To: Steve Lokness who wrote (14170 ) 3/31/2012 9:30:59 PM From: TimF Read Replies (1) | Respond to of 85487 If you're not insured and get stuck with long term care guess who pays? The tax payer. 1 - Not always. 2 - Not everyone gets stuck with long term care. Those two points mean its different issues. Obviously related issues, but still two different points. Oh, you don't think Medicare is in crises? 1 - I said health care not Medicare. 2 - Medicare's problems are more chronic than a particular crisis. A crisis would be a big thing that comes to a head and then you can solve. Chronic problems often are less solvable. 3 - Medicare's primary problem is that it causes the government to spend too much money. Obamacare only ads to that problem. It doesn't reduce government spending on health care, it doesn't even reduce total spending on health care or health insurance. At best (and even this is uncertain) it helps extend coverage to more people. But while there is some good in that, it also costs money, making the overall problem associated with Medicare worse not better. Your list is great, but only nibbles at the edges. Probably. And nibbling at the edges is probably all we can do, at least without creating even bigger problems. Obamacare also only nibbles at the edges (at best) in terms of actually fixing anything, and creates additional problems in the process. To recap, how do you pay for; 1) Demographics where a large percentage of the people need the most expensive care of their life - while the people to pay for this cost is shrinking on a percentage bases. . In the long run the government has to be less generous with what it spends. It could cover a lower percentage of the cost, or it could not cover people until they are older. 2) Long term care of the uninsured. Obamacare does pretty much nothing for this. The mandate could in theory bring in some premium dollars, but the increase in cost for covering more people, covering more conditions, and reduction in co pays and deductibles, more than counteracts this. Also to the extent the extra requirements cause more businesses to not insure people (which is very likely and may even be already happening), it causes the problem to get larger as government has to pick up the costs for more people. And the individual mandate is for "health insurance" not "long term care insurance". 3) Science that allows some to live forever at the end of life. To the extent that this actually happens to a significant extent, then they just have to pay for it themselves, and if they can't then tough luck. The same would go for their non-medical retirement costs. No plan can pay cover and ever larger percent of the population forever. Social Security and Medicare rely on the fact that people die. They simply don't work if people stop dying. Even private investments over their working life would be questionable as a solution. No matter how many dollars you get out of your investments, someone has to actually produce the things you need in retirement. If people are going to live forever they can't retire (except perhaps for those that happen to be particularly rich), or at least not permanently, they can perhaps take a 10 or 20 or 30 or more year retirement, and then go back to work. If your point about "forever at the end of life", means they live forever but are old and feeble and/or senile and can't support themsevles, but they still don't die, then we're screwed no matter what policy we take. (We could of course take the policy of killing them all off, but the evil involved in that is just "we're screwed" in a different way.) If you don't literally mean forever (or even a vast indefinite increase that still falls far short of forever, in other words if you mean extra years or decades not centuries or more), you just mean that they are living longer and longer over time. Then the proper response to that is to increase the retirement age for SS, and the eligibility age for Medicare.