This question originally appeared on Quora. 
By Gary Teal, Republican
The campaign is on, so to speak. I'm shifting into fighting mode, but I hope this answer and all future ones will be read in the spirit they are written: I have a strong opinion, and lots of smart people have a very different opinion. I am occasionally baffled by your positions, and you mine. I want to be polite, but I have to speak directly and forcefully because the outcome of these discussions matters a lot. I am delighted to find that we are discussing difficult questions about policy, and not birth certificates or flag burning or (at least for a few minutes) verbal gaffes.
I wonder who it is you believe is saying that these are not worthwhile programs. I myself don't remember meeting or even hearing of many people who are opposed to Social Security and Medicare. The meme that the Republican Party is determined to destroy those two programs is a false one, and one calculated to deceive and panic ignorant voters. Reform is not the same as repeal, and reform that saves a program from insolvency, and which enables it to continue aiding its intended beneficiaries, is the opposite of destroying it.
Unfortunately, both parties have stumbled all over themselves for decades to create this untouchable third rail, so that when any politician dares to suggest that restructuring is needed, the other party hauls out the demagoguery machine and spews lies until the poor responsible politician backs down, lesson learned, or is sent to losing candidate hell. AARP, masquerading as a discount program, does what it is after all supposed to do and wages all-out war against anyone who would reduce the future payout to one retiree by one dime, because they don't have to worry about how to pay for it. See How is the AARP reacting to Representative Paul Ryan's (R-Wisconsin) Medicare proposals? And of course, if they come to believe that one party is coalescing into a threat against some of those dollars, they'll launch the B-52s against all members of that party and essentially become an arm of the party that is in demagogue mode. To repeat myself, this is their function.
During the budget debates of the past two years, many Democrats, as well as the media, were very keen to point out, correctly, that all the arguing about Planned Parenthood funding and other discretionary spending was addressing a drop in the bucket, and that the real money was being spent on these programs we're talking about. Now someone comes forward whose political identity is built on taking a serious look at the real problem, and he becomes the VP nominee of his party. It is the full time job of some to make sure that he appears scary and crazy, and it's the hobby of many others. I hope the majority will tell those people to shut up for a few minutes and hear him out. Read his plan.
Every person who has looked into the matter for even a brief time understands that the Social Security system is non-sustainable as it was originally structured, on the basis of changing demographics alone. Pick a source, but let's agree that there were originally many workers being taxed to fund each retired worker, who was statistically likely to be without a pension, and to need these payments (especially during a depression) just to literally stay alive, for a decade or so of retirement. Again, it depends on what year and what study you want to look at, but inexorably, we move to the stage where each worker is paying all by themselves all benefits for one Social Security recipient (and then of course the ratio gets worse, as people continue to enjoy longer retirements).
To be clear, the Ryan Plan no longer includes private investment accounts, for perhaps two reasons. First, as before, the demagogues have the upper hand. Second, the fund is worse off than it was just a couple of years ago; there's much less wiggle room for adjustments, and every dollar coming in is needed immediately. Reform, if we have the courage to face it like grownups, opens a door to many possibilities. Speaking not for Romney/Ryan (which I am not paid to do on any subject, but in this case particularly not adhering to any position they've put forth), I'd like to see us focus on needy people, and abandon the notion that Social Security is a savings plan at all. The situation of most of our seniors is very different from what it was in 1930. Social Security taxes are currently not progressive, especially at the upper end. If you like the current system, you are very explicitly and literally asking the people who make up beds in hotels and who mop the floors at fast food restaurants and who work in the fields for minimum wage to pay a tax that may actually benefit a senior who does have a pension, probably has saved something, may own a house, and in an increasing number of cases, has investment income that far exceeds that of these workers who are being taxed. That's not a social safety net. It's a case of government pretending to act as a responsible banker for wage earners who haven't saved properly. Sadly, the program is now eating us alive rather than making us safe.
All Americans believe in a safety net provided by the government. People who don't have enough money to live a reasonably healthy, productive life get federal aid. Both parties support that concept and have for many generations. The two parties are actually pretty close on the spectrum when compared to other countries and other times in history. The two very difficult things that we have not done yet are to reach a consensus on what sort of medical care is the minimum acceptable level of care that an American should receive, regardless of their means, and to agree on what level of resources they should have to guarantee that they and their families will have food, shelter, transportation, clothing, and entertainment. Happily, the answers to both questions do and should shift steadily upwards as the wealth of the nation increases. But it's hard for all of us, of any age, to keep in mind the much lower standard of living that our grandparents had when they were young. Most of us have little to complain about. If the issue is morality, and the argument is that too many are living in need, a shift to a global perspective should serve to tamp down even more of the complaining. I'm glad I'm not the guy in charge of telling this to the voters. It's not welcome news. I myself have had this conversation with older voters who could only be described as rich. They strongly believe it's their money. No amount of explanation that their check is being funded out of my daughter's small income is persuasive to them, in many cases. But I would rather be, and stand with, the people selling this bitter pill than the people urging the voters to shoot the messengers and just not worry about it right now.
Ideally, individuals would always decide what to do with their own income, and they would be very generous. That's not a fantasy world - it's the way many people live their lives. Not many believe that the government could be funded by voluntary donations, so we also know that we will always have a mandatory tax system that takes money from people who make lots of it and uses that revenue both for the common good of all and for support services for those who can't afford to pay any federal taxes at all. So in addition to whatever the local Kiwanis Club or Methodist Church or Lincoln Park Neighborhood Association or volunteer food bank is doing, Americans can be sure that there is a minimum level of government programs and transfer of payments to help them lead good lives. The reason for typing three sentences of third-grade level social contract givens is that we have somehow allowed our government to create programs that don't only help those who need it most. We were led to believe that Social Security is like a savings account. We paid into it, so we'll get something out, right? Well, as I understand it, most surveys find that young people understand the system well enough to laugh out loud at that thought. That's a wonderful thing, actually. It means that some will take saving for their old age more seriously. Some of them will not save for themselves, despite their suspicion that the government cannot make them comfortable for a thirty year retirement, and they'll have to be rescued by the safety net. If they make $20k a year, one hopes that they can still save enough to maintain the same standard of living they had when they were working. It will still be better to make more money, manage it, and get rich. If they make a million dollars a year, one hopes that they will not blow it all on Facebook stock and drugs. Those people can fund the safety net. That's why we have to focus on what we will accept (as of this year, and then do it again next year) as a minimum acceptable lifestyle.
Giving everyone the same access to medical care is a dream that I hope lots of smart people will continue to work on, but one that I hope nobody gets attached to as an achievable goal. There will always be a new machine, a new drug, or a best doctor, that cannot be spread across 300,000,000 patients at the same time. We can't, in my opinion, have a system that taxes more and more and more, and borrows more and more and more, to pay for all the medical bills that one can run up if you take advantage of all the medicine and surgery and specialist care that has already and will continue to come online. Who will do the unavoidable rationing? If the argument is that the government wouldn't be as greedy as a private insurance company, I assume that means that more treatments would be approved and paid for. Doesn't sound like cost containment to me.
The really cool thing is that I can have this conversation all day, listen to the other side make its points, and not lose my temper. This is not a silly fight. I listened to CNN's breathless coverage this morning that Romney called Ryan "the next President ..." as if that were really significant (before someone found the video where Obama, amazingly, did precisely the very same thing on the same historic occasion), but after they got all they could out of that nonsense, also found that perhaps for the first time in a while, we are talking about real issues. I welcome the opinions of those who disagree with me. The exact tax rates we end up with next year, and the way Social Security and Medicaid are funded for the next ten, will be largely decided in less than ninety days. Let's spend that time talking about what each side is actually saying they will do, and not set up straw men so we can fight about things that are imaginary, like someone pushing grandma off a cliff.
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