Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.

“You can’t save Medicare by raising taxes,” says Ezra Klein:

The problem with health-care costs is that they rise faster than wages, GDP or most anything else. That’s why balancing Medicare and Medicaid’s books through straight cost-shifting, as Ryan does, entails such savage cuts in care, and why balancing their books through straight tax increases, as Egan suggests, would be such a disaster. You wouldn’t just need to raise taxes. You’d need to raise them again and again and again, because every tax increase would soon be outpaced by Medicare’s growth.

This is true. You can, if you want, save Social Security by raising taxes. That’s because the cost of Social Security is projected to rise for a couple of decades and then plateau at 6% of GDP forever, so one option for saving it is to simply raise payroll taxes to 6% of GDP. Problem solved. You can also save discretionary programs by raising taxes. That’s because discretionary spending has been pretty flat for decades, is projected to remain pretty flat in the decades to come, and can be funded by simply raising enough money to cover that cost. You might not want to do it this way, but it could be done.

But Medicare is different. Its cost trajectory is so steep that it’s impossible to keep raising taxes forever to cover it. At some point, you have to take serious steps to level out those costs. That level will certainly be higher than it is today, since in the future there will be more elderly people to take care of, but it can’t be too much higher.

So how do we rein in that cost growth? Paul Ryan says: don’t bother. Just refuse to pay those rising bills and tell the elderly they’re on their own. It’s up to them to buy insurance, and if it’s too expensive because the Ryancare voucher is too small, that’s tough. See you on the other side.

That’s really not a serious solution. We need something instead that genuinely has an effect on healthcare costs. Something that reduces the amount we pay doctors, hospitals, and insurance companies. Something that provides incentives for difficult end-of-life decisions. Something that makes credible tradeoffs between the cost of new treatments and the likely benefits. And something that gives taxpayers and patients alike a reason to care about all this.

There are both liberal and conservative ideas that can help us with this. Unfortunately, we’re not quite grown up enough yet to really start talking about them. Maybe someday.

MOTHER JONES NEEDS YOUR HELP

Straight to the point: Donations have been concerningly slow for our hugely important First $500,000 fundraising campaign. We urgently need your help, and a lot of help, over the next few weeks so we can pay for the one-of-a-kind journalism you get from us.

Learn more in “Less Dreading, More Doing,” where we lay out this wild moment and how we can keep charging hard for you. And please help if you can: $5, $50, or $500—every gift from every person truly matters right now.

payment methods

MOTHER JONES NEEDS YOUR HELP

Straight to the point: Donations have been concerningly slow for our hugely important First $500,000 fundraising campaign. We urgently need your help, and a lot of help, over the next few weeks so we can pay for the one-of-a-kind journalism you get from us.

Learn more in “Less Dreading, More Doing,” where we lay out this wild moment and how we can keep charging hard for you. And please help if you can: $5, $50, or $500—every gift from every person truly matters right now.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate