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GAO: Promoting Accountability And Transparency In Government: 

Before the Women’s Philanthropy Board: 

7th Annual Spring Symposium: 

Auburn University: 
Auburn, Alabama: 

April 6, 2009: 

By Gene L. Dodaro: 
Acting Comptroller General: 

GAO-09-572CG: 

Outline: 

* About GAO: 

* Financial Markets and Economic Recovery: 

* Transition – New President and Congress: 

* Long Term Fiscal Outlook and Risks: 

About GAO: 

GAO’s mission is to support Congress and improve government: 

* An independent, nonpartisan agency in the legislative branch of the 
federal government. 

* 3,200 employees, i.e., economists, accountants, public policy 
analysts, attorneys and computer experts. 

* Issues hundreds of reports, congressional testimonies, and other 
products each year on breadth of federal responsibilities. 

GAO’s Strategic Plan Framework: provide timely, quality service to the 
Congress and the federal government to: 

* Address current and emerging challenges to the well-being and 
financial security of the American people; 

* Respond to changing security threats and the challenges of global 
interdependence; 

* Help transform the federal government’s role and how it does business 
to meet 21st century challenges; 

* Maximize the value of GAO by being a model federal agency and world-
class professional services organization. 

Our Core Values: 

Accountability: 
Help the Congress oversee federal programs, policies, and operations to 
ensure accountability to the American people. 

Integrity: 
Ensure that our work is professional, objective, fact-based, 
nonpartisan, nonideological, balanced and fair. 

Reliability: 
Provide high-quality, timely, accurate, useful, clear, and candid 
information. 

Financial Markets and Economic Recovery: 

* Financial Regulatory System; 

* GAO Role in Financial Rescue; 

* Auditors of Bank Insurance Fund, FHFA, TARP, and U.S. Government 
Financial Statements; 

* American Recovery and Reinvestment Act. 

Modernizing the U.S. Financial Regulatory System: 

Financial Regulation: A Framework for Crafting and Assessing Proposals 
to Modernize the Outdated U.S. Financial Regulatory System. 

* Explains the origins of the current financial regulatory system; 

* Describes market developments and changes that pose challenges to the 
current system; 

* Presents an evaluation framework that Congress and others can use to 
craft or evaluate potential regulatory reform efforts; 

(GAO-09-216, Jan. 8, 2009) 

Outdated Regulatory System: 

Risks posed by: 

* Emergence of large, complex, and interconnected financial 
conglomerates; 

* Less-regulated entities are playing increasingly critical roles in 
the financial system; 

* New and complex products pose challenges to system stability and 
consumer protection. 

For Crafting or Assessing Regulatory Reform Proposals: GAO Framework — 
9 Essential Characteristics: 

* Clearly defined regulatory goals in statute; 

* Appropriately comprehensive; 

* Systemwide focus; 

* Flexible and adaptable; 

* Efficient and effective; 

* Consistent consumer and investor protections; 

* Regulators provided with independence, prominence, authority, and 
accountability; 

* Consistent financial oversight; 

* Minimal taxpayer exposure. 

Financial Institutions and Markets: 

* Emergency Economic Stability Act of 2008 created $700 billion TARP in 
October 2008; 

* GAO given statutory oversight role; 

* GAO’s TARP reports recommendations follow 3 themes: 

- Monitoring the use of funds to meet the Act’s objectives; 

- Articulating a better communication strategy; 

- Ensuring effective Treasury management structure. 

Global Financial Crisis Task Force: 

* Created by International Governing Board in November 2008. 

* Purpose: 
- enhance the knowledge base of NAOs on financial and economic matters 
related to the crisis; 
- be a source of information to help governments and the global 
community respond to the crisis. 

* Membership: U.S.A. is lead, other countries include: 
Austria; 
Canada; 
Chile; 
China; 
Cyprus; 
Denmark; 
Estonia; 
Hungary; 
Indonesia; 
Italy; 
Japan; 
Korea; 
Mexico; 
Morocco; 
Netherlands; 
Poland; 
Russia; 
Slovakia; 
Spain; 
Sweden; 
United Kingdom; 
Venezuela. 

American Recovery & Reinvestment Act: 

* Signed February 17, 2009; 

* Purposes: 

- preserve and create jobs and promote recovery; 

- assist those most impacted by the recession; 

- invest in science and health-care technology; 

- invest in infrastructure; 

- stabilize state and local government budgets. 

* Total cost, tax and spending: $787 billion, including: 

- over $580 billion in additional spending (CBO estimate). 

American Recovery & Reinvestment Act: Oversight: 

* Inspectors General: review federal program and agency implementation. 

* Recovery Accountability and Transparency Board. 

* GAO: responsibilities include: 

- conducting bimonthly reviews of selected state and localities; 

- commenting on the estimates of the number of jobs reviewing areas 
such as trade adjustment assistance, new education incentive grants, 
and efforts to increase small business lending. 

Figure: Map of the United States: 

[Refer to PDF for image] 

The following states are highlighted on the map: 
Arizona; 
California; 
Colorado; 
District of Columbia; 
Florida; 
Georgia; 
Illinois; 
Iowa; 
Massachusetts; 
Michigan; 
Mississippi; 
New Jersey; 
New York; 
North Carolina; 
Ohio; 
Pennsylvania; 
Texas. 

Source: GAO analysis. 

[End of figure] 

Transition: Assisting The New Administration & The New Congress: 

Figure: Photographs of the White House and the U.S. Capitol buildings. 

[Refer to PDF for image] 

[End of figure] 

Figure: Screen shot of the home page of the GAO Website [hyperlink, 
http://www.gao.gov]. 

[Refer to PDF for image] 

Highlighted in the screen shot is the link to GAO's Oversight of the 
Recovery Act page (GAO.gov/recovery). 

[End of figure] 

Figure: Screen shot of GAO's Oversight of the Recovery Act page 
[hyperlink, http://www.gao.gov/recovery/index.html]. 

[Refer to PDF for image] 

Links on the page include: 

* Following the Money: GAO's Oversight of the Recovery Act. 

* Bimonthly reviews. 

* Other GAO Mandates. 

* Major Cost-Saving Opportunities. 

* Video Message from Gene Dodaro, Acting Comptroller General. 

[End of figure] 

Figure: Screen shot of the 2009 Congressional and Presidential 
Transition page of the GAO Website [hyperlink, 
http://www.gao.gov/transition_2009/]. 

[Refer to PDF for image] 

Links on the page include: 

* Urgent Issues. 

* Agency-by-Agency Issues. 

* Management Challenges Across the Government. 

* Major Cost-Saving Opportunities. 

* Upcoming Reports on Major Issues. 

* Long-Term Fiscal Outlook. 

* Working with GAO. 

[End of figure] 

Other Urgent Issues: Timely Action Is Critical: 

* U.S. efforts in Iraq, Afghanistan, and Pakistan; 

* Defense readiness, spending, and care for service members; 

* Protecting the homeland and preparing for public health emergencies; 

* Improving U.S. image abroad; 

* Food safety; 

* Transition to digital TV. 

Long-Term Challenges: 

* Today’s focus—understandably—is on: 

- Dealing with financial system stress; 

- Addressing the economic downturn; 

* But: Underlying long-term fiscal challenge still needs to be 
addressed. 

Figure: Long-Term Fiscal Challenge: 

[Refer to PDF for image] 

This figure is a multiple line graph depicting the following data in 
percent of GDP: 

Year: 2005; 
Federal Surplus/Deficit[A]: -2.6%; 
Combined Surplus/Deficit: -3.1%. 		 

Year: 2010; 
Federal Surplus/Deficit[A]: -5.04%; 
Combined Surplus/Deficit: -7%. 

Year: 2015; 
Federal Surplus/Deficit[A]: -5.19%; 
Combined Surplus/Deficit: -6.9%. 

Year: 2020; 
Federal Surplus/Deficit[A]: -6.77%; 
Combined Surplus/Deficit: -8.7%. 

Year: 2025; 
Federal Surplus/Deficit[A]: -9.23%; 
Combined Surplus/Deficit: -11.5%. 

Year: 2030; 
Federal Surplus/Deficit[A]: -12.02%; 
Combined Surplus/Deficit: -14.8%. 

Year: 2035; 
Federal Surplus/Deficit[A]: -15.07%; 
Combined Surplus/Deficit: -18.4%. 

Year: 2040; 
Federal Surplus/Deficit[A]: -18.25%; 
Combined Surplus/Deficit: -22.1%. 

Year: 2045; 
Federal Surplus/Deficit[A]: -21.55%; 
Combined Surplus/Deficit: -25.9%. 

Year: 2050; 
Federal Surplus/Deficit[A]: -25.02%; 
Combined Surplus/Deficit: -30%. 

Source: GAO January 2009 analysis. 

[A] Federal surplus/deficit is from GAO’s Alternative Simulation using 
the Trustees’ assumptions. 

[End of figure] 

Figure: Long-Term Fiscal Challenge Driven by Health Care Spending: 

[Refer to PDF for image] 

This figure is a stacked line graph depicting the following data in 
percent of GDP: 

Year: 2008; 
Social Security: 4.32%; 
Medicaid: 1.44%; 
Medicare: 3.24%; 
Total: 9.00%. 

Year: 2009; 
Social Security: 4.35%; 
Medicaid: 1.59%; 
Medicare: 3.28%; 
Total: 9.22%. 

Year: 2010; 
Social Security: 4.39%; 
Medicaid: 1.68%; 
Medicare: 3.32%; 
Total: 9.39%. 

Year: 2015; 
Social Security: 4.8%; 
Medicaid: 1.79%; 
Medicare: 3.71%; 
Total: 10.3%. 

Year: 2020; 
Social Security: 5.3%; 
Medicaid: 2.03%; 
Medicare: 4.45%; 
Total: 12.68%. 
	
Year: 2025; 
Social Security: 5.71%; 
Medicaid: 2.27%; 
Medicare: 5.35%; 
Total: 13.33%. 
	
Year: 2030; 
Social Security: 6%; 
Medicaid: 2.55%; 
Medicare: 6.26%; 
Total: 15.1%. 

Year: 2035; 
Social Security: 6.09%; 
Medicaid: 2.84%; 
Medicare: 7.00%; 
Total: 15.93%. 
	
Year: 2040; 
Social Security: 6.02%; 
Medicaid: 3.13%; 
Medicare: 7.58%; 
Total: 16.73%. 
	
Year: 2045; 
Social Security: 5.89%; 
Medicaid: 3.40%; 
Medicare: 8.01%; 
Total: 17.3%. 
	
Year: 2050; 
Social Security: 5.81%; 
Medicaid: 3.64%; 
Medicare: 8.40%; 
Total: 17.85%. 
	
Year: 2055; 
Social Security: 5.77%; 
Medicaid: 3.86%; 
Medicare: 8.78%; 
Total: 18.41%. 
	
Year: 2060; 
Social Security: 5.77%; 
Medicaid: 4.08%; 
Medicare: 9.21%; 
Total: 19.06%. 

Year: 2065; 
Social Security: 5.76%; 
Medicaid: 4.30%; 
Medicare: 9.63%; 
Total: 19.69%. 

Year: 2070; 
Social Security: 5.77%; 
Medicaid: 4.53%; 
Medicare: 10.03%; 
Total: 20.33%. 
	
Year: 2075; 
Social Security: 5.79%; 
Medicaid: 4.75%; 
Medicare: 10.38%; 
Total: 20.92%. 

Year: 2080; 
Social Security: 5.81%; 
Medicaid: 4.96%; 
Medicare: 10.69%; 
Total: 21.46%. 

Source: GAO analysis of data from the Office of the Chief Actuary, 
Social Security Administration, Office of the Actuary, Centers for 
Medicare and Medicaid Services, and the Congressional Budget Office. 

Note: Social Security and Medicare projections based on the 
intermediate assumptions of the 2008 Trustees’ Reports. Medicaid 
projections based on CBO’s January 2009 short-term Medicaid estimates 
and CBO’s December 2007 long-term Medicaid projections adjusted to 
reflect excess cost growth consistent with the 2008 Trustees 
intermediate assumptions. 

[End of figure] 

Figure: Growth in Health Care Spending: Cumulative Growth in Real 
Health Care Spending Per Capita and Real GDP Per Capita, 1960-2005: 

[Refer to PDF for image: line graph] 

1960: 
Real health care spending per capita: 0;
Real GDP per capita: 0. 

1961:
Real health care spending per capita: 3.56%;  
Real GDP per capita: 0.7%. 
  
1962: 
Real health care spending per capita: 10.08%; 
Real GDP per capita: 5.2%. 

1963: 
Real health care spending per capita: 16.75%; 
Real GDP per capita: 8.3%. 

1964: 
Real health care spending per capita: 25.91%; 
Real GDP per capita: 13.1%. 

1965: 
Real health care spending per capita: 33.12%; 
Real GDP per capita: 18.9%. 

1966: 
Real health care spending per capita: 41.09%; 
Real GDP per capita: 25.3%. 

1967: 
Real health care spending per capita: 52.33%; 
Real GDP per capita: 27.3%. 

1968: 
Real health care spending per capita: 63.78%; 
Real GDP per capita: 32.2%. 

1969: 
Real health care spending per capita: 73.98%; 
Real GDP per capita: 35%. 

1970: 
Real health care spending per capita: 83.82%; 
Real GDP per capita: 33.5%. 

1971: 
Real health care spending per capita: 92.27%; 
Real GDP per capita: 36.4%. 

1972: 
Real health care spending per capita: 104.07%;
Real GDP per capita: 42.2%. 

1973: 
Real health care spending per capita: 112.03%;
Real GDP per capita: 49.1%. 

1974: 
Real health care spending per capita: 119.04%; 
Real GDP per capita: 47.2%. 

1975: 
Real health care spending per capita: 126.34%;
Real GDP per capita: 45.7%. 

1976: 
Real health care spending per capita: 142.98%;
Real GDP per capita: 52.2%. 
 
1977: 
Real health care spending per capita: 156.72%;
Real GDP per capita: 58%. 

1978: 
Real health care spending per capita: 167.52%; 
Real GDP per capita: 65.2%. 

1979: 
Real health care spending per capita: 177.46%; 
Real GDP per capita: 68.8%. 

1980: 
Real health care spending per capita: 189.9%; 
Real GDP per capita: 66.7%. 

1981: 
Real health care spending per capita: 203.97%; 
Real GDP per capita: 69.3%. 

1982: 
Real health care spending per capita: 218.9%; 
Real GDP per capita: 64.3%. 

1983: 
Real health care spending per capita: 235.76%; 
Real GDP per capita: 70.2%. 

1984: 
Real health care spending per capita: 253.03%; 
Real GDP per capita: 80.7%. 

1985: 
Real health care spending per capita: 271.16%; 
Real GDP per capita: 86.5%. 

1986: 
Real health care spending per capita: 285.9%; 
Real GDP per capita: 91.1%. 

1987: 
Real health care spending per capita: 304.78%; 
Real GDP per capita: 95.8%. 

1988: 
Real health care spending per capita: 333.87%; 
Real GDP per capita: 101.9%. 

1989: 
Real health care spending per capita: 360.77%; 
Real GDP per capita: 107.1%. 

1990: 
Real health care spending per capita: 390.16%; 
Real GDP per capita: 108.6%. 

1991: 
Real health care spending per capita: 412.48%; 
Real GDP per capita: 105.8%. 

1992: 
Real health care spending per capita: 437.5%; 
Real GDP per capita: 110%. 

1993: 
Real health care spending per capita: 458.02%;
Real GDP per capita: 113.1%. 

1994: 
Real health care spending per capita: 469.88%; 
Real GDP per capita: 119.3%. 

1995: 
Real health care spending per capita: 483.92%; 
Real GDP per capita: 122.5%. 

1996: 
Real health care spending per capita: 496.54%; 
Real GDP per capita: 128.4%. 

1997: 
Real health care spending per capita: 511.5%; 
Real GDP per capita: 136.2%. 

1998: 
Real health care spending per capita: 533.54%; 
Real GDP per capita: 143.6%. 

1999: 
Real health care spending per capita: 556.89%; 
Real GDP per capita: 151.9%. 

2000: 
Real health care spending per capita: 580.99%; 
Real GDP per capita: 158.6%. 

2001: 
Real health care spending per capita: 614.74%; 
Real GDP per capita: 157.8%. 

2002: 
Real health care spending per capita: 658.56%;
Real GDP per capita: 159.4%. 

2003: 
Real health care spending per capita: 695.26%; 
Real GDP per capita: 163.3%. 

2004: 
Real health care spending per capita: 721.37%; 
Real GDP per capita: 171%. 

2005:
Real health care spending per capita: 744.54%; 
Real GDP per capita: 177.1%. 

2006:	
Real health care spending per capita: 760.5%; 
Real GDP per capita: 180.8%. 

2007
Real health care spending per capita: 780.55%; 
Real GDP per capita: 183.7%. 

Source: GAO analysis of data from the Centers for Medicare & Medicaid 
Services, Office of the Actuary, and the Bureau of Economic Analysis. 

Note: The most current data available on health care spending per 
capita are for 2007. 

[End of figure] 

Figure: Screen shot of the Department of Health and Human Services page 
of the 2009 Congressional and Presidential Transition page of the GAO 
Website [hyperlink, http://www.gao.gov/transition_2009/agency/hhs/]. 

[Refer to PDF for image] 

[End of figure] 

Social Security: 

* Important program in need of change: 

- Provides retirement benefits to millions of individuals and families. 

- Provides benefits to survivors, other dependents, and disabled 
workers. 

- Faces significant and growing long-term financing shortfall. 

Figure: Percentage of Elderly Households Receiving Each Type of Income: 

[Refer to PDF for image: vertical bar graph] 

Social Security: 89%; 
Savings: 55%; 
Pensions: 41%; 
Earnings: 24%. 

Source: Income of the Population 55 or Older, 2004 (Washington,D.C.: 
SSA, Office of Research and Statistics, 2006). 

[End of figure] 

Figure: Cash Flow and Trust Fund Balances in the Combined Social 
Security Trust Fund: 

[Refer to PDF for image: combined vertical bar and line graph] 

Billions of 2008 dollars. 

Calendar year: 2008; 
Cash flow: $79.00; 
Trust fund balance: $2,434.70. 

Calendar year: 2009; 
Cash flow: $85.00; 
Trust fund balance: $2,582.80. 

Calendar year: 2010; 
Cash flow: $83.20; 
Trust fund balance: $2,727.00. 

Calendar year: 2011; 
Cash flow: $76.40; 
Trust fund balance: $2,868.60. 

Calendar year: 2012; 
Cash flow: $65.80; 
Trust fund balance: $3,004.80. 

Calendar year: 2013; 
Cash flow: $51.90; 
Trust fund balance: $3,131.80. 

Calendar year: 2014; 
Cash flow: $35.60; 
Trust fund balance: $3,247.00. 

Calendar year: 2015	
Cash flow: $18.50; 
Trust fund balance: $3,349.10. 

Calendar year: 2016; 
Cash flow: $0.60; 
Trust fund balance: $3,437.10. 

Calendar year: 2017 (deficits begin); 
Cash flow: ($18.60); 
Trust fund balance: $3,510.10. 

Calendar year: 2018; 
Cash flow: ($37.20); 
Trust fund balance: 3,567.70. 

Calendar year: 2019; 
Cash flow: ($56.80); 
Trust fund balance: $3,608.60. 

Calendar year: 2020; 
Cash flow: ($76.90); 
Trust fund balance: $3,631.80. 

Calendar year: 2021; 
Cash flow: ($96.50); 
Trust fund balance: $3,637.20. 

Calendar year: 2022; 
Cash flow: ($115.60); 
Trust fund balance: $3,624.90. 

Calendar year: 2023; 
Cash flow: ($134.90); 
Trust fund balance: $3,592.40. 

Calendar year: 2024; 
Cash flow: ($153.80); 
Trust fund balance: $3,539.60. 

Calendar year: 2025; 
Cash flow: ($172.30); 
Trust fund balance: $3,466.10. 

Calendar year: 2026; 
Cash flow: ($190.30); 
Trust fund balance: $3,372.20. 

Calendar year: 2027; 
Cash flow: ($208.10); 
Trust fund balance: $3,257.20. 

Calendar year: 2028; 
Cash flow: ($225.50); 
Trust fund balance: $3,120.90. 

Calendar year: 2029; 
Cash flow: ($242.20); 
Trust fund balance: $2,963.60. 

Calendar year: 2030; 
Cash flow: ($257.50); 
Trust fund balance: $2,785.90. 

Calendar year: 2031; 
Cash flow: ($271.60); 
Trust fund balance: $2,588.80. 

Calendar year: 2032; 
Cash flow: ($284.40); 
Trust fund balance: $2,372.70. 

Calendar year: 2033; 
Cash flow: ($295.40); 
Trust fund balance: $2,139.00. 

Calendar year: 2034; 
Cash flow: ($304.50); 
Trust fund balance: $1,889.20. 

Calendar year: 2035; 
Cash flow: ($312.30); 
Trust fund balance: $1,624.30. 
	
Calendar year: 2036; 
Cash flow: ($319.20); 
Trust fund balance: $1,344.50. 
	
Calendar year: 2037; 
Cash flow: ($325.00); 
Trust fund balance: $1,050.60. 

Calendar year: 2038; 
Cash flow: ($329.50); 
Trust fund balance: $743.7. 

Calendar year: 2039; 
Cash flow: ($332.60); 
Trust fund balance: $424.8. 

Calendar year: 2040; 
Cash flow: ($334.80); 
Trust fund balance: $94.3. 

Trust fund exhausted in 2041. 

Source: GAO analysis of data from the Office of the Chief Actuary, 
Social Security Administration. 

Note: Projections based on the intermediate assumptions of the 2008 
Trustees’ Report. The CPI is used to adjust from current to constant 
dollars. 

[End of figure] 

Figure: Addressing long-term fiscal imbalance will require changes in 
federal spending and tax policies: 

[Refer to PDF for image: combined stacked vertical bar and line graph] 

Percent of GDP. 

Fiscal year: 2008; 
Net interest: 1.8%; 
Social Security: 4.3%; 
Medicare & Medicaid: 4.2%; 
All other spending: 10.7%; 
Revenue: 17.7%. 

Fiscal year: 2019; 
Net interest: 4%; 
Social Security: 5.2%; 
Medicare & Medicaid: 6%; 
All other spending: 10.7%; 
Revenue: 18.5%. 

Fiscal year: 2030; 
Net interest: 7.1%; 
Social Security: 6%; 
Medicare & Medicaid: 8.1%; 
All other spending: 10.7%; 
Revenue: 18.6%. 

Fiscal year: 2040; 
Net interest: 11.8%; 
Social Security: 6.2%; 
Medicare & Medicaid: 9.9%; 
All other spending: 10.7%; 
Revenue: 18.6%. 

Source: GAO’s March 2009 analysis based on the Trustees’ assumptions 
for Social Security and Medicare. 

Notes: Discretionary spending other than stimulus provisions grows with 
GDP after 2009; stimulus provisions are assumed to be temporary. 
Expiring tax provisions are extended, except for expiring provisions 
enacted in the Recovery Act. After 2019, revenue as a share of GDP is 
brought to its 40-year historical average of 18.3 percent of GDP plus 
expected revenues from deferred taxes, (i.e. taxes on withdrawals from 
retirement accounts). Medicare spending is adjusted based on the 
assumption that physician payments are not reduced as specified under 
current law. 

[End of figure] 

Tax Issues: 

* Narrowing the tax gap. 

* Reviewing tax expenditures. 

* Weighing tax reform. 

[End of section] 

On the Web: 

Web site: [hyperlink, http://www.gao.gov/cghome.htm]. 

Contact: 

Chuck Young, Managing Director, Public Affairs: 
YoungC1@gao.gov: 
(202) 512-4800: 
U.S. Government Accountability Office: 
441 G Street NW, Room 7149: 
Washington, D.C. 20548: 

Copyright: 

This is a work of the U.S. government and is not subject to copyright 
protection in the United States. The published product may be 
reproduced and distributed in its entirety without further permission 
from GAO. However, because this work may contain copyrighted images or 
other material, permission from the copyright holder may be necessary 
if you wish to reproduce this material separately.