[ethbr0]

The alternatives are fairly simple: you can either increase revenue or decrease benefits.

Increasing revenue (number games aside) would come from productivity gains or additional working population.

Decreasing benefits would come from cutting the payout or increasing qualifying age.

Honestly, taking Medicare out of the picture as a different problem that requires different solutions, Social Security should have been indexed to life expectancy from the beginning. It was never practical to build up a surplus that would be of sufficient magnitude to address demographic imbalances over decades.

Grandfather people in the program into the current rate, apply a sliding scale to people close to retirement (only fair, so their expectations don't drastically change), and make the hard decision.

[YellOh]

I agree on indexing retirement age to lifespan, but I doubt that would get much support. See ex. the protests in France. In the U.S., the elderly are a very powerful voting bloc.

I'd argue another concern could be useless/harmful interventions. Like taxpayers paying 82k a year per person for Leqembi treatments, which seems useless at best. There are also a lot of interventions that drag on terrible-quality lives in an attempt to forestall death as long as possible; I have personal experience with elderly family members who expressed a preference for death over their treatment plans (but were no longer able to choose). If I retain the ability to choose, I would go to great lengths to avoid some of modern medicine's pallative care.

I don't know. It's all hard. Obviously I want elderly people to be healthy and cared for as much as possible, but not at infinite cost (to the taxpayer or to their own quality of life).

[ethbr0]

Medicare is an entirely different ball of yarn that should be separated as much as possible.

It's complicated enough that including it in any other reform overcomplicates the effort and kills it.

That said, I do think the "death panel" branding from Republicans was extremely intellectually dishonest and in poor taste. Everyone knew exactly what was really being discussed, and to claim mock outrage in front of cameras for political points was dodging the hard question and hurting the country.