tag:blogger.com,1999:blog-4161781017528873219.post6607578486544431790..comments2023-10-17T04:51:04.961-07:00Comments on Telemachus: The Gordian Knot of MedicareFrank Hillhttp://www.blogger.com/profile/13948885430465501408noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4161781017528873219.post-91895034423370682152012-01-31T19:38:21.442-08:002012-01-31T19:38:21.442-08:00you lost me on the means-testing argument....i am ...you lost me on the means-testing argument....i am not clear what you are saying<br /><br />i am saying that rich people do not need or deserve any federal subsidized help from anyone to pay for their health coverage. (Medicare is not insurance; it is simply a payor plan) They certainly don't need to be getting payroll tax money taken out of the pockets of manual laborers, that is for sure, to pay 38% of their Medicare costs.Frank Hillhttps://www.blogger.com/profile/13948885430465501408noreply@blogger.comtag:blogger.com,1999:blog-4161781017528873219.post-10892689457811581372012-01-31T07:59:30.588-08:002012-01-31T07:59:30.588-08:00I can't agree with you, philosophically, altho...I can't agree with you, philosophically, although I can see the merit in your proposition. The whole idea of "means tested" societal benefits is just another form of wealth redistribution, though, and is only a little "numbers fiddling" away from being a class-warfare debacle (eg: AMT).<br /><br />Moreover, anything which might require "means testing" is a red flag to me: it suggests that there is some benefit or handout that the government is providing which is beyond the minimum required for a social "safety net". After all, "rich" people don't usually need/use the minimum benefits anyway, so there should be zero cost to the government if the program is really providing only the base level of care. I don't know a lot about what Medicare covers, or how much of one's taxes paid during their working career cover the fair-market premiums to afford it... but I'll hazard a guess that the government is highly subsidizing a standard of care I would consider well above the bare minimum.<br /><br />How to fix Medicare in a "no additional wealth-redistribution" sort of way:<br />- Make standard of care "baseline". Yes, this may mean less prolonging of people's lives with expensive new drugs; so be it.<br />- Adjust the benefits so that the plan cost is in line with the taxes collected per-person on average.<br />- Take steps to reduce the actual cost of health care, instead of just enriching the insurance companies.<br /><br />And, as you noted, the most important factor:<br />- Figure out how to tie lifestyle health choices to premiums, so you pay more (above and beyond the federal subsidy) if you made unhealthy choices.<br /><br />All of these are not easy fixes, but I don't think there are easy ways to fix this program, at least in a "good" way.Nickhttps://www.blogger.com/profile/05587036619182019599noreply@blogger.com