A Framework for Medicare Reform
Table of Contents
- Executive Summary
- Introduction
- Short-Term Reform: Demand-Side Changes
- Short-Term Reform: Supply-Side Changes
- Long-Term Reform: Health Insurance Retirement Accounts (HIRAs)
- Long-Term Reform: Uses of HIRA Funds
- Distribution of Costs and Benefits
- Comparison with a Private, Voluntary Plan
- Integration with Social Security and Medicaid Reform
- A Different Approach to Low-Income Subsidies
- Estimating the Effects of the Reforms
- Conclusion
- APPENDIX A — Estimating Supply-Side Effects
- Notes
A Different Approach to Low-Income Subsidies
The approach to Medicare reform outlined here is based on the idea that each generation should pay its own way. However, even after mandatory saving over an entire worklife, there will be those who have not saved enough to fund their own post-retirement health insurance. Should the financial shortfall experienced by people be made up by the members of their age cohort? Or should this deficit be viewed as more properly a concern of society as a whole? If the latter, then we may want to keep a residual part of the program to be funded by taxpayers —say, through an assessment roughly the size of the current payroll tax.
