Fixing(?) Entitlements

[Schneed10]

Originally Posted by CRedskinsRule

So if we can set aside partisanship, and trump/hc hatred, can this country fix entitlements in a way that protects the sick, and elderly while preserving the US economy for future generations. I would love to here Schneed way in on the healthcare costs.

Seems to me that something does need to be done, but what?

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CMS estimates Medicare will run out of money in 2026 so something definitely has to change with the healthcare side. When Medicare was first conceived 65 was set as the age at which it began, now life expectancy is much longer. I don't see how you can fix Medicare without adjusting the age of eligibility. It's hard to see it working without that. Math should be fairly easy - if life expectancy has increased by 5 years since Medicare was conceived, then raise the age of eligibility by five years.

Really, the same should be done with social security because it's the same concept there. People will have to stay in the workforce longer - I don't see any way around that because we need more money coming into the Medicare and SS funds to support those drawing down on them.

This part isn't complicated, it's just politically inconvenient. Nobody wants to be the bad guy to delay benefits to seniors. That's why it won't be voted into place until the public recognizes that the programs themselves are genuinely at risk. Right now it's a figment in the minds of some, but once it becomes a reality for people that they stand to lose their Medicare safety net entirely, only then does it become politically expedient to support it.

In other words, once it's too late. Hope you're all saving your money as effectively as possible. Those capable of supporting themselves on their own two feet stand to come out the other side in decent position. Others will experience difficulties.

[Giantone]

Originally Posted by Schneed10

CMS estimates Medicare will run out of money in 2026 so something definitely has to change with the healthcare side. When Medicare was first conceived 65 was set as the age at which it began, now life expectancy is much longer. I don't see how you can fix Medicare without adjusting the age of eligibility. It's hard to see it working without that. Math should be fairly easy - if life expectancy has increased by 5 years since Medicare was conceived, then raise the age of eligibility by five years.

Really, the same should be done with social security because it's the same concept there. People will have to stay in the workforce longer - I don't see any way around that because we need more money coming into the Medicare and SS funds to support those drawing down on them.

This part isn't complicated, it's just politically inconvenient. Nobody wants to be the bad guy to delay benefits to seniors. That's why it won't be voted into place until the public recognizes that the programs themselves are genuinely at risk. Right now it's a figment in the minds of some, but once it becomes a reality for people that they stand to lose their Medicare safety net entirely, only then does it become politically expedient to support it.

In other words, once it's too late. Hope you're all saving your money as effectively as possible. Those capable of supporting themselves on their own two feet stand to come out the other side in decent position. Others will experience difficulties.

https://en.wikipedia.org/wiki/Social...ity_Trust_Fund

[CRedskinsRule]

Originally Posted by Schneed10

CMS estimates Medicare will run out of money in 2026 so something definitely has to change with the healthcare side. When Medicare was first conceived 65 was set as the age at which it began, now life expectancy is much longer. I don't see how you can fix Medicare without adjusting the age of eligibility. It's hard to see it working without that. Math should be fairly easy - if life expectancy has increased by 5 years since Medicare was conceived, then raise the age of eligibility by five years.



Really, the same should be done with social security because it's the same concept there. People will have to stay in the workforce longer - I don't see any way around that because we need more money coming into the Medicare and SS funds to support those drawing down on them.



This part isn't complicated, it's just politically inconvenient. Nobody wants to be the bad guy to delay benefits to seniors. That's why it won't be voted into place until the public recognizes that the programs themselves are genuinely at risk. Right now it's a figment in the minds of some, but once it becomes a reality for people that they stand to lose their Medicare safety net entirely, only then does it become politically expedient to support it.



In other words, once it's too late. Hope you're all saving your money as effectively as possible. Those capable of supporting themselves on their own two feet stand to come out the other side in decent position. Others will experience difficulties.

Thanks for actually discussing the actual issues. I believe the systemic issues should outweigh politics but I agree with you. Politicians can/will not make tough choices if Joe Public is not pushing it, and as you said right now its a monster under the bed issue, both sides can use it to scare there base by saying the right call words.

I believe social programs should be keyed to (at least) 3 main measurables:
Average life expectancy
Localized cost of living
average cost of preventative care medical figured independently from general cost of living.

If you can find baselines around those statistics and total percentage of federal budget allocated to these programs then you should be able find the intersecting values that keep the system working right.


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[Schneed10]

Originally Posted by CRedskinsRule

Thanks for actually discussing the actual issues. I believe the systemic issues should outweigh politics but I agree with you. Politicians can/will not make tough choices if Joe Public is not pushing it, and as you said right now its a monster under the bed issue, both sides can use it to scare there base by saying the right call words.

I believe social programs should be keyed to (at least) 3 main measurables:
Average life expectancy
Localized cost of living
average cost of preventative care medical figured independently from general cost of living.

If you can find baselines around those statistics and total percentage of federal budget allocated to these programs then you should be able find the intersecting values that keep the system working right.


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Yes and those statistics already exist as part of the Medicare reimbursement formula - Medicare pays based on wage index, so a hospital located in New York gets paid more than a hospital located in Nebraska simply by virtue of the fact that nurses and doctors in New York have higher wage rates than those in Nebraska.

Philadelphia's wage index for example is 1.06, it's hardwired into the Medicare formula, SS could just borrow from the same thing.

And cost of Medical care is available through the Bureau of Labor & Statistics, can just look at the CPI for Medical Care Services. You're right, it should be easy to hardwire this.

Getting several hundred congress men and women to understand how it works is one hurdle, because embarrassingly may do not. And then there's the political hurdle, why support something that isn't a fire yet. But agree, it's not as hard as people think.

[MTK]

Originally Posted by Schneed10

CMS estimates Medicare will run out of money in 2026 so something definitely has to change with the healthcare side. When Medicare was first conceived 65 was set as the age at which it began, now life expectancy is much longer. I don't see how you can fix Medicare without adjusting the age of eligibility. It's hard to see it working without that. Math should be fairly easy - if life expectancy has increased by 5 years since Medicare was conceived, then raise the age of eligibility by five years.

Really, the same should be done with social security because it's the same concept there. People will have to stay in the workforce longer - I don't see any way around that because we need more money coming into the Medicare and SS funds to support those drawing down on them.

This part isn't complicated, it's just politically inconvenient. Nobody wants to be the bad guy to delay benefits to seniors. That's why it won't be voted into place until the public recognizes that the programs themselves are genuinely at risk. Right now it's a figment in the minds of some, but once it becomes a reality for people that they stand to lose their Medicare safety net entirely, only then does it become politically expedient to support it.

In other words, once it's too late. Hope you're all saving your money as effectively as possible. Those capable of supporting themselves on their own two feet stand to come out the other side in decent position. Others will experience difficulties.

The retirement age is already gradually increasing for benefits. The easy solution to me is to drastically raise the cap or eliminate it. Right now the maximum earnings subject to Social Security payroll tax is only $132,900. If we want to get serious about expanding and strengthening Social Security I'm down with Bernie's ideas.

[Schneed10]

Originally Posted by MTK

The retirement age is already gradually increasing for benefits. The easy solution to me is to drastically raise the cap or eliminate it. Right now the maximum earnings subject to Social Security payroll tax is only $132,900. If we want to get serious about expanding and strengthening Social Security I'm down with Bernie's ideas.

I would agree with raising the cap. When the cap was set it was done in a time when $100K was a real high salary.

The age of eligibility and the cap both need to get with the times. We live longer now, and $250K is the new $100K. Put both in line relative to when the plan was instituted and then you've got something. It's a mathematically objective notion too.

[Buffalo Bob]

Originally Posted by Schneed10

I would agree with raising the cap. When the cap was set it was done in a time when $100K was a real high salary.

The age of eligibility and the cap both need to get with the times. We live longer now, and $250K is the new $100K. Put both in line relative to when the plan was instituted and then you've got something. It's a mathematically objective notion too.

Raising the cap is a lot better than raising the retirement age. Even though people are living longer the wear and tear on the body on a lot of manual labor jobs hasn't changed since social security was implemented.

[Schneed10]

Originally Posted by Buffalo Bob

Raising the cap is a lot better than raising the retirement age. Even though people are living longer the wear and tear on the body on a lot of manual labor jobs hasn't changed since social security was implemented.

Can't design a whole system around the portion of the workforce aged 65-70 who remain in physical labor jobs.

My perspective is simple - when the program was conceived the retirement age was set such that there was a 7 year gap between retirement and life expectancy (death). And it was set with a cap of $100K because that was a shitload of money at the time.

Update both to today's terms. Take life expectancy minus 7, that's the new retirement age (72). And take the cap and inflate it to today's dollars ($250K or so). Both factors together return the program to a) what it was intended to be all along and b) solvency.

Don't cherrypick, you expose your political bias. Both should be done, otherwise it's gerrymandering the original intent of the program.