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I work @ the nih, formerly at the cdc... can I politely ask why they were optimistic? When I first started seeing rumblings about this a year ago, my first thou

I work @ the nih, formerly at the cdc... can I politely ask why they were optimistic? When I first started seeing rumblings about this a year ago, my first thought was "the deficit is entitlement spending; this is a political problem, not a bureaucratic one". Anyways, like you, I genuinely wish the DOGEsters would have asked us what we thought was inefficient about gov work. I have been in many meetings where 90% of it was spent complaining about compliance. I personally hate the USAJOBS system. Like any big company, there's a lot that can be improved. Instead, they went scorched-Earth and assumed we were all deep state leeches. Elon acted like he had just done a leveraged buyout of the US government. For me, he remains the most embarrassing man on Earth.

stackskipton 11mo ago
Agreed, anyone who just glanced at federal budget would know, it's Social Security/Medicare/Medicaid/Defense. Touching anything else is just tinkering at edges.
- phantasmish 11mo ago
  Social Security comes from its own budget paid by a separate tax. When its savings (accrued by that same dedicated tax) runs dry it has to cut spending. It will not, under current law, deficit spend. The only problem to solve there is whether we want to adjust its funding so benefit levels don’t drop in the nearish future. People bringing it up in discussions of the general budget usually either don’t understand how it’s funded, or are presenting it inaccurately because they want to end it.
  - biophysboy 11mo ago
    This is part of what I meant by "political problem". People see the mainline deficit number without thinking about the underlying stocks/flows of the system. There are feedback loops embedded in this that are unavoidably political (nobody wants to take grandma's retirement money). There's no "founder's mentality" that can avoid this basic fact.
    - wolfcola 11mo ago
      Except you blamed “entitlement spending” for the deficit, which the comment above clearly disproves.
      - biophysboy 11mo ago
        I “blame” it only in the sense that it’s part of the negative cash flow, even if it has its own dedicated pool of cash. I don’t use the term “entitlement” pejoratively. But I am not a “panic about the deficit” guy. There’s a lot of trivial things we could do: rethink fee for service, negotiate more w/ providers, raise taxes, etc
- amatwl 11mo ago
  The United States government is an insurance company with an army.
- pabs3 11mo ago
  > Defense American soldiers I've met overseas seemed to think the defense department is mainly a social healthcare/education/jobs program. Perhaps these need to be split from the defense budget, and applied to the entire population.
- throw0101a 11mo ago
  > Agreed, anyone who just glanced at federal budget would know, it's Social Security/Medicare/Medicaid/Defense. It's almost a trope/meme to label the US government as "an insurance company with an army": > Think of the federal government as a gigantic insurance company (with a sideline business in national defense and homeland security), which does its accounting on a cash basis, only counting premiums and payouts as they go in and out the door. An insurance company with cash accounting . . . is an accident waiting to happen. * Peter Fisher, 2003, Bust Treasury official; https://nsjonline.com/article/2017/08/hill-the-insurance-company-with-an-army/ https://nsjonline.com/article/2017/08/hill-the-insurance-com...
  - robocat 11mo ago
    I struggle to understand the metaphor. From link: The U.S. federal budget is now 50 percent consumed by spending for Social Security, a social insurance program; Medicare and Medicaid, two of the largest health insurance programs in the country; and various other social safety net programs which act as insurance plans as well. Except for one thing. None of these federal insurance programs operate as licensed sanctioned insurance plans as we see in the private sector where money is collected from the individual and invested or managed in a fiduciary manner to build assets to pay for claims in the future. Voters think they've saved: "I paid my taxes all my life". But what would it mean for a government to save money over decades? How else can a government run except on a cash basis? Aside: I belong to a non-profit health insurance co-op and a non-profit car insurance - they run by matching payouts to premiums and limiting what they cover (e.g. Southern Cross Healthcare is extra healthcare on top of what the NZ government provides). Edit: ooops, I've just noticed my car insurer AMI Insurance which was a mutual insurance company before the Canterbury earthquakes went bust and the government sold it (now part of IAG).
    - throw0101a 11mo ago
      > But what would it mean for a government to save money over decades? * https://en.wikipedia.org/wiki/Social_Security_Trust_Fund https://en.wikipedia.org/wiki/Social_Security_Trust_Fund The SSA had actually been collecting 'extra' money (from Baby Boomers) for awhile now and putting off to the side, but that extra income stopped a while ago, and the trust fund where it was stored was being tapped to keep benefits up. The "shortage" in Social Security that is sometimes in the US news is the estimated time when the 'extra' funds run out, and benefits will only be covered in cashflows. And this is not sudden thing: many government pension systems in the world are facing similar situations. The politicians in the US have not done anything about (for decades), whereas Canada did decide to change their system: * https://en.wikipedia.org/wiki/Canada_Pension_Plan#1998_reforms https://en.wikipedia.org/wiki/Canada_Pension_Plan#1998_refor... Other countries are facing debates (France, Denmark, etc).
AnthonyMouse 11mo ago
> "the deficit is entitlement spending; this is a political problem, not a bureaucratic one". Sort of? Medicare is about a trillion dollars, but what percentage of that is actually helping people and how much is going to unnecessary tests or fraud or overpaying for things? If e.g. HHS issues some bad rules that increase healthcare costs, that increases the cost of Medicare and Medicaid and the VA, but if you're doing it properly you're not ignoring that part of HHS just because its regulatory budget is comparatively smaller when it's doing things that incur billions in indirect costs. Moreover, you can't find a trillion dollars in a program that costs a million dollars, but if it costs a million dollars and isn't worth a million dollars then that's not a reason to keep it. And nobody can claim with a straight face that the military budget contains no inefficiencies, but that's not entitlement spending. > Instead, they went scorched-Earth and assumed we were all deep state leeches. The general problem is that nobody wants their thing to be the thing that gets cut even when it's the thing that ought to be, and then how do you tell if something is actually important when somebody will claim that everything is? It's legitimately a hard problem and DOGE did not succeed in solving it, but that means we need a solution that actually works or people are going to keep coming at you with knives drawn because the status quo is untenable.
- estearum 11mo ago
  They could just go after Medicare fraud (committed largely by extremely wealthy corporations in extremely detectable ways), get an easy $100B or so under their belt, then reconvene on next steps. That'd require them to be willing to go after their grifter buddies, and to understand anything about our institutions other than what they read on Twitter. > The general problem is that nobody wants their thing to be the thing that gets cut even when it's the thing that ought to be, and then how do you tell if something is actually important when somebody will claim that everything is? We have a process for this. It's called appropriations. It happens in Congress.
  - AnthonyMouse 11mo ago
    > They could just go after Medicare fraud (committed largely by extremely wealthy corporations in extremely detectable ways), get an easy $100B or so under their belt My impression of the 2025 feud between Musk and Trump is that Musk actually wanted to do stuff like that and Trump wouldn't do it. And they should do it, but this year's deficit is ~$1.8T despite federal receipts pushing the record high in real dollars per capita (as usual) and consistent with historical norms as a percent of GDP. So what about the other $1.7T? > We have a process for this. It's called appropriations. It happens in Congress. We also have some strong empirical evidence that the outcome of that process is huge deficits, so something has to change if it's not to stay the same.
edm0nd 11mo ago
Because I think everyone agrees there is extreme amounts of waste in government spending and budgets. I was hopeful when they announced DOGE but imo they went about it entirely wrong.
deleted 11mo ago
[deleted]

stackskipton 11mo ago

Agreed, anyone who just glanced at federal budget would know, it's Social Security/Medicare/Medicaid/Defense. Touching anything else is just tinkering at edges.

phantasmish 11mo ago
Social Security comes from its own budget paid by a separate tax. When its savings (accrued by that same dedicated tax) runs dry it has to cut spending. It will not, under current law, deficit spend. The only problem to solve there is whether we want to adjust its funding so benefit levels don’t drop in the nearish future. People bringing it up in discussions of the general budget usually either don’t understand how it’s funded, or are presenting it inaccurately because they want to end it.
- biophysboy 11mo ago
  This is part of what I meant by "political problem". People see the mainline deficit number without thinking about the underlying stocks/flows of the system. There are feedback loops embedded in this that are unavoidably political (nobody wants to take grandma's retirement money). There's no "founder's mentality" that can avoid this basic fact.
  - wolfcola 11mo ago
    Except you blamed “entitlement spending” for the deficit, which the comment above clearly disproves.
    - biophysboy 11mo ago
      I “blame” it only in the sense that it’s part of the negative cash flow, even if it has its own dedicated pool of cash. I don’t use the term “entitlement” pejoratively. But I am not a “panic about the deficit” guy. There’s a lot of trivial things we could do: rethink fee for service, negotiate more w/ providers, raise taxes, etc
amatwl 11mo ago
The United States government is an insurance company with an army.
pabs3 11mo ago
> Defense American soldiers I've met overseas seemed to think the defense department is mainly a social healthcare/education/jobs program. Perhaps these need to be split from the defense budget, and applied to the entire population.
throw0101a 11mo ago
> Agreed, anyone who just glanced at federal budget would know, it's Social Security/Medicare/Medicaid/Defense. It's almost a trope/meme to label the US government as "an insurance company with an army": > Think of the federal government as a gigantic insurance company (with a sideline business in national defense and homeland security), which does its accounting on a cash basis, only counting premiums and payouts as they go in and out the door. An insurance company with cash accounting . . . is an accident waiting to happen. * Peter Fisher, 2003, Bust Treasury official; https://nsjonline.com/article/2017/08/hill-the-insurance-company-with-an-army/ https://nsjonline.com/article/2017/08/hill-the-insurance-com...
- robocat 11mo ago
  I struggle to understand the metaphor. From link: The U.S. federal budget is now 50 percent consumed by spending for Social Security, a social insurance program; Medicare and Medicaid, two of the largest health insurance programs in the country; and various other social safety net programs which act as insurance plans as well. Except for one thing. None of these federal insurance programs operate as licensed sanctioned insurance plans as we see in the private sector where money is collected from the individual and invested or managed in a fiduciary manner to build assets to pay for claims in the future. Voters think they've saved: "I paid my taxes all my life". But what would it mean for a government to save money over decades? How else can a government run except on a cash basis? Aside: I belong to a non-profit health insurance co-op and a non-profit car insurance - they run by matching payouts to premiums and limiting what they cover (e.g. Southern Cross Healthcare is extra healthcare on top of what the NZ government provides). Edit: ooops, I've just noticed my car insurer AMI Insurance which was a mutual insurance company before the Canterbury earthquakes went bust and the government sold it (now part of IAG).
  - throw0101a 11mo ago
    > But what would it mean for a government to save money over decades? * https://en.wikipedia.org/wiki/Social_Security_Trust_Fund https://en.wikipedia.org/wiki/Social_Security_Trust_Fund The SSA had actually been collecting 'extra' money (from Baby Boomers) for awhile now and putting off to the side, but that extra income stopped a while ago, and the trust fund where it was stored was being tapped to keep benefits up. The "shortage" in Social Security that is sometimes in the US news is the estimated time when the 'extra' funds run out, and benefits will only be covered in cashflows. And this is not sudden thing: many government pension systems in the world are facing similar situations. The politicians in the US have not done anything about (for decades), whereas Canada did decide to change their system: * https://en.wikipedia.org/wiki/Canada_Pension_Plan#1998_reforms https://en.wikipedia.org/wiki/Canada_Pension_Plan#1998_refor... Other countries are facing debates (France, Denmark, etc).

AnthonyMouse 11mo ago

> "the deficit is entitlement spending; this is a political problem, not a bureaucratic one". Sort of? Medicare is about a trillion dollars, but what percentage of that is actually helping people and how much is going to unnecessary tests or fraud or overpaying for things? If e.g. HHS issues some bad rules that increase healthcare costs, that increases the cost of Medicare and Medicaid and the VA, but if you're doing it properly you're not ignoring that part of HHS just because its regulatory budget is comparatively smaller when it's doing things that incur billions in indirect costs. Moreover, you can't find a trillion dollars in a program that costs a million dollars, but if it costs a million dollars and isn't worth a million dollars then that's not a reason to keep it. And nobody can claim with a straight face that the military budget contains no inefficiencies, but that's not entitlement spending. > Instead, they went scorched-Earth and assumed we were all deep state leeches. The general problem is that nobody wants their thing to be the thing that gets cut even when it's the thing that ought to be, and then how do you tell if something is actually important when somebody will claim that everything is? It's legitimately a hard problem and DOGE did not succeed in solving it, but that means we need a solution that actually works or people are going to keep coming at you with knives drawn because the status quo is untenable.

estearum 11mo ago
They could just go after Medicare fraud (committed largely by extremely wealthy corporations in extremely detectable ways), get an easy $100B or so under their belt, then reconvene on next steps. That'd require them to be willing to go after their grifter buddies, and to understand anything about our institutions other than what they read on Twitter. > The general problem is that nobody wants their thing to be the thing that gets cut even when it's the thing that ought to be, and then how do you tell if something is actually important when somebody will claim that everything is? We have a process for this. It's called appropriations. It happens in Congress.
- AnthonyMouse 11mo ago
  > They could just go after Medicare fraud (committed largely by extremely wealthy corporations in extremely detectable ways), get an easy $100B or so under their belt My impression of the 2025 feud between Musk and Trump is that Musk actually wanted to do stuff like that and Trump wouldn't do it. And they should do it, but this year's deficit is ~$1.8T despite federal receipts pushing the record high in real dollars per capita (as usual) and consistent with historical norms as a percent of GDP. So what about the other $1.7T? > We have a process for this. It's called appropriations. It happens in Congress. We also have some strong empirical evidence that the outcome of that process is huge deficits, so something has to change if it's not to stay the same.

edm0nd 11mo ago

Because I think everyone agrees there is extreme amounts of waste in government spending and budgets. I was hopeful when they announced DOGE but imo they went about it entirely wrong.

deleted 11mo ago

[deleted]