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Mark R. Kennedy

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Graduate Economics: Balancing the Budget Without Benefit Cuts or Tax Increases

Posted: 05/16/2012 2:54 pm

Amid the celebration of Mother's Day and a child's college graduation this past weekend, there emerged a kernel of wisdom that can break the gridlock, preserve our nation's strength, and allow America to continue to lead the world to peace and prosperity.

Dramatic? Admittedly. True? Absolutely.

This powerful insight is simply that incentives work.

Sunday's University of Dallas graduation ceremony was a powerful witness to a wonderful mother on Mother's Day. My wife and I watched our youngest graduate from college, enjoyed the company of all four of our children together, witnessed all four complete college in four years, and paid our last tuition payment! Oh, happy days!

Without taking anything away from my wife's nurturing guidance and the talent and drive of our children, my role also played a vital part: I exercised graduate economics! I have great children. America is full of wonderful people. Yet well-defined and well-intentioned incentives can powerfully and positively impact behavior for even the best people.

I negotiated with my children before they were born (it's easier that way) that if there was no dating before they were 16, Dad would help with the first four years of any college where they were accepted. The fifth year was on them. Amazingly, they all met the criteria and completed their degrees in four years at great schools -- Notre Dame, Michigan, and the University of Dallas.

This approach of clearly defined incentives, if applied to many government services, would go a long way in solving our deficit.

How could incentives break the stalemate in Congress and save the union? The simple answer is in their application to health care. In making the case for health care reform, President Obama said, "Put simply, our health care program is our deficit problem. Nothing else even comes close." As a former CFO, I absolutely agree. California Gov. Jerry Brown recently outlined his budget prescription by warning citizens that he had no choice but to cut spending and raise taxes. I absolutely disagree. Regrettably, like so many politicians, Gov. Brown has ignored the power of incentive in his own state. As a result, many will suffer.

California's Safeway grocery stores estimate that applying incentives to health care could result in a 40 percent reduction of direct health care spending in the United States. This could balance the budget without benefit cuts or tax increases.

How can this be? The problem of rising health care costs could be solved by allowing businesses to apply their well-honed expertise in offering customers the opportunity to have more for less -- in this case, better health at a lower cost. Individuals also must have incentives to make healthy lifestyle choices.

From where do these gigantic savings come? First, benefits would spring from improved transparency. Safeway's study revealed wide differences in the cost of medical care. An easy comparison of providers' cost and quality, combined with an incentive to seek out the best deal, could yield dramatic results for consumers.

Safeway found that substantive savings also would come from better lifestyle choices. By its estimates,

1. 70 percent of health care costs are driven by behavior
2. four chronic conditions are responsible for 74 percent of health care costs, and
3. obesity is a driving factor in all four chronic conditions.

Taken together, this means that the biggest driver of health care costs is obesity, which is largely behavioral and reversible. Kudos to Michelle Obama for shining a light on this priority!

Safeway used these findings to implement a health care plan that rewarded people with incentives and lowered premiums based on progress in four measures:

• Weight
• Tobacco use
• Control of cholesterol levels
• Control of blood pressure levels

Safeway achieved lower health care costs at a time when others were experiencing significant increases. And Safeway employees became healthier over that same period.

Unleashing the power of choices in health care for private companies and government programs could dramatically reduce health care costs while improving the health of the overall population and the competitiveness of the national economy.

Providing incentives to my children helped me to balance my checkbook. By doing the same, America could remain solvent with a lot less pain to beneficiaries and taxpayers. Perhaps Gov. Brown and other politicians need a remedial course in incentive economics.

Mark R. Kennedy leads George Washington University's Graduate School of Political Management and is Chairman of the Economic Club of Minnesota. He previously served three terms in the U.S. House of Representatives and was Senior Vice President and Treasurer of Federated Department Stores (now Macy's).

 

Follow Mark R. Kennedy on Twitter: www.twitter.com/MNMarkKennedy

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Amid the celebration of Mother's Day and a child's college graduation this past weekend, there emerged a kernel of wisdom that can break the gridlock, preserve our nation's strength, and allow America...
Amid the celebration of Mother's Day and a child's college graduation this past weekend, there emerged a kernel of wisdom that can break the gridlock, preserve our nation's strength, and allow America...
 
 
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Allene Stucki
05:04 PM on 05/16/2012
One half of the people who frequent this forum are screaming about the hunger that is supposedly rampant in America, and the other half are screaming about obesity. Isn't there any 'happy medium' left?
10:45 PM on 05/17/2012
Indeed - a very 'happy medium' if some ate less, and left more for those who are hungry!
04:10 PM on 05/16/2012
"Taken together, this means that the biggest driver of health care costs is obesity, which is largely behavioral and reversible. Kudos to Michelle Obama for shining a light on this priority!"

Quite wrong. See this article here: This Is Why You're Fat: The 2012 Farm Bill and the Real Obesity Lobby. Our choices are limited through our personal economics. Many cannot afford to eat healthy and too much of what we are offered on a convenient basis is determined by it's profitability to the vendor, which means it will be low nutritional value, high carbohydrate grain based food.
10:04 PM on 05/16/2012
There are many contributors to America leading the world in obesity. There is no doubt that the incentives in the Farm Bill warrant review, but any solution to healthier lifestyles begins with individuals taking responsibility for their own choices.
10:49 PM on 05/17/2012
A couple articles you may find interesting: http://www.npr.org/blogs/thesalt/2012/05/16/152823181/how-to-make-healthy-eating-easier-on-the-wallet-change-the-calculation. Here's the full USDA study: http://www.ers.usda.gov/Publications/EIB96/EIB96_Reportsummary.pdf. I thought the most interesting finding was this:

"When measured on the basis of edible weight or average portion size, grains, vegetables, fruit, and dairy foods are less expensive than most protein foods and foods high in saturated fat, added sugars, and/or sodium."
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wmnorton
Moderate where moderate used to be
03:42 PM on 05/16/2012
As someone who is way over weight and losing slowly, your idea has merit, you did not offer any choices for how to implement the plan. Any ideas on that?
09:54 PM on 05/16/2012
Safeway gave a lower premium to those like you that made progress towards a healthier lifestyle. More employers doing the same and the government offering incentives for healthy lifestyles could have a big impact.
10:00 PM on 05/16/2012
Safeway charges a lower premium to not only those that have lower BMI's, but also those who made progress on meeting goals to live healthier lifestyles. Smoking also has a big impact. Safeway found that they were not permitted as a self-insured company under ERISA to charge those that smoked the full extra cost of insuring smokers. As such, it is current federal policy that businesses are required to make non-smokers subsidize smokers. Therefore, there is an federally imposed subsidy to smoke.
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wmnorton
Moderate where moderate used to be
11:10 PM on 05/16/2012
Not as you would think, actually smokers subsidies non-smolers, Non smokers last longer so they keep getting diseases that need to be treated, smokers on the other hand get lung cancer or heart disease and die quickly. That is why the insurance companies have it the way it is, it is cheaper for them in the long run. Yes I know you said federal subsidy but who do you think writes the rules, hint it is the industry that is not subject to Anti- trust laws, that is not baseball.
Thanks for the info on how Safeway works it's insurance