30 Issues: Getting Real On Medicare and Social Security

Monday, September 24, 2012

30 Issues in 30 Days is our election year series on the important issues facing the country this election year. Today: The current state of Medicare and Social Security, and how they might change. Visit the 30 Issue home page for all the conversations.

Open Prep: Questions, Articles, and Links to Get You Started

Key Questions

  • What do taxpayers owe their grandparents, and what do grandparents owe the future?
  • What is the distribution of government spending between the elderly and the young?
  • How do the Obama and Romney/Ryan plans differ?

What are your key questions on this topic? Post them below and get the conversation going!



Links and Articles

Third Way's report, "Collision Course: Why Democrats Must Back Entitlement Reform" inspired a Bill Keller column in the New York Times, "The Entitled Generation" and a response from James Galbraith.

James Capretta defends the Romney/Ryan proposal in “The Medicare Distortions

See also Esquire's "The War Against Youth" and Next Avenue's response, "The War Between the Generations Is Nonsense"

Got a Follow Up?

Each Friday we'll be following up on one of that week's issues. Got a particular follow-up question from this conversation? Comment below or tweet us. Tweet to @brianlehrer



Jim Kessler

Comments [61]

sally from Coal Creek Canyon, CO

I enjoyed listening to your guests discuss social security and medicare, but I found myself becoming increasingly irritated with the reference to "elderly entitlement." I was born in 1952 and began working part-time when I was 14. I recall being shocked with my first paycheck, which was quite small because it seemed that so much of my money was being taken out for federal taxes and SSI. Now I am 60 years old and reluctantly retiring because of a disability. I've worked 46 years and paid into SSI all those years. To me it isn't entitlement. I worked for it. Entitlement implies getting something for nothing. Can't this nation find a different set of words to describe this insurance that I have been paying into for so long and never yet received a penny from. It just sounds wrong. And I do feel 'entitled' to something from SSI as I have contributed to it for so long. Though frankly I never thought it would still be around when I reached retirement because the "experts" have been claiming for years that SS was going bankrupt. Hence I loved James Galbraith's assessment for the future. Hope he is a visionary!!


Oct. 24 2012 07:10 PM
Shawn Eng from Brooklyn, New York

Hire Singapore to run the healthcare system. In some ways, it's more right wing that what American conservatives can handle and more left wing than what American liberals will tolerate.

Oct. 06 2012 08:28 PM
CC from NYC

Brightest idea I've heard: abolish FICA wage the ceiling (currently, earners pay into FICA only to $110K for 2012; nothing beyond).
The proposal: continue FICA payments - no ceiling.

Sep. 28 2012 11:36 AM
Don Levit from Sugar Land, TX

NABNYC is correct that the excess payroll taxes (and "interest") are no longer in the trust fund.
It was borrowed over the years by the Treasury to pay for government expenses, and is owed back to the trust fund as part of our intragovernmental debt (which, along with debt held by the public, comprises our total debt).
How does the government view the strength of its commitment?
There are 4 levels of liabilities, ranging from Explicit Liabilities - the strongest commitment - to Implicit Promises - the weakest commitment.
Future Social Security and Medicare benefits are Implicit Promises.
They are not even considered as liabilities, for the program can be changed or even abolished, at any time by an act of Congress.
Don Levit

Sep. 25 2012 11:46 AM
Ellen Szuchmacher from Forest Hills, NY

Only people who don't have to use Plan D consider it a success. It costs seniors, including me, a lot of money because the government caved and didn't negotiate cheaper drug costs nor does it allow discount coupons for brand named drugs. My husband is a physician and I work in the office. Medicare has it's problems but private insurance companies are interfering with patients and their health care. Medicare Advantage plans cost the government more but don't offer savings or better healthcare. They just put roadblocks in the way by having doctors spend time and staff on the telephone talking to clerks who read from a list for care authorizations.

Sep. 24 2012 03:04 PM

Kudos to Hugh Sanson for pointing out the elephant in the chat room: SocSec should have been a separate discussion all by itself.

Medicare and Medicaid should have been a second day's issue.

Brian and his staff have fallen for the Republicans' and Corporatists' desire to conflate the two programs and thus confuse the electorate.

They've succeeded with Brian and his staff alas. Brian sounded somewhat perplexed, even stunned, that Galbraith would not play that conflation game.

WOW!!!!! But that happens when the Very Serious People, who may be very wrong are also very successful in the broadcase and political worlds. People begin to mimic their thinking, in order to be among the VSP's. It's a form or regulatory capture. Or employee capture of its employees' thinking: At some point, employees have to learn to think like their employers in order to keep their jobs, or they must be very clever to sound as if they do.

Sep. 24 2012 12:31 PM
Justin D. from New York City

I just couldn't help but comment on James Capretta's analysis I just heard on your show. He suggested that somehow seniors are driving health care costs because they use too many services. Following both my mother's and my father's care with doctors as the got older in the area, my experience was the opposite.

My mother had numerous doctor's appointments towards the end of her life, with various specialists, i.e. bone, liver, lung, g.i. etc. She never wanted to go to these appointments. She'd rather spend the day doing other things, go to the park, library. It was the doctor's requesting the follow up appointments or tests and her trying to be a compliant patient that made her use health care costs.

Perhaps Mr. Carpetta should consider that fact that seniors often have more problems as their bodies start to fall apart. Their use Medicare isn't driven because it is free or has low costs, but rather often it is driven by illnesses and their doctors approach to care. Most seniors don't have other options.

I at times get the impression that these "fellows" have such a macro p.o.v., it would help enlighten them to spend sometime in the trenches following the care that many seniors actually get. You should do a show about how poor the care can be in area hospitals for seniors, especially elderly ladies The system is terrible. People left in their feces for hours, medicines delivered late or forgotten, just to name a few. The nurses are overwhelmed caring for too many patients. The only oasis is the occasional kind nurse that goes out of her way.

Using the supply/demand model for health care can be an intellectual slippery slope. Illness has a built-in demand. It doesn't fluctuate with more or less care provided, its response to the lack of care is not less illness but rather more or, at times, death.

Sep. 24 2012 12:19 PM
Joseph Bell

Despite what the last guest stated Medicare Part D Durg coverage has not really benefitted from free-market competition. The Medicare is prohibited by law from negotiating bulk rates from Drug companies on behalf of the millions of Medicare beneficiaries. Just compare the dramatic difference in costs and co-pays (lower) in very large employer and Union Group Drug plans and Veterans Admin coverage where group buying power negotiation takes place. Even the Affordable Care Act forbid price negotiation as a group on behalf of Medicare beneficiaries.

Sep. 24 2012 12:12 PM
Marcia from Baldwin, NY

I always think it so strange that Social Security is considered an "entitlement" by so many.

I have worked since I was 15 or 16 years old and , yes, I paid for it during my entire professional life.
In addition, our Social Security checks are already "means-tested", which means ADDITIONAL monies are being deducted from our checks for both medicare and pharmaceuticals. And that, regardless of the fact that I already pay for prescription coverage -- and the "donut hole" has yet to disappear.

Why not raise, or rather, eliminate the contribution limit?

It's easy to be flippant about someone else's finances. Think like the wealthy: most signed a pledge not to pay any further taxes, but it's okay to "take" Social Security away from those who paid for the benefit their entire work life. And by the way, while Congress legislates for us, they legislate very differently for themselves!

What a wonderful way to eliminate the middle class. Amazing!

Take a look at the other side: had the government not used the Social Security monies, these "problems" might not exist. If we take a loan, it has to be repaid. Are we responsible twice?

Sep. 24 2012 12:11 PM

Brian keeps referring to the Third Way as "centrist," yet Galbraith represents the actual centrist position: Strong support for SocSec and Medicare*. Third Way is a Democratic form of Corporatism, with the Republicans being Corporatism on steroids and hell bent on destroying any semblance of government programs which assist the lower economic quintiles.

Essentially, a leftist or liberal position is not allowed to be expounded on the general media in this nation. Enough is enough, say those holding power. Rightwing extremists are OK to a certain extent since they make the rabid rightwingers in power look more moderate by comparison.

But real liberals? Real leftists? OMG, no way! Note how rare appearances by Galbraith actually are, even on public radio....

Why do Republican voters from those lower quintiles support Republicans? Because all the dog whistle hints that minorities are getting all the really, really good assistance make these voters think they're being cheated. If it's not easy to live on welfare, it must be because those other people are getting all the GOOD welfare. Same for the current food stamps program, SNAP. All the good SNAP assistance must be going to "those people."

Right now, because everyone (except Federal employees and some few others) are on SocSec and Medicare, people perceive both programs as being fair. And they support these programs. Indeed, it's only those on the far right who do not support these programs.

Except for Corporatists of both parties who think big bidnesses could make a bundle off handling private retirement savings and off private senior insurance. (And they could get in on that, and make their bundles, too.) Except "savvy businessmen" wouldn't cover those sick old folk, ya' know? And there's not much profit in handling really small savings -- or at least, there wouldn't be much growth to cover one's retirement years for small savers, after all the fees and whatever else is cooked up to rake profits off their meager savings.

Atrios over at has a riff going on this.

*Back before Obamacare passed, a majority of Americans, in the lower to mid-60's when polled, supported some form of Medicare for All. But that was off the table for Obama from the git go. Alas. Usually bargainers start out with the optimum position, then offer to change for actual compromise. Obama started with the compromise position! Brilliant!

Sep. 24 2012 12:11 PM
NABNYC from SoCal

Social security and medicare are not "entitlements," they are savings programs by which employees and employers are required to pay money into a savings account, to be used as a pension and medical care program for the employee when they retire. The money that is paid in is held in trust by the government, for the benefit of the workers. Unfortunately the government has slashed taxes on corporations and the rich, and borrowed the money that working people have saved for their own retirement. Now the government claims "the system" is broke, but that's a lie. The government just doesn't want to have to pay the money back.

The country exists for the benefit of the citizens and working people, but unfortunately the government is using our taxdollars to wage wars against the world on behalf of corporate programs to plunder resources. We need to get ourselves back to the original understanding, that the government exists to improve our lives, not to wage wars, not to make corporations and politicians rich.

The social security (payroll) tax should be levied on all income and gain, including capital gains. It's just that simple. If we agree that all working people are entitled to a pension (no longer provided by private employers) and healthcare once they reach 65, then we need a rational way to fund the program. We already have that in place. Current governments continue halting the payments into social security trying to manufacture a "crisis," where none should exist. They simply want to toss old sick people out into the gutters and let them die. Our nation needs to fully fund social security so it can be a complete pension, and fully fund medicare, by assessing the payroll taxes against all income including capital gains.

The same people (government) whole stole our social security and medicare savings are now telling us "the system is broke," because they don't want to repay the money they stole. Nobody should buy these lies.

Sep. 24 2012 12:08 PM
may tuner from nyc

I agree with conservative.

My dementia sick mother will make a great deal with an insurance broker and it will save her money.

And I will start negotiating with hospitals and doctors when I get into the emergency room.

that's how the saving will come rolling in....

and god forbid you regulate the medical thieves/ over billers / fraudsters.

Sep. 24 2012 12:07 PM
ek from bkln

I completely agree w rj from prospect.

Sep. 24 2012 12:00 PM

J Capretta-- more conservative fear mongering.
Not buying it.

Sep. 24 2012 11:59 AM
Martin Chuzzlewit from Manhattan


Sep. 24 2012 11:58 AM
mejimenez from manhattan

Deeply saddened to hear Brian continuing to conflate Social Security and Medicare in spite of Galbraith's multiple attempts to explain that their issues are completely separate. At more fundamental level, the speakers should have been presented in the reverse order: conservative first, centrist second, and progressive last (so as to clean up the mess). Galbraith was good, but Dean Baker would probably have made the points more crisply. Kudos to commenters HughSansom and Sean Bailey for laying out the facts in a clear fashion.

Sep. 24 2012 11:57 AM
mick from NYC

The blurb says the Mr. Capretta is at the AEI and the Ethics and Public Policy Institute. Conservative ethics...isn't that an oxymoron? Again, Bryan takes his assertion that raising payroll taxes is counterproductive. He gave Galbraith some tough questions, why not these rubes? And any softball questions he does toss are based on what Jim Kessler said, effectively ruling Galbraith an irrelevant non-participant in this discussion. Of the one percent, by the one percent, and for the one percent!

Sep. 24 2012 11:54 AM

Please remember that raising the income contribution level for SS would be a huge impact on the self-employed, who pay 12.4% into SS (i.e. they don't have "an employer" who is picking up half). So who are the self-employed? Farmers, small businesses etc. I favor means testing, even though that most likely means my personal benefits would be reduced despite the fact that I have paid in significantly. Lowering the benefits for those with higher incomes will extend the availability of fund for those with lower incomes. This is no different than means testing for medicare - which Romney supports.

Sep. 24 2012 11:54 AM
Ben Smith from nyc

Is he for VAT tax?

Sep. 24 2012 11:48 AM
Lonnie K. Stevans from Amityville, NY

Mr. Kessler needs to get his facts straight: about 30 percent of the public debt is held internationally. This means that the majority of the debt is "owed to ourselves," and does not represent a burden on future generations since interest payments would be transferred from taxpayers to bondholders.

Sep. 24 2012 11:46 AM
Danny from Queens

@deandpcr, we do pay for them, but we all need realize that per person we pull a hell of a lot more out of them then we put in and that is the problem. That doesnt mean I dont fully support them, just hat we need to be realistic about it.

Sep. 24 2012 11:45 AM
RJ from Prospect hts.

I appreciate the intent behind having 3 different points of view consecutively. However, Prof. Galbraith and Mr. Kessler have just stated diametrically opposed positions on Social Security funding--current workers paying for seniors, or not--and the average listener (I'll consider myself there) does not have adequate information to reconcile the 2 (soon to be 3) points of view. It would have been much more effective to use this entire time period to moderate a panel of all 3 simultaneously, so one can respond (collegially) to the others, and so give the listeners an opportunity to judge the most relevant and accurate point of view.

Sep. 24 2012 11:45 AM
fuva from harlemworld

So, YES, reform entitlements if they are on an unsustainable tract. But this MUST be done in ways that counteract income inequality which, of course, has increased stress on entitlements. These economists tend to completely ignore the economic pressures of unsustainable inequality because, of course, they are as clueless as they were before the crash...

Sep. 24 2012 11:44 AM
NER from NJ

The Affordable Care Act includes, in its expansion of Medicaid, increases the reimbursement rate for primary care doctors to match Medicare payment rates, which are higher, in 2013 and 2014.

Also, the federal government will pay all of the costs of the expansion of Medicaid until 2016, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent thereafter. Some states that already insure childless adults under Medicaid would receive more federal money for covering that group through 2018.

Sep. 24 2012 11:44 AM

Please stop referring to DSocial Secutrity and Medicare as entitlements. They are not! we pay in for them.

Sep. 24 2012 11:42 AM
harry from nyc

I have yet to meet a poor doctor, or middle class doctor that makes less then 125000 a year.

I am sure there are some locked up in lunie tune assylums, but do we need to count those?

Sep. 24 2012 11:42 AM
Dennis Maher from Lake Luzerne

The solution to the SS problem of raising retirement age is NOT a good one. I see in myself and my friends that health starts a downward turn for most of us at about 60 years of age. I struggled to work til 66. To make people wait longer to retire will create many hardships. I suspect that if Congress had no way to spend the SS fund, we wouldn't have the problems we do.

And let's give Obamacare a chance. Keep improving it if we can't have single payer.

Sep. 24 2012 11:42 AM
sp from nyc

Under no circumstances should Social Security and Medicare be means-tested. The overwhelming support these programs enjoy is a function of their universality. As soon as you make them welfare programs, support will begin to erode. This is precisely what the financial and health insurance thieves are salivationg for--shove anyone who can even marginally afford it into the maws of these criminal enterprises, leaving the very poor and sick to beg for adequate support from an ever less popular support network.

Sep. 24 2012 11:39 AM
Suzanne from Manhattan

When you make the argument that a decrease in the amount of social security payments to people making $200,000/yr would "make a divide between the middle and upper class/income people vs. the poor"....Do you really think that anyone earning over $200,000/year after the age of 65 is Middle Class/Income? Don't know what neighborhood you're from, but last time I looked, $200,000 income is well in the upper 5%.

Sep. 24 2012 11:39 AM
Jamie from ncy

Ambulettes not ambulances

yes it true

Sep. 24 2012 11:37 AM
mck from NYC

Jim Kessler is a long time congressional staffer with a masters degree from the Kennedy School in public policy. What makes him an expert on economics? As Dr. Galbraith said, the panic mongers arguments don't stand up to the tests of history or mathematics. A decent host would ask Kessler for figures not just generalities and references for where he gets those figures. With Fox and Limbaugh do we really need National Republican Radio?

Sep. 24 2012 11:36 AM

So Simpson-Bowles, which was not an actual committee recommendation, but the product of an investment banker and a senile Republican Senator, is where the Third Way sees salvation?

Again, who pays the Third Way's electric bills?

Sep. 24 2012 11:36 AM
RUCB_Alum from Central New Jersey

Social Security rates should be dropped to pre-Greenspan Commission levels - for the youngsters in the audience, the Greenspan Commission DOUBLED SocSec withholding in order to build a surplus of funds to ensure solvency and lay away extra to handle the Baby Boomers. Al Gore suggested that this money be lockboxed and not spent to cover current expenditures but that is a tangent...

Anyway, withholding rates for SocSec should go back to pre-Greenspan levels but the income that withholding is applied against should GO UP. My recommendation would be to index the cut-off to a multiple of the median income, thereby avoiding future haggling over cut-offs, say 5X or 10X. I would also let the company match for the self-employed end at half of that.

MediCare could be easily capped by opening the VA hospitals and facilities for all 55+ citizens who have no or insufficient coverage. Drop the eligible age by 10 years every 5 and we would have a national health service - a floor which you can not fall below - AND a robust private hospital and insurance system.

In my view, neither Mr. Romney or his running mate are being honest on the best way to solve these problems.

Sep. 24 2012 11:35 AM

Sorry, 3d Way guy, but Social Security is not "an entitlement" -- it's insurance we pay into. Yeah, we paid into that, we built that.

Sep. 24 2012 11:33 AM
Lenore from Manhattan

re: Bowles Simpson and Ryan--it wasn't a gaffe it was a lie on Ryan's part.

Sep. 24 2012 11:32 AM

What the are odds of Brian asking this Third Way representative where the group's funding -- and his salary -- comes from?


Sep. 24 2012 11:31 AM
Wen from Brooklyn

Please let the guests explain economic repression to the listeners and let them explain what happens to the fed balance sheets should rates rise on the long end. These are important things to learn about.

Sep. 24 2012 11:27 AM
harry from nyc

What does your commemtaor have to say about fraud in Medicare and Medicaid?

Sep. 24 2012 11:23 AM
jgarbuz from Queens

What does national bankruptcy mean? It means a drastic drop in the standard of living, to very deep poverty. But not forever nor even for that long. Entire continents have recovered after plague, Mongols, Nazis, and even Hiroshima and Nagasaki today are bustling cities. But for a period of time, it can mean destitution and homelessness for a large sector of the population. At some point, the economy rebalances and recovers to a large degree.

Sep. 24 2012 11:23 AM
fuva from harlemworld

See...I LOVE and deeply appreciate this "30 Issues" series, but it will be less effective if the experts speak about semi-complex issues like economics at break neck speed and makes statements like "debt, deficits don't matter, because other people have debt, deficits" without clear explanation and without Brian slowing the discussion down and getting clarification...This country requires rules for substantive discourse...

Sep. 24 2012 11:22 AM
Amy from Manhattan

How does increased worker productivity help support Social Security? The payroll tax is based on a percentage of salary, so it's a question of how much those fewer workers are paid (which has stagnated), not how much they produce for that salary.

Sep. 24 2012 11:22 AM
Clarel from Jersey City, NJ

Listening to Professor Galbraith, I'm starting to think that the public debt crisis is similar to the pending end of the world predicted by the Mayan Calendar. Yet, there seems to be a lot of credible people who think that we do in fact have a public debt crisis, and that we have to treat China with kid gloves because they hold so much of our debt. So, what gives?

Sep. 24 2012 11:21 AM
Wen from Brooklyn

the federal reserve can say the interest rates will remain low, because they are printing money to buy our bonds to ensure it - this is not sustainable. Let the guest explain economic repression - important to know about.

Sep. 24 2012 11:21 AM
Dorothy from Manhattan

LOL. Poor Bryan. He's trying sooo hard to create a crisis and Galbraith won't give him a break.

Sep. 24 2012 11:19 AM

Contrary to what your learned guest asserted, Andrew Jackson paid off the national debt in 1835.

Sep. 24 2012 11:17 AM
Jordan from Nassau County

I'd like to echo the other posters above. Remove the income cap on the contribution limit, and let everyone pay a fair percentage of their income. Can you ask your guest about how much revenue this would produce?

Sep. 24 2012 11:14 AM

Eliminate the FICA cap & make more types of income subject to it.

Add in the fund "mgrs" 2%/20% & bonuses & income paid during each tax year.

Reduce the ability to defer income unrelated to capitals gains.

Make capital gains kick in only after 10 or more years.

Sep. 24 2012 11:12 AM
Edward from Washington Heights AKA pretentious Hudson Heights

Medicine has benefited from advances in Technology. I don't see why Medical care, aided by technology, hasn't seen drops in costs as any other tech industry has.

I visited an ICU a while back. Almost all the staff were sitting infront of computer terminals.

The speed and cost to sequence the genome is another example.

Sep. 24 2012 11:06 AM
Jerry from Elmhurst

Social Security has not contributed ONE PENNY to the deficit - it has actually financed our national debt !!!

Sep. 24 2012 11:05 AM
Seth Pickenstiff

Means testing, means testing, means testing!

Sep. 24 2012 10:54 AM
Sean Bailey from Maplewood

Key points to consider:

1) Social Security is the most successful social insurance program in history. It works because everyone in society contributes(though the rich contributed way less than the rest of us as a percent of income).

2) It does not contribute to the debt--it cannot by statutue. The Trust Fund bonds do fund government activities (what else would you expect to happen--keep the money in a lock box? It's the same as U.S. Treasuries bought by China or anyone else.

3) Conservatives have opposed SS since it's inception and make the same false claims now that they did in the 1930s,40s,50s,60s, etc. History has proven them wrong.

4) You pay 6.2% of your salary and your company matches that with another 6.2%. Most people, when quizzed, have no idea that it's such a substantial amount of money.

5) Middle class retirement has been decimated by the advent of the 401K and the decline of Defined Benefit Pensions. Huge CEO pay increases and record corporate profits correspond with the decline of companies getting out of funding pensions.

6) Why isn't this a separate issue, anyway? The retirement crisis facing boomers is huge and not even being discussed in the campaign. Social Security needs to be expanded, first by removing the cap so that earners over $106K continue to pay 6.2%.

7) Social Security is a guaranteed retirement income stream that is inflation protected (cost of living increase) and has rights of survivorship--your spouse or minor children get a benefit if you die.

8) Raising retirement age and changing the COLA formula is a benefit cut, plain and simple. You get less over your lifetime.

9) The oligarchs want to means-test Social Security, meaning if you're making more than $40,000 a year, they want you to tap Social Security as you need it, like a welfare program, and not get your full benefit as inthe past. That's part of their plan to ultimately kill it by driving a wedget between the classes.

10) Obama's decision to use the FICA tax as vehicle for stimulus by cutting your SS contribution to 4.2% as he has done in the past 2 years is a disasterous development and plays into the right's long-term agenda to kill SS. Now every time the economy is in trouble, presidents and Congress will look to SS tax cuts as a way of juicing the economy. It was a terrible precendent that should never be allowed to happen again.

11) Obama's proposal, in his current budget, to allow employers to automatically invest a portion of their employees pay into a mutual fund is a terrible idea, basically privatizing what should be an increase in Social Security savings. We need to increase our contribution levels higher, around 15%, but keep it out of Wall Street's hands.

Sep. 24 2012 10:49 AM

1. Social Security and Medicare are separate. Lumping them together is deeply misleading.

2. Social Security if supported by a trust fund. Modest changes in Social Security now would require _no_ reduction in future benefits (by raising eligibility age, for example). Elimination of the ceiling in compensation subject to FICA, for example, would go a long way to solving the problem. Any person who says the _only_ way to solve any future problem is by cutting benefits is just lying.

3. The principle reason for problems in Medicare is skyrocketing medical costs, especially in prescription medications. If free marketers were honest, they would support opening the US medical market to international competition, but they oppose this. So much for free market dogma. Anyone who ignores increasing costs in pharmaceuticals is lying by omission.

Sep. 24 2012 10:12 AM
Katie Kennedy from Huntington, NY

Eliminate the income tax cap on FICA. You could have a "doughnut hole" where there would still be a cap, but then, after reaching eg. a Million Dollars a year, the cap comes off and you pay again. Two things are very important to mention: 1. WE ALL PAY INTO SOCIAL SECURITY. IT IS NOT AN ENTITLEMENT the Romney sense. 2. Obama did not "rob" Social Security or Medicare. Please point this out. It's a Republican LIE. Finally, I remember news stories in the '60s when elderly people (they were "elderly" then, not Senior Citizens, were eating dog food because pensions, and social security were not enough, which, I believe brought about Medicare. Let's not go back there.

Sep. 24 2012 09:56 AM
jennifer from Manhattan

I am hoping that your guests address the question of Medicaid and paying for long-term care (i.e. nursing homes) for the elderly. How much of the Medicaid budget is used for this?

It is a very common practice for older people to begin shifting their assets in order to qualify for Medicaid so they will meet the asset and income tests for Medicaid when the time comes for long-term care and/or nursing homes. Put the house in the kids' names and wait five years, etc. From a macro perspective it is a wealth transfer to a younger generation while that generation is also footing the tax bill for the health care, except the advantages aren't fairly distributed.

I am hoping your guests discuss whether anyone is focusing on the huge costs of long-term care and the impact on the Medicaid/Medicare budget and whether anyone is thinking about a more fair system. Thanks.

Sep. 24 2012 09:55 AM
John P MacKenzie from Long Island City

Please crunch the issue of Obama "robbing" Medicare and the role of Medicare Advantage.

Sep. 24 2012 09:33 AM
g from staten island

1) People should be able to access healthcare--medicare or medicaid.
2)People have paid their "social security premium". Adjust the premeium as necessary to have a secure retirement. S.S. should not be an individual "investment". Some investments fail and as we age our brains may not be able to do the job of evaluating investments.

Romney said he won't take money out of medicare--but he hasn't said it won't be a vooucher system--ever. If the voucher doesn't cover all the care you need, which of your illnesses do you choose not to treat? Well, I guess you could choose how you will die-- and we won't need the "death panels" talked about during the last presidential campaign. You will have to do your own rationing if there are vouchers.

Sep. 24 2012 08:27 AM
Pls Read before show! : Polypill/BMJ. from Lower costs & better health!

Here's how to dramatically reduce medicare costs
AND improve patients' health :

A strategy to reduce cardiovascular disease by more
than 80%
N J Wald, M R Law

Sep. 19 2012 03:48 PM
You can always import young people later. from no real demographic crisis only an economic one

If one is concerned about demographics, it's a red herring.

First, as people stay healthier as they age, many will
WANT TO and be ABLE to continue working for much longer
than they currently do (unless our economy tanks - see
discussion on trade).

If you STILL need more young people in the workforce,
you can always import young people later. (As long as
there are jobs and the economy hasn't tanked).
By simply redesigning immigration rules to maximize
the economic benefit to current Americans one
can easily avoid any demographic concerns - and
pick and choose the best, brightest, hardest working
and best educated to add to our country.

Sep. 19 2012 03:46 PM
Eliminate protectionism in healthcare

Eliminate protectionism in healthcare.
Allow qualified doctors and nurses and other practitioners
from other countries with high life expectancies to
practice right away. Actively recruit them and encourage
them to come - particularly to help poor and remote
patients who currently dont have adequite access to quality care.

Allow reimportation of medicines and medical devices from
countries with good healthcare systems. This will lower price.

Actively fund research into treating, delaying, preventing and
ideally curing common chronic diseases - diabetes, heart disease,
dementia, stroke, COPD, common cancers.
Maybe tax existing patent revenue to fund this.

Improve access and encourage use of primary care.

More supply and competition means higher quality and lower price.

Sep. 19 2012 03:42 PM
Eliminate income cap on FICA tax-no more problem.

I agree with the previous poster.

If you simply eliminate the income cap on the FICA
tax - and include ALL INCOME - including capital gains -
the problem is largely solved.

Sep. 19 2012 03:36 PM
Smokey from LES

The easy and obvious way to make Social Security secure for decades is to raise the contribution limit - currently about $108K. Anyone making $108K can continue to contribute to the trust fund to keep it healthy and strong.

I think I've read if we made the contribution limit about $175K we would never have to discuss this issue again.

With more and more people working without any pension plan at work, and with the the decline of the middle class to be able to save during life, Social Security becomes more and more important for the 99%.

Sep. 14 2012 02:25 PM

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