This is a tough question.
I obviously want comprehensive reform of all entitlement programs, so selecting just one is a bit of a challenge. Sort of like being asked to pick your favorite kid.
Would I reform Social Security? That’s a logical choice. It’s the biggest program in the federal budget, so it’s presumably the biggest problem.
And it sure would be nice to have personal retirement accounts, just like Australia, Chile, and other nations that have modernized their systems.
But Medicare and Medicaid are growing faster than Social Security and the Congressional Budget Office projects that those two entitlements eventually will become a bigger burden on taxpayers than Social Security.
And since our goal should be to minimize the long-run burden of government spending, that suggests that it’s more important to reform the healthcare entitlements.
But which program should be fixed first?
There’s certainly a strong case to deal with Medicare. The health program for the elderly already is very expensive and it’s going to become even more of a budget buster because of demographic changes.
Moreover, shifting to a “premium support” system would be good for seniors since they would have the ability to pick a plan best suited to their needs. Basically the same type of system now available to members of Congress.
All things considered, though, I would deal first with Medicaid. There are three reasons why I would target the health program designed to supposedly help the poor?
- Medicaid is hugely expensive today and will become even more costly over time.
- The block-grant reform proposal is a good first step for restoring federalism.
- Obamacare can be partly repealed by block-granting the exchange subsidies as part of Medicaid reform.
For more information, here’s my video explaining how to reform the program.
I’m not going to cry – or even complain – if politicians instead decide to fix Medicare or Social Security. Just so long as they’re taking steps in the right direction, I’ll be happy.
What I don’t want to see, however, is a gimmicky plan such as Simpson-Bowles that merely papers over the underlying problems for a couple of years. The wrong type of entitlement reform is probably worse than doing nothing.
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
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[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] All of which explains why I think Medicaid reform should be the first priority when looking at how to fix the entitlements mess, even before Medicare reform and Social […]
[…] All of which explains why I think Medicaid reform should be the first priority when looking at how to fix the entitlements mess, even before Medicare reform and Social Security […]
[…] And if you want to be even more specific, the fastest-growing entitlement program is Medicaid, which was originally supposed to be a very small program to subsidize health care for poor people but has now metastasized into a budget-gobbling fiscal disaster. Arguably, it’s the entitlement program most in need of reform. […]
[…] P.S. For what it’s worth, if Trump is going to fix just one entitlement program, Medicaid is a good choice. […]
[…] And if you want to be even more specific, the fastest-growing entitlement program is Medicaid, which was originally supposed to be a very small program to subsidize health care for poor people but has now metastasized into a budget-gobbling fiscal disaster. Arguably, it’s the entitlement program most in need of reform. […]
[…] And if you want to be even more specific, the fastest-growing entitlement program is Medicaid, which was originally supposed to be a very small program to subsidize health care for poor people but has now metastasized into a budget-gobbling fiscal disaster. Arguably, it’s the entitlement program most in need of reform. […]
[…] Entitlement programs are a far bigger threat to America’s long-run fiscal stability the Ex-Im Bank, with Medicaid serving as a particularly sobering example. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
[…] I was asked last week which entitlement program is most deserving of reform. […]
Gary,
The word “entitlement” has become so twisted, consider how is being used.
I don’t agree….I believe SS IS an entitlement..as we paid so WE are entitled
to receive such benefits…as they are an implicit contract, not unlike an
insurance policy that will provide an annuity…which is exactly what SS is.
The problem is how so much of what the public demands they consider entitlements even though they paid nothing into any distinct fund as
the SSTF is.
Which these “cliques” are used to lean our views one way of another,
which is why I most often defer from answering…just happened to
answer this one, solely to make a point.
Thanks for your feedback,
Anthony..
Just another SS recipient who took the early option
Having paid tens of thousands of dollars into them, I do not consider SS and Medicare to be entitlements. That said, both have been misused and abused by both the government and people who have not paid into them. Both programs need to be changed so that funds are protected for use by those who have actually contributed. The outflow of payments to non-contributors needs to stop, and so does piracy by the government to divert program funds to cover other budget shortfalls.
I would not focus on any one program…but..the single element which impacts all of the them. The method used to determine govt expenditures…I find the “automatic triggers” which determines how much govt pays to all recipients, welfare, food stamps, SS, medicare, etc….must be eliminated and replaced with fixed payouts based on fund available…and formula based on premiums
paid. This would be a huge shift to current practice.
Return Social Security to it’s pre-Johnson status. If you don’t pay into the system, you get nothing out. Take it out of the general fund and put it back into an account by itself where no politician can ever touch it again.
I should add to my comment above, NO DISABILITY PAID TO ANYONE THAT CAUSED THEIR DISABILITY… No smokers (or even ex smokers) No alcoholics, and no obese people should receive one red cent, they cause their problem then they deal with it. Why should the hard working class pay for it with their hard earned tax dollars. Get this… why would a fat person loose the fat knowing they’ed loose out on Disability money???? My Nephew received over $3,000.00 a month on Disability and all he drank all his life was Beer.. I told him he shouldn’t receive anything, no one forced him to drink so why should I and the rest of the working class pay him.
2 years on Welfare at a time and 5 year max in a life time…. Put a co-pay of $20 on Medicaid per visit, that would stop the abuse of the Medical part… Build Tenements for those who wish to get housing, no more Section #8 (free housing)… Go back to using Food Stamps NOT a credit card and any store found to be selling Tobacco, Alcohol, Candy, Cookies, Ice-cream or any other junk food and taking Food-Stamps as payment fined $100,000.. All receiving “ANY” Government hand out has to take a DRUG test Monthly, and also do some sort of work for the City, County, or State of 20 hrs a week.
If Social security or Medicare are to be reformed, the two ways I would suggest doing it is:
1) to take those that have not paid in off the rolls. Both SS & MC should go to the productive workers that paid in. And:,
2) take those able bodied young people that are drawing disability off the rolls. Make them seek employment so money is going in. Both 1 & 2 are robbing the fund of money put in over many years by people that did it the way they were supposed to…
.
Don has a great initial list…my concern is with “entitlement” programs that working people paid into for their future…they should be last on the list of reforms and those that are giveaway programs should take the hit first.
I would start with eliminating the Department of Education, Repeal the Endangerd Species Act, Repeal Bacon-Davis, Reduce the EPA by 50% or better yet eliminate it. Stop all grants for foreign projects. Stop funding of Planned Parenthood – save 300,000 ‘kids’ a year. Tort Reform – lawyers need to find productive work. Limit unemployment payments to 26 weeks max. Eliminate the TSA – review the cost of the Patriot Act – reduction of the Dept of Homeland Security would be good. Elimination of FMEA – how did the Federal Government become responsible for desastor relief. What is insurance coverage for?
Medicare wins hands-down in this choice: Social Security is simply a transfer program with no structural inefficiency apart from the bureaucracy that runs it. On the other hand, Medicare is full of inefficiency caused by the core principle of third payer economics at its heart, which does far more damage than if it was only a transfer program.
The problem I have with block grants is that some states will abuse the grants, doling out to political favorites or holdilng back from less favored groups. Other than that, I would follow your priorities.
We need to stop giving cash or it’s equivalent to those that are not good at making their own choices. Stop all money give aways to welfare folks. Only food , medical clothing and shelter to be provided, and only that which is approved. The US military would be a great organization to help with this effort.(We need to bring most home anyway.) For those truely in need, this would be great. For the abusers, not so much. Can you imagine how happy you would be to see the US military coming to pick you and your children up from a truely abusive or destitute situation. Also, the mitlitary would be great at finding work asignments for the same group each according to their abilities. I saw a news broadcast that said a welfare mom with”fatherless” children needs to make over 67K to warrant getting off the dole from an economic standpoint.
The biggest expense of government is illegal aliens. If you cannot support yourself without any government then go the hell back to where you came from