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title: "House Oversight: Estate Documents (Nov 12) (HOUSE_OVERSIGHT_020834)"
source: "House Oversight: Estate Documents (Nov 12)"
sourceUrl: "https://www.justice.gov/epstein"
date: "2026-01-01"
category: "House Oversight"
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---
costs onto the private market to help subsidize lower payments from public programs. This
tends to help drive a cycle of higher private market costs causing higher insurance premiums,
leading to the slow erosion of private market coverage and a greater enrollment burden for
government programs.
The Patient Protection and Affordable Care Act, enacted in early 2010, includes the biggest
changes to healthcare since 1965 and will eventually expand health insurance coverage by
~10%, to 32 million new lives. Increased access likely means higher spending if healthcare
costs continue to grow 2 percentage points faster than per capita income (as they have over the
past 40 years). The CBO sees a potential $143B reduction in the deficit over the next 10 years,
but this assumes that growth in Medicare costs will slow - an assumption the CBO admits is
highly uncertain.
Unemployment Insurance and Social Security are adequately funded...for now. Their
future, unfortunately, isn't so clear.
Unemployment Insurance is cyclical and, apart from the 2007-09 recession, generally operates
with a surplus. Payroll taxes kept Social Security mainly at break-even until 1975-81 when
expenses began to exceed revenue. Reforms that cut average benefits by 5%, raised tax rates
by 2.3%, and increased the full retirement age by 3% (to 67) restored the system's stability for
the next 25 years, but the demographic outlook is poor for its pay-as-you-go funding structure. In
1950, 100 workers supported six beneficiaries; today, 100 workers support 33 beneficiaries.
Since Social Security began in 1935, American life expectancy has risen 26% (to 78), but the
"retirement age" for full benefits has increased only 3%.
Regardless of the emotional debate about entitlements, fiscal reality can't be ignored - if
these programs aren't reformed, one way or another, USA Inc.'s balance sheet will go
from bad to worse.
Federal Government Spending Had Risen to 24% of GDP in 2010,
Up From an Average of 3% From 1790 to 1930
Federal Government Spending as % of GDP, 1790 - 2010
Federal Spending as % of GDP
kB/ww.kpcb.com
40%
35%
30%
25%
20%
15%
3% Trendline Average
1790-1930
10%
5%
0% -
24% in 2010
1790 1810 1830 1850 1870
1890
1910
1930
1950
1970
1990
2010
Source: Federal spending per Series Y 457-465 in "Historical Statistics of the United States, Colonial Times to 1970, Part If" and per
White House OMB. GDP prior to 1930 per Louis Johnston and Samuel H. Williamson,
"What Was the U.S. GDP Then?"
MeasuringWorth, 2010. GDP post 1930 per White House OMB. Neither federal spending nor GDP data are adjusted for inflation.
USA Inc. | Summary
KP
CB www.kpcb.com
USA Inc.
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