Ok, I agree with you that there are multiple options, etc. Eventually, we'll choose one or more of the options and implement it. That's all I was saying. And when we do, that exponential growth on the graph goes away, and the world is saved once again! Hooray! Ok. My point is the structure of medicare isn't the fundamental problem here. The cost of healthcare is the fundamental problem. I'm not really sure what your point is about the 'overruns'. The old people aren't paying their own healthcare costs, working people are paying it for them. Does it really matter if we pay it via a payroll tax, or an income tax, or the combination of the two that we currently use? barfo
I don't think Brian was drawing a distinction. But you are free to take that tangent if you wish. barfo
If people paid their own health care bills, the cost would go way down. As it is now, people are directed to go to specific doctors where their co-pay is accepted. If people paid out of pocket, and the first doctor quotes them $100 to remove a hangnail, the person can go next door tooth doctor who charges $50. Competition and free markets are a great thing.
That's the part I disagree with. Unless it's pushed (and pushed past the AARP people who don't want it touched) there won't be changes, and it will remain status quo. And I see it as sufficiently third-rail as not to be implemented by weak partisan leaders sweating the next election. I use "overruns" as defined in the following manner. The payroll tax set up for M/M (akin to your "premiums") comes in at around 100B a year. The cost of care (as budgeted!) is ~800B a year. So the overrun for this program (which is easy to identify, since it has a documented revenue stream--tax--that's supposed to pay for it and a budgeted expenditure amount) is ~700B, or basically DoD+DHS. We're looking at across-the-board cuts to solve our deficit problem, yet keeping as a sacred cow the unfunded expenditures of an exponentially-growing entitlement program making up almost half of the deficit. I don't want to put words in anyone's mouth, but I surmise that that's the model that Denny and others think will happen with SS in the near future. Like I said before, I'm not as pessimistic about SS, but M/M has to be clamped back hard.
Well, we seem to be going back and forth on this. Either there will eventually be a solution or there won't. If there won't, then I guess we'll starve to death after spending all our money on healthcare. I think there will be a solution, however. I don't think it will happen tomorrow. Maybe by 2020. Ok, but that's just semantics. No one actually expects the payroll tax to cover the cost of medicare, the 'overruns' are intentionally paid for from the general fund. No, it doesn't. Healthcare costs have to be clamped back hard. The reason M/M costs are exponential is because healthcare costs are exponential. Even if we got rid of medicare and medicaid entirely, healthcare costs would still be growing exponentially. Killing off medicare doesn't reduce the cost (enough), it just changes who pays. barfo
That is one of the two most likely solutions as far as I can see. The other is the opposite solution. barfo
Or perhaps people could fucking save something for their retirement. Social Security was never meant to live on. We should stop pretending that's its purpose.
