The Coming Generational Storm written by Laurence Kotlikoff and Scott Burns is now available online.

It is one of the earlier works that really brought the issue of Social Security and Medicare funding over the next 50 years to the fore.  The punchline is that at some point either benefits must be cut, taxes raised or some combination of both.  While Social Security gets most of the attention it is the Medicare costs that are the bigger problem.

Unlimited health care is not a basic human right. For example, how much should the public be willing to spend to extend the life of an individual by an additional year.  While people will argue about what that limit should be, a limit clearly must exist.  With that said, one of our cultural values is that a “basic” level of health care should be a human right.

So the question becomes, how do you decide that dividing line between what should be covered for everyone and what will be available to only those who can pay.  Right now this is defined implicitly by what Medicare and Medicaid will and won’t cover.  I don’t see easy answers here but you can be sure it will be at the core of any debate on the future of Medicare and Medicaid.