[lotsofpulp]

I have pondered about it for over a decade. Our societies drastically prioritize the elderly over the young. They are the ones with political power, after all.

Here’s an easy example: why does the US pay doctors more via Medicare (for people over 65) than via Medicaid (for poorer people, including kids).

[giantg2]

That's not a great example. One is a single payer system funded by workers and the other is government welfare. Plus, the elderly can be on both programs simultaneously. If anything, this is an example of money influencing politics since the people who have been paying those taxes for Medicare are more likely to donate to politicians than people who require Medicaid.

[lotsofpulp]

> If anything, this is an example of money influencing politics since the people who have been paying those taxes for Medicare are more likely to donate to politicians than people who require Medicaid.

That is what I wrote, the elderly have more political power.

The same legislature that allocates society’s resources towards healthcare for people age 65+ also chooses to allocate less resources to people who happen to be poor (or have poor parents).

The Additional Medicare Tax is another lovely reminder of how society’s resources, because funnily enough, even though it has been widely known Medicaid does not even pay enough to keep the lights on, there is no Additional Medicaid Tax.

[giantg2]

"That is what I wrote"

Could you point that out? I saw that the elderly had power - not the wealthy. Many elderly are also poor. Much of the political influence on Medicare comes from those who are working as they near retirement. For example, talks about raising the required age do not affect those already receiving it, but future recipients. Those are the people involved. The people receiving it could care less since the already have their's.

The reason the poor recieve less is because it's not single payer and is funded by other taxes. The general population (voters) feels that the vare minimum is all they deserve (for better or worse, that's how it is).

Again, there is a Medicare tax because it is a non-means-tested single payer system. There is no Medicaid specific tax because it is intended for a small minority of indignant individuals. As with other welfare programs, it paid for out of the general taxes and nothing specific.

It's a money and voter base issue. Yeah, that can be correlated with being old, but there's more to it.

[lotsofpulp]

> I saw that the elderly had power - not the wealthy.

Multiple groups can have varying amounts of power. In this case, I am using the fact that one group is getting a better benefit than another group as proof that the group getting the better benefit has power. Why else would they have it, and why else would those that do not have go without?

> The reason the poor recieve less is because it's not single payer and is funded by other taxes. The general population (voters) feels that the vare minimum is all they deserve (for better or worse, that's how it is).

This is my point. Voters skew older, and providing healthcare to the poor at least equivalent to Medicare is not a priority.

> Again, there is a Medicare tax because it is a non-means-tested single payer system.

This is incorrect. Medicare premiums get more and more means tested every year.

https://www.ncpssm.org/documents/medicare-policy-papers/medi...

Even Social Security is means tested, look up bend points in the benefit formula.

And at the end of the day, all taxes are fungible. Government received money and pays money for benefits. Who gets how much is a political exercise.

[giantg2]

"Why else would they have it, and why else would those that do not have go without?"

I already told you - the people working to get it later are included in the group. It's not just old people.

"Voters skew older, and providing healthcare to the poor at least equivalent to Medicare is not a priority."

It's not a priority because the poor are a small voting segment. The voting segment concerned with Medicare include the elderly and those who are working and thinking about their future retirement, which is a huge segment.

"Medicare premiums get more and more means tested every year."

That's not exactly means-tested. You get Medicare if your old enough, then yes you have premiums and deductibles since this is insurance after all. You even have contribution requirements for things like part A. The permium cost can vary based on income, but that doesn't affect the actual coverage or eligibility.

Yeah, money is fungible. The laws are pretty clear on the funding sources and amounts for the entitlement programs, unlike with welfare programs that are more open-ended and less predictable.

Bend points are not means testing. You get your benefits regardless of your situation. The insurance just pays out based on a formula to adjust to cover the more basic expenses. You can see this intent in the way the formula for payouts is designed as a replacing percent of income as well as in the tax cap.

Stuff like Medicare and Social Security are not welfare programs that are means tested. The costs and benefits can vary based on contributions and income but you are entitled to the benefit. These programs are not powerful just because of the old people. The workers expecting these benefits in the future are a huge source of the political power. It's the money and the fact that people have been paying in with an expecting of benefits that's the difference.

[lotsofpulp]

> The permium cost can vary based on income, but that doesn't affect the actual coverage or eligibility.

> The insurance just pays out based on a formula to adjust to cover the more basic expenses.

Both of these are means testing.

https://en.wikipedia.org/wiki/Means_test

> A means test is a determination of whether an individual or family is eligible for government assistance or welfare, based upon whether the individual or family possesses the means to do without that help.

> The workers expecting these benefits in the future are a huge source of the political power. It's the money and the fact that people have been paying in with an expecting of benefits that's the difference.

I see what you are saying, but I don’t think many people buy it anymore. The demographics alone make it quite obvious that workers today should not be expecting those benefits, not to mention the continuous devaluation of them already for many years.

The old/young divisions are thoroughly established. Technically, I guess the division is old and young expecting inheritances versus young not expecting inheritances. There are just so many examples. California’s prop 13, defunding state colleges in favor of indebting students, tiered taxpayer funded DB pensions and retiree healthcare that are only available to older employees.

NJ just cut taxes big time for people 65+:

https://www.nytimes.com/2023/06/21/nyregion/property-tax-cut...

[bugglebeetle]

We need to pick which out-group to sacrifice vs. take care of everyone is the kind of thinking that creates most of America’s problems.