[JeremyStein]

"It's a TAX on the YOUNG to care for the OLD."

<sarcasm> Yeah! Who do those old people think they are, getting all weak and sickly!? </sarcasm>

Most of the western world believes that society should be taxed to provide health care for everyone. Like education, welfare, and social security, it's something we all pay for to live in a moral, civilized society. Thank God Ayn Rand doesn't run the universe and the government forces you and me to pay for Grandpa's medication.

[cwan]

I have no problems paying taxes - but let's not be disingenuous about it claiming that they are forcing the young to pay for insurance for their own good. If we need taxes to pay for services of the elderly, then let's call it like it is.

The screwed up part of the system is that the idea used to be that you'd pay into the system with an expectation that you would eventually get the same services as you got older - but have you even looked at the actuarial tables lately? Practically ever western country has massive unfunded liabilities especially as the baby boomers retire.

Personally I like Megan McArdle's solution - let people buy catastrophic loss insurance and fund the rest out of your own pockets. The premiums would be relatively minimal - but the idea that we have to have the government provide insurance / or that even what's proposed in the current legislation solves this problem is frankly nuts. I find it absolutely bizarre that as a Canadian, that while the US government spends more per capita on publicly funded Medicare/Medicaid than Canadians do, coverage for Americans is spotty at best - and you want the US government to get even more involved in healthcare through regulation and direct interventions?

[jojopotato]

Every country with a declining birth rate and a promise to the older generation has massive unfunded liabilities. The United States, China, Japan, everyone is having to deal with the problem of "How do we pay for the elderly when we have so few children?"

I'm not saying I have an answer, but we need to address the real question previous generations never had to face before, which is how much burden do we want to put onto the younger generation to take care of the older one when there are so much fewer young people? At what point do you say "The cost to keep Grandma alive another 6 months costs too much."?

[cwan]

My problem with this is that in effect we are asking the young to pay for services that they will not ever see. There is a fundamental fairness problem here. It's also not as if governments (and many people who voted for them) never understood the demographics.

As for keeping Grandma alive, the closer we come to a government run system, the less you will be in control of what happens to your Grandma and instead subject to increasingly draconian policies of what is and isn't covered given that governments the world over are trying to do more with dwindling resources - something is going to give.

[jojopotato]

I guess my point was really that because the demographics are so bad, we're going to have to downgrade our expectations for quality and length of care for the elderly, and nobody wants to think about that.