Bring entitlement spending under control
Social Security, Medicare and Medicaid cannot be allowed to gobble up unlimited taxes. Sustainable limits must be placed on these and other entitlements.
Wars come and go. Entitlements grow. Even if the wars are ended and the military trimmed, the debt-and-spending crisis will return unless entitlement spending is under some principle of control.
In a few cases, the answer may include taxes. Social Security might raise the cap on taxable income, which has been $106,800 since 2009, in conjunction with a slower growth in benefits. But Social Security is the easy case.
Medicare and Medicaid have much bigger problems. The rise in their spending is fueled by the aging population and ever-more-expensive advances in medical care. Their problems cannot be solved with taxes unless American workers want government to take an ever-increasing share of their pay.
Entitlements require a limit. For most of the programs the money should be limited to the people with the greatest need. Medicare may have to be means-tested.
Rep. Paul Ryan, R-Wis., has proposed that future Medicare enrollees buy private medical coverage, but the government would pick up some of the cost. How much might depend on the income of the recipient.
Ryan also proposed that Medicaid, which is already means-tested, be block-granted to the states. It is a harsh proposal, but it does solve the problem.
From the liberal side there is a thought of a single-payer system for everyone, which could be harsh in a different way. Both approaches are radical departures from what exists now, but each may contain some element of a solution that would work, and that Americans would accept.