The question of Social Security, Medicare, and Medicaid still looms large after the fiscal cliff agreement.
We're witnessing a real train-wreck happening with our entitlement spending. We need to move away from the promises we made for generations. Instead of being forced into a bind where we have to tax later, I would rather see us face this head on and figure out the easiest one first: Social Security.
If we want to continue with Social Security, we need to make changes that delay what age you need to be to take Social Security. That means pushing it past the age of 67 as the point at which you can receive full benefits.
However, the bigger issue here is health care. Medicare isn't working. Yes, it's paying people's bills, but with borrowed money.
If I were emperor, I would eliminate Medicare for a certain age and under (55, 45 or whatever you want it to be) and instead give those people vouchers that allow them to buy health care in the open market. The ultimate answer with health care is to eliminate Medicaid and, for people of lower income, if we're going to provide them with government assistance, give them vouchers to buy individual health policies.
We need to eliminate employer-provided health care, government-provided health care and set the rules of standardized policies that people could buy on the open market.
In this were the United States of Howard, there would be just 12 health plans offered: 3 HMOs, 3 PPOs, 3 HSAs and 3 of the traditional 80/20 splits.
Every insurer would have to sell identical plans. That way you could switch to another insurer's HMO plan No. 2 if your insurer's HMO plan No. 2 is too costly. You would pay your premium based on age, and there would be no redlining based on your past medical history. You wouldn't be required to have health insurance, but you wouldn't be allowed to buy it when you're sick; instead, you'd have to wait 18 months.
That's the short version of the conversation I believe we need to have in our country. And I'm just including the bare details here.