Urban Institute calculation of lifetime payroll taxes and entitlement benefits

[DSpencer]

Re: Urban Institute calculation of lifetime payroll taxes and entitlement benefits

As I parse this thread, all you're missing is a (kinda) rough segue. I wanted to talk about the details of a particular calculation of who pays for -- and receives -- what. That calculation is part of an inter-generational and inter-class propaganda fight over taxation and entitlement spending policy... fighting over pieces of a pie of fixed size, as it were. That whole thing is sort of a "blame game" which doesn't address the bigger policy issue of whether we can perhaps get more value for less money (larger pie). The way I read jk's comment is that the blame game isn't all that productive, since it distracts attention from where the money is going. So that's where the thread took a detour from my original post.

I agree with you that because Medicare has a fixed pricing schedule, the specific issue of price discovery and bargaining isn't directly relevant to Medicare's program costs. As c1ue points out, the standard form of Medicare fraud is to perform unnecessary procedures and provide unnecessary or ineffective services. Also, there are issues about the structure of pay-for-service versus pay-for-outcome/maintenance systems. I think the price discovery issue does speak to the bigger matter of US healthcare costs, which probably feeds back into Medicare indirectly. Also, there's a tie-in here to the simple fact that folks with most any sort of coverage (Medicare or employer-sponsored) are insulated from the cost of their care, and so aren't strongly incentivized to control costs.

So I guess I see the thread as branching several different ways that are fundamentally related to the cost of healthcare but which don't always address each other specifically.

That's a good summary and hopefully my comment didn't come across too harsh. It just felt like the thread was being steered away from the original topic to one that's in an ongoing state of discussion in other threads already (healthcare costs) and furthermore in a way that didn't even make sense by blaming hospitals cash prices for the medicare problem.

I agree with your assessment on the 2% interest. Unless the money is actually productively invested, how can that be counted? As you've said, it's all just artificial pockets of the same entity and they can be mixed together at any time.

I somewhat dislike generational theories because they seem to overestimate the differences between generations and underestimate the individual differences within a generation. However, there is definitely an interesting dynamic taking place. The younger generations get called lazy and irresponsible by the generations that have lived beyond their means for their whole life and manage to put aside their differences when it comes to SS and Medicare. There is such political power that even the "fiscal conservatives" bend over backwards to sing the praises of our pyramid scheme.

I can't help but feel like I'm going to be the one without a chair when the music stops. Paying a fortune into these programs every year and then getting a statement that basically says "By our (likely way too optimistic) estimates, we are going to start going bankrupt before you retire" certainly doesn't help.

You can keep everything I've paid in, just please let me opt out of this scam already!