If you ask any honest person, who has studied the federal budget, they all say that Medicare is not sustainable. Some here won't make it through that first sentence without getting defensive, but the math is impossible to get around.
The FICA withholding revenues do not cover the cost of Medicare.
The problem is that people like Paul Ryan want to present pretend solutions, which don't occur for five more congress'. Paul Ryan is pretending to "fix" Medicare, but the fix doesn't kick in till 2022.
No congress in 2022 (a congress going into midterm elections) will allow Medicare to devolve into Ryan's voucher program. It is just rhetoric, which distracts from a real problem.
Fixing Medicare will be unpopular, and there is no way around it. In order to get costs under control, we will need to raise FICA revenues, and we'll also need to consider some form of means testing.
No one is going to want to hear that we need a Medicare copay, which varies based on the net wealth of the beneficiary. Quite simply the people with the means will have to cover a heavier portion of their health care costs.
No one is going to want to hear that we need to increase taxes on working class people, but that is exactly what increasing the FICA rate means. We can of course extend the FICA tax into higher tax brackets, but the heavy lifting will need to occur at the bottom.
There is also a very difficult conversation about end of life care, that we might be too immature to have. Heath care spending in the final two months of life skyrockets, despite those dollars often being spent for negligible results.
Medicare requires an adult conversation, and Paul Ryan isn't doing that. The are two major flaws in Ryan's logic.
1. No one will accept two concurrent and unequal Medicare systems in place at the same time
2. No future congress will politically allow Medicare to be replace with a voucher program under their watch
This budget will become a political football through this election, and that is really a sad thing. We need to fix Medicare, so that the next generation knows they can afford health care in their old age. It is inexcusable for people like Paul Ryan to just pretend voodoo math tricks are a substitute for reform.