Raising the eligibility for Medicare is not exactly the most obvious solution for the program. With Social Security, it makes some sense: Social Security benefits are the same no matter how old you are, and the longer people keep working, the more you collect from them in payroll taxes. But with Medicare, people are much less expensive between the ages of 65-67; it's later that the costs start to escalate. Sure, you'll save some money on doctor's visits, and of course some people will die before they enroll. But overall, it's not much of a fix--particularly since many of those people will simply end up on subsidized insurance through the exchanges.
1. I infer he understands that the Medicare Payment Advisory Board isn't going to live up to the high hopes for it. It may not even survive.
2. I infer he understands that most other plans for Medicare cuts won't get through Congress, and that it will only get tougher to pass such plans each year.
3. I infer he understands that somewhat fewer Medicare recipients at any point in time will, possibly, make it easier to reform and indeed improve other aspects of the program.
4. I infer he understands that Medicare truly is the budget-buster of our time and that its future will not ever be ruled by technocratic principles.
Partisans will want to blame this on the other party, but both sides have demagogued the issue when it suited them. If there were an easy solution, we would have implemented it already.