The other, more dangerous, cliffs

The "fiscal cliff" isn't nearly the biggest cliff we face -- if we're talking about dangerous precipices looming on the horizon. Here are three:

The child poverty cliff. A staggering number of our children are impoverished. Between 2007 and 2011, the percentage of American school-age children living in poor households grew from 17 percent to 21 percent.


Last year, according to the Agriculture Department, nearly 1 in 4 young children lived in a family that had difficulty affording sufficient food at some point in the year.

Yet federal programs to help children and lower-income families -- such as food stamps, federal aid for poor school districts, Pell grants, child health care, subsidized lunches, child nutrition, prenatal and postnatal care, Head Start and Medicaid -- are being targeted for cuts by deficit hawks who insist we can no longer afford them.


It seems as if no one in Washington is any longer talking about reducing poverty in America. All we hear from both parties is the importance of preserving the middle class.

The states, meanwhile, have been laying off teachers and social workers, ending preschool and after-school programs, and cutting local family services. Twenty-three states reduced spending on education this year, much of it on poor schools.

Yet unless we focus on better schools, better health and improved conditions for these poor kids and their families, America will soon have a significant population of under-educated and desperate adults.

The baby boomer health care cliff. Health care costs already take 18 percent of our entire economy, and we're soon approaching a cliff that will require far more. Between now and 2030, when 76 million boomers join the ranks of the elderly, those costs will soar.

This is the major reason the federal budget deficit is projected to explode in future years -- not Medicare and Medicaid but the rising health care costs underlying these programs.

These costs, in turn, are the result of a mind-bogglingly inefficient system. We're spending almost 2.5 times more on health care per person than any other rich nation, yet the typical American doesn't live as long as the citizens of those nations, and we have a higher rate of infant mortality.

We spend $30 billion a year fixing medical errors -- the worst rate among advanced countries -- largely because we keep patient records on computers that can't share the data. Meanwhile, administrative costs are eating up 15 percent to 30 percent of all health-care spending in the U.S., twice the rate of other rich nations. The money goes mainly into collecting money -- doctors and hospitals from insurers, insurers from companies and policyholders.

The Affordable Care Act will reduce these inefficiencies, but not nearly enough.

The president also has to lead the way in using Medicare and Medicaid's bargaining power over providers to get lower costs and to move from a fee-for-service system to a fee-for-healthy-outcomes system of health care.

But the real health care cliff can only be avoided if we adopt a single-payer health care system.

The climate cliff. The third big cliff we're heading toward is climate change. Global emissions of carbon dioxide jumped 3 percent last year and are expected to jump another 2.6 percent this year, according to scientists who are carefully measuring the atmosphere.

This puts the human race perilously close to the tipping point when ice caps irretrievably melt, sea levels rise, and the amount of available cropland in the world becomes dangerously small. Some say we're already there.


Yet many Republicans (and their financial patrons, such as billionaires Charles and David Koch) continue to deny climate change.

Not even the Obama administration is any longer pushing for a cap-and-trade system to limit carbon emissions, or a carbon tax that would deter excessive use of carbon-based energy.

Yet unless we act to reduce carbon emissions, other major emitters around the world won't do so on their own. The only binding pact so far is the Kyoto Protocol, which the U.S. never joined. And we took scant leadership at the international climate talks that just concluded in Qatar.

While the "fiscal cliff" could be dangerous, these other three cliffs pose far greater perils.

Yet we seem unable to avoid hurtling over them because American politics is obsessed by the federal budget deficit, paralyzed by ideological fights over the size of government, and overwhelmed by the power of big money.

Robert B. Reich, Chancellor's Professor of Public Policy at the University of California and former U.S. secretary of labor, is the author of "Beyond Outrage: What has gone wrong with our economy and our democracy, and how to fix it," a Knopf release now out in paperback.

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