Many of us appear to want to as much as we can get without planning or paying for it. We hate taxes, but we want a lot done for us anyway. A distant relative says about Medicare, “I deserve every penny I get, I paid for it.” My answer, yes she deserves every penny she gets, but no, she did not pay for it all.
Most people love Medicare and want every benefit imaginable (and believe me, I do because I am close to applying for it), but lots of people do not want to pay over our working lives anywhere near what the benefits will cost. This is NOT a criticism of Medicare. It is a criticism of people in my generation and younger who are not yet retired and also not willing to pay more to improve the pay/receive ratio for their future Medicare benefits.
My Career Total of Medicare Taxes
I’ve cut out a small section of my Social Security/Medicare summary showing how much I’ve contributed to the two programs over my working life as a teacher (only two years of not working since college) and about seven years away from retirement.
To Medicare I’ve paid, and my employers on my behalf, about $43,000 (see above). Actuaries predict a person my age will cost a lot more, maybe twice that, when I begin drawing Medicare benefits. So if we really want all the Medicare benefits, and I do, how come we are not telling the politicians to get their acts together and tell us to pay up for this amazing benefit?
As the Rolling Stones said, “You can’t always get what you want.” I worry that pretty soon we won’t be able to get much of what we want; we’ll get just what we pay for, because many people in the U.S. keep letting wimpy politicians convince us that we don’t need to plan for or pay for what we use.
- Bottom line: You want good benefits when you retire? You pay more taxes.
- Bottom line #2: Occasionally things get adjusted — up and down — for everyone, young and old. Without the occasional agreed-upon adjustments, the radical politicians scare people about the future, but the real goal of these politicos is to make things go down dramatically and maybe even destroy the Medicare program.
The MedicareBlogger at the TusconCitizen.com newspaper has an interesting column that every adult child and senior should read. Her February 28, 2011 post, Part D and the Deficit, describes the process that brought us the Part D prescription benefits, as well as the politics that basically increased and added benefits while disregarding (blew off, actually) the true cost. When the chief actuary at HHS tried to share and publish correct information, he was told he would be fired. Read her complete article and follow the MedicareBlogger links at the post.
As Our Parents Age So Do We 
You have made some excellent points in this post. It highlights two phenomena that, as a certified elder law attorney, frustrate me greatly. One is “either/or” thinking and the other is NIMBY thinking (“Not In My Back Yard”). Either type, or both in combination, will put a long term hurtin’ on us.
Medicare Part D was an ill-thought-out and very expensive program (which is why I smile when I hear traditional Republicans talk about fiscal responsibility). Similarly, Medicaid is a huge, and getter bigger, share of state and federal budgets and it is squeezing out other important priorities.
Social Security deserves special mention. In 1936, when the program was established, the average life expectancy in the US was 61 years (the unemployment rate was also around 25% and there was a great deal of incentive to get older workers out of the labor pool). To replicate the 1936 actuarial assumptions, we would need to set the Social Security retirement age around 78 years for men and 84 years for women. And all that takes no account of the age demographics of 2011 compared to 1936 (back in ’36 they weren’t even thinking of WWII, let alone what all those soldiers coming home from the war would start doing . . . think “Boomers”!).
I am not advocating scrapping Social Security to save money (“either/or” thinking”); I am advocating a commitment to reality and facts. Then fashion some solutions that recognizes those facts.
If people are committed to keeping benefits at the same level, then one of two things will need to happen (as you correctly observed). Either taxes will need to rise (dramatically, in fact) or people will need to shoulder more of the direct burden for their welfare.
I guess I am a middle of the roader (which is rare in my world of elder law where many of my great colleagues are zealous, if not rabid, advocates for the status quo). The trouble with the status quo is that we will all be doomed. You’ve heard the cute “rearranging deck chairs on the Titantic” expression? I’d add “while admiring the pretty colors the sparkling iceberg is giving off in the moonlight” to that.
I am as committed to maintaining sensible programs as anyone, but also committed to the idea that if we don’t do something . . . there’ll be nothing for anyone.
Mention Social Security reform and AARP and others will go off the deep end. Poor George W didn’t ever get a good hearing on that (and I am no great fan of his). Mention keeping anything at all around and the “limited government” types start rallying. Then there are those that scream to whack the budget in some areas (perhaps the military) but leave it the same in others (perhaps entitlement programs). And, of course, vice versa. Classic NIMBY thinking.
There must be a more sensible alternative than simply whacking the budget. That does nothing to address the underlying problems.
I am an expert in Medicaid (among other elder law areas) but will be the very first to say the system is crazy. From a policy standpoint we pay 100% for a quadruple heart bypass or a brain surgery through Medicare with affordable Medigap policies, but scream that “wealthy” seniors shouldn’t use Medicaid to pay for nursing homes (in case it is congestive heart failure and Alzheimer’s they have instead of drastically more expensive conditions that Medicare will cover). The inefficiencies in the system are also stunning.
I came up with an idea as alternative. You can read about it on my blog, if you wish (http://bit.ly/ihk43D). It must be a commonsense proposal because it has ticked off a number of folks!
But all I care about is this: What will work? I don’t give a flip if the politician is Republican or Democrat if he or she is committed to constructive (and creative) solutions to the mess we’re ALL in. Thanks for the fine post; I enjoy your blog.
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