I am in my thirties, a single parent, trying to make
payments on my house and save for my kids' college tuition.
I work a full-time job that has no health insurance, and a
part-time job that has health insurance, but it's very expensive.
Still, I get by and manage to save a little for the college
fund. My worry is this:
I've had good luck in finding jobs where I can get health
insurance so far, even when it costs so much (nearly $800
a month for a very basic plan.) But what am I going to do
when I get too old to find jobs with health insurance? I read
how employers that provide health insurance are more and more
reluctant to hire older workers because they push up health
insurance bills. Will Medicare be around when I retire? Will
it be worth anything? Will I have to work until age eighty
to get it?
What's the answer, Auntie Pinko?
Auntie Pinko wishes I had "the answer!" Not only would it
help millions of Americans (including Auntie herself) but
I could probably get rich as a 'beltway bandit,' consulting
at $50,000 a pop to Congressional committees. I'm not sure
there is an answer - because I'm not sure we really know enough
about the questions yet, in spite of the amount of hot air
and smoke that has been emitted on this issue.
Many people (who should really know better, in Auntie's
opinion) are quick to write off the American people as unwilling,
or unable, to make hard choices - especially choices that
involve sacrifices. I think that's both unfair and untrue.
When we have the facts clearly before us, Americans can usually
make pretty good decisions. The problem arises when the facts
are numerous, complex, and contradictory (which is certainly
the case with the issue of providing for our older citizens)
and/or when it is in the political and economic interests
of people with power and money to obscure those facts, and
the public officials we elected and trusted to work on our
behalf collude with those people.
But I've been around long enough to remember when Social
Security was a brand new solution, and there wasn't any Medicare
yet. The issues were just as complex then, and the special
interests just as noisy and powerful. It took a lot of work
to make some facts emerge clearly. For what it's worth, I
think that those facts are still true today:
FACT: With the best will in the world to provide
for their own long-term futures, a substantial majority of
Americans cannot do so without some assistance, whether that
assistance is in the form of 'coerced' savings programs like
dedicated payroll taxes, subsidized benefits programs, or
other means. The "whys" of this fact are numerous and complex,
but the fact remains true, and short of Divine intervention,
it won't change in the future. Auntie is old enough to remember
when "the gummint" didn't provide any safety nets for the
elderly, and everyone knew they had the responsibility to
look after themselves and their own families. The results
were pretty ugly, hopeless, and depressing for a great many
Americans then, and there's no reason to assume it would be
any different in the future.
FACT: Aging Americans who do not have the
resources to adequately meet their own needs for shelter,
health care, and other basic needs constitute a severe challenge
to the economy. They stress the ability of their families
to ensure education for the younger generations following
them, participate in an economy increasingly reliant on luxury
consumption, and contribute productively to the workforce
as elder-care demands escalate. When their families cannot
or will not care for them (or they have no families) they
disproportionately drain some of the most expensive types
of resources-emergency rooms, nursing care facilities, psychiatric
FACT: Elderly people who have worked hard
all their lives and been raised in the American ethic of self-reliance
and independence have deep difficulties accepting anything
regarded as a "handout." In fact, many would rather suffer
miserably and even die of cold, hunger, or neglected medical
conditions than "take charity." This fact was critical in
determining the structure of the payroll-tax mechanism as
a way of funding the retirement-subsidy programs like Social
Security and Medicare.
FACT: Americans have a low tolerance for watching
large numbers of elderly people suffer destitution and misery.
No matter how logical the arguments of social Darwinism might
be, or how attractive the arguments of libertarians and government-bashers,
or even the anti-tax reformers' appeals to our cupidity, we
will turn to government for remedies. Reliance on voluntary
charity and the nonprofits supported by our generosity will
never be able to adequately address the problems.
What does this mean to any "answer" we might formulate?
It's too early to say, since there are a great many more facts
and issues that have arisen in the last fifty years to complicate
the debate further. What Auntie suspects is that the answer
will not be an "either/or" solution. Here are my predictions,
for what they're worth:
The question of basic income support will be resolved
by a combination of raising the retirement age (not unreasonable
in the light of how greatly life expectancy and extended quality
of life have increased since it was originally pegged at 65)
increasing individual contributions through both individual
and employer contributions, and some form of (hopefully) mild
means-testing that will limit benefits to the wealthiest and
The question of health care will escalate to a hellishly
painful crisis, and ultimately be resolved by folding senior
health care into an across-the-board national solution based
on a combination of tax-subsidized basic care (with greater/more
comprehensive levels of benefits for children and seniors
than the adult population) and private-market supplements
partially subsidized through some level of mandatory employer/employee
cost sharing, plus sliding-scale subsidies for the indigent
The question of other benefit subsidies (affordable
housing, transportation, access to public facilities and services,
independent living assistance, and end-of-life care) will
be devolved to state level, but ultimately funded by a combination
of revenue-sharing from the federal budget and subsidies to
the private sector for the infrastructure investments required,
combined with incentives for ongoing private sector participation.
This will all play out over the next thirty years as the
baby-boom generation hits the retirement curve like a ton
of bricks, and becomes increasingly impatient and intolerant
of being used as the ball in a partisan Super Bowl. The party
that recognizes this and comes to terms with the reality first
will end up with the political boodle, but it will be a hard,
costly fight in many ways.
Well, there you have it, Melissa. You read it here first,
and Auntie's perfectly prepared to be proven wrong. But not
very wrong, I bet. Thanks for asking Auntie Pinko!
Do you have a question for Auntie Pinko?
Do political discusions discombobulate you? Are you a liberal
at a loss for words when those darned dittoheads babble their
talking points at you? Or a conservative, who just can't understand
those pesky liberals and their silliness? Auntie Pinko has
an answer for everything.
Just send e-mail to: firstname.lastname@example.org,
and make sure it says "A question for Auntie Pinko"
in the subject line. Please include your name and hometown.