over the next 25 years, and continue to rise significantly further after that. 3 the ability to control health - care costs as our population gets older, while still providing highquality care to those who need it, will be critical not only for budgetary reasons but for maintaining the dynamism of the broader economy as well. the aging of the u. s. population will also strain social security, as the number of workers paying taxes into the system rises more slowly than the number of people receiving benefits. this year, there are about five individuals between the ages of 20 and 64 for each person aged 65 and older. by 2030, when most of the baby boomers will have retired, this ratio is projected to decline to around 3, and it may subsequently fall yet further as life expectancies continue to increase. overall, the projected fiscal pressures associated with social security are considerably smaller than the pressures associated with federal health programs, but they still present a significant challenge to policymakers. the same underlying trends affecting federal finances will also put substantial pressures on state and local budgets, as organizations like yours have helped to highlight. 4 in rhode island, as in other states, the retirement of state employees, together with continuing increases in health - care costs, will cause public pension and retiree health - care obligations to become increasingly difficult to meet. estimates of unfunded pension liabilities for the states as whole span a wide range, but some researchers put the figure as high as $ 2 trillion at the end of 2009. 5 estimates of states ’ liabilities for retiree health benefits are even more uncertain because of the difficulty of projecting medical costs decades into the future. however, one recent estimate suggests that state governments have a collective liability of almost $ 600 billion for retiree health benefits. 6 these health benefits have usually been alignment with tax revenues over time. equivalently, the so - called primary budget deficit ( the budget deficit exclusive of interest payments ) must be reduced to zero. see the two long - term scenarios for mandatory federal spending on health care shown in figure 2 – 3, p. 41, in cbo, the long - term budget outlook, in note 2. see rhode island public expenditure council ( 2010 ), analysis of rhode island ’ s debt including pension and opeb obligations ( providence, r. i. : ripec ). see alicia h. munnell, richard w. kopcke, jean - pierre aubry, and laura quinby (

. i would now like to elaborate on some of the channels through which foreign developments more generally might be expected to affect the outlook for the u. s. economy. 3 channels and linkages perhaps the most direct link between economic conditions abroad and in the united states is foreign demand for u. s. exports. to be sure, exports account for a smaller share of the u. s. economy — about 12 percent — than the global average of about 30 percent. even so, when foreign demand for u. s. exports falls, the effect on u. s. production is evident. the pace of economic expansion abroad is a key determinant of the demand for u. s. exports. most recently, the international monetary fund projects foreign gdp growth in 2019 to have slowed to its weakest pace since the financial crisis. largely as a result, real u. s. exports been about flat over the past year, an unusual development outside of recession. u. s. exports also have slowed as a result of a decline for further discussion, see richard h. clarida ( 2019 ), “ global shocks and the u. s. economy, ” speech delivered at the bdf symposium and 34th suerf colloquium, sponsored by banque de france and the european money and finance forum, paris, march 28, https : / / www. federalreserve. gov / newsevents / speech / clarida20190328a. htm. - 4in exports to china following the imposition of tariffs on u. s. goods and also more recently because of production - related disruptions in aircraft deliveries. the pace of economic growth in our major trading partners affects the demand for u. s. exports not only directly, but also indirectly by influencing the value of the dollar. when foreign growth weakens and central banks abroad ease monetary policy to support their domestic economies, returns on dollar assets appear relatively more attractive, capital flows into u. s. markets, and these flows will tend to boost the foreign exchange value of the dollar. in addition, elevated uncertainties about the global outlook and / or other evidence of financial stress abroad can also drive up the value of the dollar, as investors flow into the safe haven traditionally provided by u. s. assets. a stronger dollar, for either reason, makes u. s. exports more expensive for foreign buyers, makes u. s. imports from abroad more attractive to u. s. purchasers