  James Capretta examines how Medicare’s basic characteristics have resulted in alarming unfunded liabilities, and he proposes reforms that would substantially restructure the program. These proposed reforms include combining the various Medicare benefit programs into one rationalized insurance product entirely funded by a Medicare payroll tax, allowing premiums to vary based on lifetime earnings and coverage preference, and facilitating savings for health care premiums and costs in retirement. While reforms of this nature are politically ambitious and will require an extended timetable for implementation, such changes would transform Medicare into a program that is more sustainable, more consistent with stronger economic growth, less burdensome on workers, and less distorting of the US health care system than it is today. Medicare can’t be ignored forever
James C. Capretta | Real Clear HealthMedicare is one of the three major entitlement programs — along with Social Security and Medicaid — that is the primary reason the federal government is expected to run massive and growing deficits in the coming years. James Capretta argues that what is needed is both a short-term agenda for how to improve the program’s performance and a long-term vision for what might be done to make Medicare more affordable and sustainable in a society with a growing population of older citizens.  
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