In order to make a difference, sometimes all you need to do is show up. During one of my medical school rotations through the Emergency Department, I had a memorable patient who rolled in via ambulance after being found unresponsive. The residents assessing her performed a basic respiratory and circulatory survey, drew some blood, and left her breathing shallowly in the trauma room.

It seemed odd to neglect a neurological exam on a patient with clearly altered mental status, so I dove in and performed a basic neuro exam. Among other findings, she had an absent corneal reflex and decorticate posturing on one side of her body -- both suggesting that her unresponsiveness was neurological. These findings were initially dismissed, but after further prodding, the team finally agreed to a head CT. Sure enough, this lady had suffered a large hemorrhagic stroke.

In this case, being "right" was merely an academic victory. Unfortunately, the damage was already done, intervention options were limited, and her prognosis was extremely poor. But my simply "showing up" and asking some basic questions about her neurological status resulted in a more rapid diagnosis.

I'm running for Congress to ask some basic, but tough, questions. Hopefully, it's not too late -- our nation is bleeding red ink, and our legislators and bureaucrats are ignoring the fact that we're slowly slipping into an economic coma. We can't let our government go through the motions and pretend that our current situation is like every other "slowdown", when in fact we are in completely uncharted waters, with an unprecedented set of challenges.

While there are entire books written about the economic dilemmas we face today, the bottom line is that we have never before been so dependent on our federal government, and our federal government has never before been so broke. There are two ways to look at how broke we are: the national debt as stated by the Treasury, and the national debt as would be reported if our government followed the same accounting rules as corporations. The Treasury claims a national debt of $9.4 trillion, but excludes the future costs of entitlements like Social Security and Medicare. These future entitlement liabilities cannot be ignored however, and raise the total debt to about $60 trillion on a GAAP basis. This number is like the blood pressure of 180/120 before that unfortunate lady had her massive hemorrhagic stroke -- it's very, very dangerous.

Here are three numbers for you to remember: 40, 50, and 60. World GDP outside the United States is approximately $40 trillion. All the private wealth in the United States is approximately $50 trillion. Again, our total federal obligations are approximately $60 trillion -- the national debt along with the present value of liabilities for Social Security, Medicare, and other entitlements. Does that make sense? Is that manageable?

No, it is not. David Walker, our recently-retired Comptroller General and director of the GAO has been saying as much for some time now. He even compares us with a vulnerable Roman empire. But are we doing anything to change our direction? No, we are not.

What happens if we stay on our current track? Alan Greenspan left us a clue in 2005, which is playing out before our eyes today. When asked in a Senate banking committee hearing about our ability to meet our massive Social Security obligations, he replied, "We can guarantee cash, but we cannot guarantee purchasing power."

While Greenspan is not known for clarity, this message is unambiguous: the government, through the Federal Reserve, can print as much paper money as necessary to pay off the bonds in the Social Security "trust fund" and otherwise provide "benefits". Printing that much paper (or electronic) money, however, will destroy what shreds of confidence are left in our fiat currency. So you'll get your promised Social Security dollars, but they won't actually buy anything.

Again, have you looked at your gas bill lately? In 2001, oil was around $28 per barrel, and gold was around $280 per ounce. One ounce of gold would purchase about ten barrels of oil. In 2008, oil is around $105 per barrel, and gold is around $930 per ounce. One ounce of gold purchases about nine barrels of oil. Clearly, the price of oil in gold hasn't gone up nearly as much as the price of oil in Federal Reserve Notes. Are you still saving "money" in Federal Reserve Notes?

So how do we save ourselves from a declining paper currency? There are no easy answers, but one important step in the right direction is simply to admit that we need a much smaller federal government. Specifically, a federal government that limits its spending to those powers enumerated in the Constitution. Is that tough medicine to take? Yes, it is. It's chemotherapy for a cancer that is killing us. But ignoring the problem will not make it go away.

While the G7 leaders meeting this weekend are talking a tough game about protecting the dollar, the record of central banks "defending" paper currencies is pretty dismal. Ultimately, people will find out what currencies are worth -- just watch Zimbabwe, where they recently began printing a note valued at 50 million Zim dollars. In a few weeks, that won't be worth anything either.

I'll leave you with one chart to ponder, considering the relationship between debt and GDP for the United States and the rest of the world:

Our liabilities are about four times our GDP. The rest of the world has liabilities of about half its GDP. Are we the guardian of liberty, and guardian of the world's reserve currency? Or do we have more in common with a banana republic?

Here's the message as shared with North Carolina's College Republicans this weekend:

[kml_flashembed movie="http://www.youtube.com/v/LTy2JFtom1M" width="425" height="350" wmode="transparent" /]

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