He has to act now -- and so must Congress.

$296 billion in all revenues and $603 billion spent last month; all of which was with President Trump in office.

This, while Speaker Johnson (and Trump) both want to continue this insane level of spending beyond revenues -- more than a 50% deficit last month -- until the end of September.

This is, on an average basis, worse than Joe Biden's last months in office (October - January) as the total across October to present is $1,147 billion -- or, if you prefer to be fair, equally bad since January is typically 1120 payments month and thus usually has a large amount of received corporate taxes, and it did this year as is usually the case.

Note that Social Security, which people will try to lump in, is not the problem.  It takes in a huge amount of tax (and pays out a huge amount); in contrast Health and Human Services spent $145 billion last month which is more than all income tax receipts deposited from individuals and more than 14 TIMES that deposited from corporations and yet the total deposited from Medicare tax was $28 billion -- or just nineteen percent of what was spent.

For rather-obvious reasons you can't cut CMS program benefits by 80%.

But you can cause costs to fall by close to that amount if you go after cost, and the Executive has the means to do that as I've pointed out through using 15 USC Chapter 1 and the two standing Supreme Court decisions backing its applicability to medical, pharmaceutical and health-insurance related businesses, including of course those involved in Medicare Advantage.

In total CMS has spent $1,030 billion thus far this year or one third of the total $3,039 billion spent by the Federal Government and yet it has received only $164 billion in taxes against that, or sixteen percent of what it has spent.

In addition prescription drug spend in Medicare has risen a stunning 80% over last year's run rate -- that currently stands at $74 billion against $41 billion this time last year while the entire last year spend was just over $100 billion.

Hospital payments are up 20% over last year and physicians payments are up 31%.

There is no way to tax out of this nor any other way to stop this runaway train other than by taking a meat axe to costs and it is clear that there is no way this sort of increase in spend comports with inflation or anything associated with it.  15 USC Chapter 1 is clear and again, the Supreme Court has ruled twice that actions taken by these industries are not exempt from that criminal law.

The full plan I put forward back when I wrote Leverage and then added detail to it as Obamacare came into focus is still where I believe long-term this must go but that requires Congress to act -- and without a threat to veto literally everything until they do it they won't.  However, directing every hospital in America, every medical provider, every drug company and every other entity within the medical field to post one single price for each procedure or item that every person will and does pay with all such charges and costs advised in advance, publicly available and easily searchable with no game-playing, and further require that affirmative, written consent be collected in advance of action taken or thing provided except in emergencies where consent is physically impossible, nor can you bill for anything you cause (such as an infection you GIVE the patient), with any attempt to game or otherwise obfuscate this order resulting in a Racketeering indictment with the predicate act being criminal extortion ("buy insurance or get a 10x bill up your back door"), thereby  immediately breaking any and all collusion between insurance companies, PBMs, pharmacies, drug companies, doctors, clinics and hospitals, which will restore competition immediately, and further make clear that any provider or pharmaceutical company that does not do this will be prosecuted under 15 USC Chapter 1, fined to the maximum extent of the law corporately which each person differentially charged a separate and distinct offense AND all of their executives will be criminally indicted, tried and upon conviction they will do 10 years in federal prison.

This can be done right here, right now, entirely within the Executive between the FBI and DOJ and Congress neither has to pass anything nor can Congress prevent or halt it.

Insurance company agreements to pay rest with their customer, the insured.  They must not ever do what they do now, which is to make both health and billing decisions in the middle and thus forcibly impose cost-shifting and ratchet prices which inures directly to their benefit and screws both Americans generally and the government as their operating margin is fixed by law.  There is of course much more and the link above explains it all -- but in the immediate time frame we must focus on what the Executive can do as Congress clearly will not until and unless they're forced to by their constituents.

If this is done at the Executive level prices will collapse immediately -- and, along with it, all the convoluted billing and insurance schemes, and their employees, will disappear.  Yes, that will be extremely disruptive to those employed in such pursuits and produce an immediate and deep recession.

We have no choice and it has to happen right now.

It is not possible to stop this in-process trainwreck now without serious disruption to our economy -- that is simply not avoidable and the option to do so all the way back to when Obama was in office, and I put forward a plan to do so which would have had much less disruption and evaded this entire fiscal mess, was ignored.

If we do not stop it now the consequences literally grow by the day and risk fiscal and possibly even civil collapse.

Trump does not have six months to sit on this until the new fiscal year and Speaker Johnson has repeatedly lied about "this will be the last CR" so there is no reason to believe any such thing will be forthcoming -- not that it matters because if not dealt with now the probability of a market crash into the fall and winter followed by a long economic malaise that will not clear in time for the elections is nearly-certain.

Politically the hit has to be taken right now because the economic impact will be severe and of course the current Administration will be blamed for it -- and yes, they're partly responsible not only for attempting to play games with the current CR but in point of fact Trump was President four years ago too, before Biden -- and did nothing to stop it then despite, I remind you, multiple campaign platform planks in 2016 that would have largely done so.  But no matter the apportionment of blame across parties and Administrations and sessions of Congress the hit has to be taken now and this foolery must be stopped with finality so that NEVER AGAIN can a federal department find itself collecting only sixteen percent of its spend in taxes and being a full THIRD of every dollar the government spends; there is no way we will get through the next couple of years without this blowing up the economy and the mid-term elections will begin to be contested next spring.

By next summer we have to be on the path of recovery; there is no avoiding the very large economic hit, so the choice is to either do it now -- not an empty promise (that will once again prove to be a lie) for the fall but right now -- or have it happen into the maw of the election in which case the GOP loses both House and Senate and that is if the bond market allows this "oh we'll work on it" charade to continue for that long.  It might not, and if it doesn't all assets will collapse in price, rates will soar irrespective of The Fed cutting off essentially consumer and corporate borrowing and unemployment will shoot the moon concurrent with real shortages and perhaps worse.