Social Security and Medicare are allegedly in trouble — if not today, then in the foreseeable future. To secure these programs, we should:
Continue to tax and collect funds on wages beyond the current Medicare maximum of $127,200. Under this definition, wages should include stock options, at current value, and deferred compensation. This would result in an influx of cash.
Cap the Social Security monthly benefits at $2,687 plus annual cost of living increases. If an individual is making more than $127,000 a year he/she should be smart enough to save independently for retirement.
The original goal of Social Security was to provide a safety net for low-wage earners. This will limit increased payouts.
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Finally, increase the standard retirement age for those born after 1986 by one month for each five-year period (i.e. add one month for birth dates 1986-1990, two months for 1991-1995, etc.). This should not create a major disruption in retirement planning, but slow the outflow of benefits.
Medicaid benefits should be reserved for those at or below the poverty level. If a state wishes to include others, then it should define residency requirements and its responsibility to pay the additional benefits.
Also, we must find incentives to create efficiencies in the health-care delivery process.