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Gov. Christie's SSC and Medicare reform proposal

meridian

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Just listening to the soundbites by the pundits, I brushed aside his proposal as another usual right wing attack on Social Security and Medicare.

But then, I read the proposal, and find it quite reasonable and has a lot of merits, except for #5, which I don't quite understand the ramifications. Here's the link and direct copy of the text:

Chris Christie's SSC and Medicare reform proposal

No change for current recipients.[/B] "The changes I propose today would not affect seniors currently in these programs or seniors approaching retirement. ... Anyone who tells you differently is simply not telling you the truth," Christie said. Raise the Social Security retirement age.[/B] Increase the early retirement age by two months a year from age 62 until it reaches age 64, and raise the full retirement age by two months a year until it reaches age 69. These changes would be implemented gradually starting in 2022.Raise the eligibility age for Medicare.[/B] Make it 67 by 2040 and 69 by 2064.Add means testing to Social Security.[/B] The test would affect those with non-Social Security income of more than $80,000 per year, and phase out Social Security payments entirely for those with $200,000 a year of income from sources other than Social Security.Expand means testing for Medicare Parts B and D.[/B] Seniors with income above $85,000 a year would pay 40 percent of premium costs, increasing to 90 percent for those with income above $196,000 a year.Eliminate payroll taxes for workers age 62 and older.[/B] "Economists estimate that this payroll tax cut for those over 62 would contribute to labor supply growth and therefore GDP growth in the U.S. This growth would offset much of the lost revenues from the tax cut," Christie said, noting that it is counterproductive to ask older workers to continue to pay payroll taxes when it
won't increase their benefits.Reform Social Security Disability.[/B] Increase the number of recent years a worker must have been on the job to qualify, speed up determination decisions, shorten the time before someone with a temporary disability must return to work, and encourage vocational rehab, wage subsidies and preventive care services to keep partially disabled people working.Change how cost of living adjustments, or COLAs, are calculated.[/B] Adopt the chained consumer price index as a basis for COLA adjustments, and give a one-time 5 percent increase in monthly benefits to all beneficiaries when they reach age 85. The chained-CPI, which is a little lower than the inflation measurement currently used, better reflects how people spend money.Standardize Medicare's deductibles.[/B] Adopt a standard annual deductible of $550.Put a cap on Medicaid.[/B] The federal government should send the states a fixed amount per Medicaid enrollee, Christie says, with different inflation-adjusted caps for each category of recipient, including the elderly, disabled, children and non-elderly, non-disabled adults.Better manage the dual-eligible Medicare/Medicaid recipients.[/B] Require them to participate in a managed-care program that limits double dipping.Require co-pays for Medicaid recipients above the poverty level.[/B] Having skin in the game gives recipients motivation to spend less.
This post was edited on 4/17 3:54 PM by meridian
 
It actually looks like a very moderate approach.

I could see both Repubs and Dems getting behind a comprehensive package like this.

Which of course means it has no chance.
 
I agree with making more use of means testing

even though such changes would send social security and medicare down the road into welfare programs. I would at least double the thresholds for means testing if not make them even higher than that.

There are other ways to do means testing for Medicare, such as using vouchers and thus making the program look like the SNAP program. The advantage there would be to introduce competition into the the system. Also, permitting HSA's for medicare participants would be a good thing to accompany either means testing or vouchers. This would also introduce competition. Moreover, anything that gives the patient greater benefit by not abusing the system would be good for the system and stop much of the useless and expensive end of life care.

The dems say vouchers would "change Medicare as we know it" to which I would say "so what"? The Christie changes would cement the Medicare structure, and its inherent end of life problems, probably in perpetuity. I'm not sure this is a good forever program.

The other way to reform SS is to build on the GWB proposal which would be to begin at least a partial conversion to a money-purchase system instead of a defined benefit system. This would limit the unlimited exposure of the department of treasury to longer and longer life expectancies.

I also think an automatic increases in eligibility ages would be in order, maybe tied to life expectancies.
 
Re: It actually looks like a very moderate approach.

Originally posted by TheOriginalHappyGoat:
I could see both Repubs and Dems getting behind a comprehensive package like this.

Which of course means it has no chance.
LOL. How true.

My only criticism of his proposal is that it needs to be more aggressive in raising the retirement, in terms of age and, perhaps, how quickly the changes are implemented. Or, at least increase the full retirement age even more and widen the gap in monthly pay between early and full retirement. Also, the proposal to eliminate social security payments by workers over age 62 is a really great idea.
 
Pulling the plug on grandma may be lurking . . .

in that cap on Medicaid . . . same for catastrophically disabled folks. The devil is in those details, for sure, as the people who need skilled nursing care at end of life and for vast periods during their lives simply aren't going to be able to pay for the care required after the cap is exhausted.
 
There are many things I like about Christie

Unfortunately, I don't think he has the temperament to be President. On first glance, this does seem to be a very moderate type of much needed reform.
 
That's something we'll have to address, eventually.

So long as medical advances continue to extend life without extending useful life, that's a problem that is going to lurk in the background. It won't go away, no matter how we manage Medicare.

goat
 
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Not exactly

The problem is reduced substantially if the patient and family have a financial stake in end of life care decisions; or, maybe if fee for service model for delivery of care were eliminated.

This problem and the préexisting condition problem were two of the bigger reasons why we needed health care reform. We mucked up one problem and kicked the other down the road with utilization panels aka death panels.
 
The SS means testing is ridiculous. At least at those income levels. Someone making 100k, pays roughly 12.5k/ year in SS taxes, either via self employment tax, or combined employee/employer contributions. For possibly over 30 years....and they should be entitled to zero squat, if they manage to build a good retirement income?

You could argue means testing it at much higher incomes than 80k, but that's
a non starter in my view.

Besides the fact that SS doesn't have that significant a shortfall, adjusting retirement age would fix it. Medicare is the big problem and should be the main focus
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What I don't like about it is it really helps out the super rich in that the upper middle income earner pays in a big chunk throughout their topping out at I believe 118.5 this year but you stop paying after that, so they don't get anything for their contribution but Bill Gates income after 118.5 is no longer being taxed essentially to support the new welfare system.
 
The dems say vouchers would "change Medicare as we know it" to which I would say "so what"?

There's no bigger threat to Medicare than leaving it as is. I know the people who defend leaving it as is don't see it that way. But they're not very good at math. I personally have mixed feelings about moving it toward a means-tested voucher system (though I don't have a problem with means-testing it in general). But, then, it's hard to compare and contrast reform options when there really aren't a complete set of options up for evaluation. At present, it seems like the standard against which any reform is compared is the status quo -- which is both very popular, and very broke.

The other way to reform SS is to build on the GWB proposal which would be to begin at least a partial conversion to a money-purchase system instead of a defined benefit system.

Yeah, this really should be a no-brainer -- if for no other reason than it would enable us to harness higher rates of return on the trust fund's assets over time. But there are lots of other reasons, too.

But Democrats will never allow this to happen. Not for any good reasons, or the reasons they say. But because of the cat that Sen. Moynihan let out of the bag once upon a time.
 
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What I don't like about it is it really helps out the super rich in that the upper middle income earner pays in a big chunk throughout their topping out at I believe 118.5 this year but you stop paying after that, so they don't get anything for their contribution but Bill Gates income after 118.5 is no longer being taxed essentially to support the new welfare system.

But, as the program is and always has been, the taxes and benefits are tied together. So, yeah, the taxes max out -- but so do the benefits. That's the fatal flaw of any SS reform that is predicated on lifting the cap on taxable income (well, that and the fact that we have a number of fiscal holes to fill -- with Medicare and Medicaid dwarfing this one -- and only so much dirt with which to fill them). This tie between taxes paid in and benefits due would have to be severed, and I think that's a much bigger deal than most people who advocate this approach presume.
 
Besides the fact that SS doesn't have that significant a shortfall, adjusting retirement age would fix it. Medicare is the big problem and should be the main focus

The shortfall in the healthcare programs is obviously much bigger in dollar amounts. But this really isn't a mutually exclusive thing -- where we do one or the other. They both need to be addressed.

Left alone, and assuming the general fund pays back each of the trillions of dollars it owes the SSTF, within a couple decades SS will be able to pay for about 2/3 of its obligations. That's hardly insignificant. And, if you think it is, try chopping a third off of everybody's check and see what happens.
 
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Just listening to the soundbites by the pundits, I brushed aside his proposal as another usual right wing attack on Social Security and Medicare.

But then, I read the proposal, and find it quite reasonable and has a lot of merits, except for #5, which I don't quite understand the ramifications. Here's the link and direct copy of the text:

Chris Christie's SSC and Medicare reform proposal

No change for current recipients.[/B] "The changes I propose today would not affect seniors currently in these programs or seniors approaching retirement. ... Anyone who tells you differently is simply not telling you the truth," Christie said. Raise the Social Security retirement age.[/B] Increase the early retirement age by two months a year from age 62 until it reaches age 64, and raise the full retirement age by two months a year until it reaches age 69. These changes would be implemented gradually starting in 2022.Raise the eligibility age for Medicare.[/B] Make it 67 by 2040 and 69 by 2064.Add means testing to Social Security.[/B] The test would affect those with non-Social Security income of more than $80,000 per year, and phase out Social Security payments entirely for those with $200,000 a year of income from sources other than Social Security.Expand means testing for Medicare Parts B and D.[/B] Seniors with income above $85,000 a year would pay 40 percent of premium costs, increasing to 90 percent for those with income above $196,000 a year.Eliminate payroll taxes for workers age 62 and older.[/B] "Economists estimate that this payroll tax cut for those over 62 would contribute to labor supply growth and therefore GDP growth in the U.S. This growth would offset much of the lost revenues from the tax cut," Christie said, noting that it is counterproductive to ask older workers to continue to pay payroll taxes when it
won't increase their benefits.Reform Social Security Disability.[/B] Increase the number of recent years a worker must have been on the job to qualify, speed up determination decisions, shorten the time before someone with a temporary disability must return to work, and encourage vocational rehab, wage subsidies and preventive care services to keep partially disabled people working.Change how cost of living adjustments, or COLAs, are calculated.[/B] Adopt the chained consumer price index as a basis for COLA adjustments, and give a one-time 5 percent increase in monthly benefits to all beneficiaries when they reach age 85. The chained-CPI, which is a little lower than the inflation measurement currently used, better reflects how people spend money.Standardize Medicare's deductibles.[/B] Adopt a standard annual deductible of $550.Put a cap on Medicaid.[/B] The federal government should send the states a fixed amount per Medicaid enrollee, Christie says, with different inflation-adjusted caps for each category of recipient, including the elderly, disabled, children and non-elderly, non-disabled adults.Better manage the dual-eligible Medicare/Medicaid recipients.[/B] Require them to participate in a managed-care program that limits double dipping.Require co-pays for Medicaid recipients above the poverty level.[/B] Having skin in the game gives recipients motivation to spend less.
This post was edited on 4/17 3:54 PM by meridian
Agree with goat. This is way too close to a middle-of-the-road type legislation for anything to happen. CC is gonna have to go WAAAAAAAAAAAY right from this if he wants to be the nominee.
 
Agree with goat. This is way too close to a middle-of-the-road type legislation for anything to happen. CC is gonna have to go WAAAAAAAAAAAY right from this if he wants to be the nominee.

Christie's not going to be the Republican nominee regardless for a variety of reasons, not the least of which is that a brash temperament that might be suitable for a Republican governor in deep blue New Jersey doesn't translate well to the presidency.

And, once again, I wish it were the case that Republican candidates had to go WAAAAAAAAAY to the right to be nominated. But pretty much all nominees since Reagan demonstrate this is hardly reality.

The actual race for the actual nomination will probably come down to Walker and Bush. Rubio might be in the conversation, too. But I get the feeling he's a distant third.
 
What I don't like about it is it really helps out the super rich in that the upper middle income earner pays in a big chunk throughout their topping out at I believe 118.5 this year but you stop paying after that, so they don't get anything for their contribution but Bill Gates income after 118.5 is no longer being taxed essentially to support the new welfare system.
You do realize that this is a tax that's designed to pay for a specific program, and that there is a severe reduction in benefits to those higher income earners that the people with the worst deal from the program are the highest earners.

One of the best times of the year is when I reach the SS maximum and no longer have to pay for a program that I'm forced to be in and is a bad deal for me. It's like getting a six percent raise every fourth quarter.

Outside of that, there's not much to criticize about Christie's proposal. Increasing the retirement age is a no brainer, this isn't 1933 with the life expectancies of that time.
 
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