGE when it comes to fixing the rampant inefficiencies of the federal government. Those Medicare and Medicaid overpayments are documented annually, for example. The Government Accountability Office and various inspectors general file regular reports. The Congressional Budget Office maintains a list of things that could be cut to reduce the deficit. Various members of Congress—most prominently, Sen. Rand Paul (R–Ky.)—periodically publish lists of silly, wasteful, or dubious government spending.
What’s lacking, in short, is not ideas but the political will to act on them.
The amount of political will is going to matter, because that is very relevant to the second point: Unless Trump is willing to set aside his promise not to touch America’s entitlement programs, the DOGE will be unable to follow through on its mandate.
Again, look at those improper payments made by Medicare and Medicaid. The $101.4 billion of improper payments the two entitlements made in 2023 accounted for 40 percent of all improper payments across the entire government that year, according to the GAO. That same GAO report suggested a simple change in how Medicaid bills some of its services that, if implemented, could save $141 billion over 10 years.”
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“The same problem pops up when you start looking at other big swings that the DOGE could take. Seven of the top nine suggestions made by the Congressional Budget Office’s annual report on “options for reducing the deficit” involve changing elements of America’s three federal entitlement programs. Capping Medicaid spending, increasing premiums for Medicare Part B, or reconfiguring how Social Security benefits are paid to wealthier Americans each could save hundreds of billions of dollars over the next decade. None will be possible as long as entitlement reform is off the table.
All of this is a function of the federal government’s fiscal reality: Entitlements are the biggest and fastest-growing segment of the budget. This year, so-called “mandatory spending”—primarily Social Security, Medicare, and Medicaid, along with a few other government-funded health care programs—will cost nearly $4 trillion, while all discretionary spending will total less than $1.8 trillion.
Musk has promised $2 trillion in spending cuts, but he could propose eliminating all discretionary spending—good luck zeroing out the Pentagon—and would still fall short of that goal. It is impossible to be serious about fiscal reform while promising not to touch the entitlement programs.”