4 ms·

One reason those programs are not means tested is because it means that everyone can depend on them. Once they are means-tested to only apply to poor/middle cla

by runako 1y ago

One reason those programs are not means tested is because it means that everyone can depend on them. Once they are means-tested to only apply to poor/middle class people, they will begin to be aggressively cut like the other means-tested programs. Also worth noting net worth "over a million dollars" is not extravagant for a Medicare-age person who did not have a pension, for example. This is basically a median home and $600k in savings. Not poor, but also not likely to be able to pay anything close to rack rate for health insurance for an older person.

acdha 1y ago
I’d also add that there’s a powerful benefit to having something like Medicare as a right of citizenship: it builds social cohesion and avoids the stigma which is often attached to social programs. Some landlords go to great lengths to avoid section 8 tenants, for example, and that has a substantial negative cost to society.
- FireBeyond 1y ago
  > I’d also add that there’s a powerful benefit to having something like Medicare as a right of citizenship While not attached to citizenship, there already is something built in. New immigrants to the US often have to have a financial sponsor (I did, on my K-1 fiance visa). That sponsor has to agree (and demonstrate ability) that in the event that the new immigrant claims public benefits in the first ten years of their residence in the US (Medicare, Social Security, etc.) that the government is entitled to recoup those benefit costs from the sponsor.
AnthonyMouse 1y ago
The Medicare budget is approximately $1400/month for each person over 65. A completely plausible means testing approach isn't "if you have a million dollars you have to go pay a billion dollars for healthcare" but rather that if you have that much money you have to pay the $1400 to get Medicare. Someone with $600,000 and earning 5% APY would be getting more than that in interest, not including appreciation or imputed rent on the $400,000 house, and would stop having to pay the full rate if their net worth fell below the threshold anyway.
- runako 1y ago
  > you have to pay the $1400 to get Medicare This is a political non-starter as it opens the possibility that younger people could also just buy into Medicare instead of paying more for private insurance, something which has been declared strictly off-limits. (Although it would help offset costs to have a lower-risk pool of insureds come into the program, in addition to the other societal benefits.) > earning 5% APY would be getting more than that in interest Remember that we are largely talking about retirees. That $1400 + their Social Security is how they pay living expenses. If they have to pay it for healthcare, they have to find another way to pay living expenses. > imputed rent on the $400,000 house They live in the house, which lowers their monthly expenses to a level where they can pay them using Social Security and the interest from their savings. Larger point here is that the suggestion to means test for seniors represents a clawback, a violation of promises made decades ago, around which people planned their elderly (perhaps non-working) years. And we're talking about doing so before we ask the rich to pay (as Warren Buffet says) the same tax rates as their secretaries, and before we trim the military budget back to the levels requested by the military.
  - AnthonyMouse 1y ago
    > This is a political non-starter as it opens the possibility that younger people could also just buy into Medicare instead of paying more for private insurance, something which has been declared strictly off-limits. Whether something would have a particular policy outcome and whether you have the votes to pass it are two different things. Moreover, you could obviously require wealthy retirees to pay for Medicare without allowing younger people to do it. Stranger things have happened. > Remember that we are largely talking about retirees. That $1400 + their Social Security is how they pay living expenses. If they have to pay it for healthcare, they have to find another way to pay living expenses. They do have another way to pay living expenses. They have $600,000+ plus a house, and as soon a they only had $599,999 plus a house they would no longer have to pay the full rate for Medicare. > Larger point here is that the suggestion to means test for seniors represents a clawback, a violation of promises made decades ago, around which people planned their elderly (perhaps non-working) years. You can just as easily make the contrary argument. These programs were never funded -- social security started out making payments to people who never paid in and there isn't anywhere near enough in the "trust fund" to make existing payouts. The people paying the taxes to make up the shortfall were too young to be eligible to vote or not even born when those promises were made, so by what right does an older generation have to bind them to a promise it made to itself and then never actually funded? > And we're talking about doing so before we ask the rich to pay (as Warren Buffet says) the same tax rates as their secretaries, and before we trim the military budget back to the levels requested by the military. How about we do this and trim the military budget back to the levels requested by the military so that we can lower the taxes on the secretary to the same rates paid by Warren Buffet?

by runako 1y ago

acdha 1y ago

I’d also add that there’s a powerful benefit to having something like Medicare as a right of citizenship: it builds social cohesion and avoids the stigma which is often attached to social programs. Some landlords go to great lengths to avoid section 8 tenants, for example, and that has a substantial negative cost to society.

FireBeyond 1y ago
> I’d also add that there’s a powerful benefit to having something like Medicare as a right of citizenship While not attached to citizenship, there already is something built in. New immigrants to the US often have to have a financial sponsor (I did, on my K-1 fiance visa). That sponsor has to agree (and demonstrate ability) that in the event that the new immigrant claims public benefits in the first ten years of their residence in the US (Medicare, Social Security, etc.) that the government is entitled to recoup those benefit costs from the sponsor.

AnthonyMouse 1y ago

The Medicare budget is approximately $1400/month for each person over 65. A completely plausible means testing approach isn't "if you have a million dollars you have to go pay a billion dollars for healthcare" but rather that if you have that much money you have to pay the $1400 to get Medicare. Someone with $600,000 and earning 5% APY would be getting more than that in interest, not including appreciation or imputed rent on the $400,000 house, and would stop having to pay the full rate if their net worth fell below the threshold anyway.

runako 1y ago
> you have to pay the $1400 to get Medicare This is a political non-starter as it opens the possibility that younger people could also just buy into Medicare instead of paying more for private insurance, something which has been declared strictly off-limits. (Although it would help offset costs to have a lower-risk pool of insureds come into the program, in addition to the other societal benefits.) > earning 5% APY would be getting more than that in interest Remember that we are largely talking about retirees. That $1400 + their Social Security is how they pay living expenses. If they have to pay it for healthcare, they have to find another way to pay living expenses. > imputed rent on the $400,000 house They live in the house, which lowers their monthly expenses to a level where they can pay them using Social Security and the interest from their savings. Larger point here is that the suggestion to means test for seniors represents a clawback, a violation of promises made decades ago, around which people planned their elderly (perhaps non-working) years. And we're talking about doing so before we ask the rich to pay (as Warren Buffet says) the same tax rates as their secretaries, and before we trim the military budget back to the levels requested by the military.
- AnthonyMouse 1y ago
  > This is a political non-starter as it opens the possibility that younger people could also just buy into Medicare instead of paying more for private insurance, something which has been declared strictly off-limits. Whether something would have a particular policy outcome and whether you have the votes to pass it are two different things. Moreover, you could obviously require wealthy retirees to pay for Medicare without allowing younger people to do it. Stranger things have happened. > Remember that we are largely talking about retirees. That $1400 + their Social Security is how they pay living expenses. If they have to pay it for healthcare, they have to find another way to pay living expenses. They do have another way to pay living expenses. They have $600,000+ plus a house, and as soon a they only had $599,999 plus a house they would no longer have to pay the full rate for Medicare. > Larger point here is that the suggestion to means test for seniors represents a clawback, a violation of promises made decades ago, around which people planned their elderly (perhaps non-working) years. You can just as easily make the contrary argument. These programs were never funded -- social security started out making payments to people who never paid in and there isn't anywhere near enough in the "trust fund" to make existing payouts. The people paying the taxes to make up the shortfall were too young to be eligible to vote or not even born when those promises were made, so by what right does an older generation have to bind them to a promise it made to itself and then never actually funded? > And we're talking about doing so before we ask the rich to pay (as Warren Buffet says) the same tax rates as their secretaries, and before we trim the military budget back to the levels requested by the military. How about we do this and trim the military budget back to the levels requested by the military so that we can lower the taxes on the secretary to the same rates paid by Warren Buffet?