Now that the first Baby Boomers are turning 65 Medicare, the health benefit program for seniors, is set to feel a mighty strain, according to an analysis by a senior fellow at the Urban Institute.
Eugene Steuerle, an Institute fellow and the Richard B. Fisher Chair at the nonpartisan institute, is also a former deputy assistant secretary of the Treasury. He says, while Social Security's woes get the most attention, Medicare is actually in much worse shape.
The problem, he says, is that past and current retirees, and most working-age adults, will never pay for all their Medicare benefits. The government's Medicare costs now top three percentage points of GDP and are headed to above six percentage points of GDP by 2055.
But Medicare taxes and escalating premiums cover ranges from about 51 to 58 percent over time.
Borrowing from China
"To pay for the rest, we borrow from China and elsewhere, and use up ever-larger shares of income tax revenues, leaving ever-smaller shares for other government functions," Steuerle said. "Bottom line: without reform, current workers would continue to shunt many of their future Medicare costs onto younger generations, just as their parents did with Social Security."
Both Medicare and Social Security are threatened by a rather positive development; people are living longer. But with that extended lifespan, come medical needs that simply haven't been paid for.
But Medicare has an additional problem. Health care costs are exploding, must faster than the overall rate of inflation.
Structured like much other health insurance, Medicare essentially lets us consumers deal with doctors over what someone else in our government or private insurance system will pay.
"For years, numbers that Medicare actuaries and many others have been crunching have pointed to the system's unsustainability," Steuerle said. "Sadly, the lack of agreement on an alternative has led us and our elected representatives to blink when it comes to tackling this core structural problem."
Not only does this current structure lead to more borrowing from abroad, Steuerle says it saddles future generations with most of the costs of cutting edge medical break-throughs.
'I want a new drug'
"A better type of hip replacement comes along. A new drug for congestive heart failure. A more effective treatment for prostate cancer. Sign me up," Steuerle said.
But the benefits from these medical advances come at a steep price, and so far, says Steuerle, no one is paying it. The older among us are not required to work longer or pay for more than a minor share of these extra benefits. Providers, in turn, have come to expect ever-larger shares of national income as a reward for science's leaps.
This is not an economic problem that leads to a political one, Steuerle says, but a political problem that threatens undesirable economic consequences.
"Only political reform of how we make economic decisions -- addressing inconsistent promises for low taxes and high benefits that people have come to expect -- can move us away from a system where promised benefits supposedly rise forever faster than GDP and where future, not current, workers must be left to bear most of the costs and consequences," he said.