Robert J. Samuelson: Detroit not an isolated case; many governments are struggling

Published: Tuesday, Aug. 6 2013 12:00 a.m. MDT

There's one escape valve. "States can't contract away their police powers: the ability to protect the health and welfare of their citizens," says Amy Monahan, a law professor at the University of Minnesota. They may be able to cut existing benefits if they can convince courts that these overburden other public goals. Both Minnesota and South Dakota cut COLAs and were upheld by state courts, she says. A similar change in Colorado is under appeal; so are Rhode Island's cuts. This is a legal no-man's land, with huge discretion left to judges.

Medicaid's expansion is also on autopilot. Even without Obamacare, spending would rise significantly. Older Americans and the disabled now account for two-thirds of costs, though representing only a quarter of beneficiaries. As the population ages, this burden will grow. Their medical care is simply more expensive. In 2011, spending for Medicaid's average aged recipient totaled $15,931, more than five times the average cost for children, $2,851, reports CMS.

It's literally schools versus nursing homes. We need a better balance between workers' legitimate desire for a comfortable retirement and society's larger interests. Instead, our system favors the past over the future. Things could be done to mitigate the bias. None would be easy or popular. But it's first necessary to acknowledge the bias and discuss it openly. This we are far from doing.

Robert J. Samuelson is a Washington Post columnist.

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