# "Social Security and Medicare...pose the greatest threat to America's global role..." **URL:** \ **Category:** Great Debates\ **Created:** [January 23, 2006, 7:16am UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228 "2006-01-23T07:16:16Z")\ **Posts on this page:** 5\ **Page:** 1
**Author:** ![Rodgers01](https://avatars.discourse-cdn.com/v4/letter/r/b19c9b/32.png) [@Rodgers01](https://boards.straightdope.com/u/Rodgers01)\ **Post date:** [January 23, 2006, 7:16am UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228/1 "2006-01-23T07:16:16Z")
For anyone who followed [this](http://boards.straightdope.com/sdmb/showthread.php?t=349833) thread, I was going to post this [article](http://www.foreignpolicy.com/story/cms.php?story_id=3331&page=0) for Foreign Policy magazine’s take on the subject. (Basically, what would happen if the US did not, as is often claimed, pay for the defense of the world.) But there was a quote towards the end of the article that I thought deserved a discussion of its own: > [@](#): > > In the end, however, what other nations do or do not say about the United States will not be crucial to whether, or for how long, the United States continues to function as the world’s government. That will depend on the willingness of the American public, the ultimate arbiter of American foreign policy, to sustain the costs involved. In the near future, America’s role in the world will have to compete for public funds with the rising costs of domestic entitlement programs. **It is Social Security and Medicare, not the rise of China or the kind of coalition that defeated powerful empires in the past, that pose the greatest threat to America’s role as the world’s government.** What do you think? Am I hastening a future of anarchy by supporting national healthcare? ---
**Author:** ![Martin\_Hyde](https://avatars.discourse-cdn.com/v4/letter/m/47e85d/32.png) [@Martin\_Hyde](https://boards.straightdope.com/u/Martin_Hyde)\ **Post date:** [January 23, 2006, 8:43am UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228/2 "2006-01-23T08:43:49Z")
An interesting although not quite on-topic issue is Medicaid. Medicare is primarily for people who are either over 65, have end-stage kidney disorder, or who are receiving benefits under certain other SSA programs. Medicaid is medical coverage for the poor, and is managed and funded to a large degree by the states. In the 1980s Ronald Reagan proposed an interesting plan, he said the Federal government would take over Medicaid and take care of all the funding, and the states would be responsible for welfare (food stamps, aid to families with dependent children etc.) The states and congress didn’t really hop on board for that. What’s interesting is if that had been done we’d be a lot closer to a national health care system than we are right now because Medicare (for the elderly) and medicaid (for the poor) would both be federally funded and managed and part of an expanded national health care system. The states would have been wise to take up Reagan’s offer since now they foot a good bit of the bill for medicaid AND welfare. ---
**Author:** ![Sam\_Stone](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Sam\_Stone](https://boards.straightdope.com/u/Sam_Stone)\ **Post date:** [January 23, 2006, 9:02am UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228/3 "2006-01-23T09:02:10Z")
The thing is, while the U.S. is certainly picking up an increasing burden of care for the elderly, _so is every other country_. If you want to see where the real disaster is going to come, have a look at Europe. Their birthrates are lower, their benefits much higher, and their population is already older. In addition, while America’s economic growth is high enough that it can grow its way out of the problem, growth in Europe is becoming stagnant. The implosion of Europe will be the biggest story of the next 30 years. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [January 23, 2006, 7:18pm UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228/4 "2006-01-23T19:18:51Z")
I doubt that domestic entitlement programs are really going to cripple US military spending any time within the next 30–50 years. Medicare, which is where benefit costs are projected to seriously skyrocket, will probably be folded into some kind of single-payer program that restricts health-care costs. And Social Security will probably get by for at least the next several decades with “tweaks” such as reducing early-retirement benefits and raising the payroll tax cap. In any case, we have enough slack in our tax system to allow for cushioning short-term funding crises, if any become really severe, with modest upper-bracket tax increases. In short: definitely something to think about, but not a harbinger of inevitable impending doom doom doom. I’m also skeptical about **Sam** ’s catastrophic though vague predictions of a full-scale economic “implosion” of Europe in the next few decades. Yes, many European countries do currently have a serious mismatch between the projected costs of social benefits for their aging populations and the projected demographic ability to support those costs. But that doesn’t mean that they’re automatically doom doom doomed to suffer the projected consequences. Some of the countervailing factors include: - Greater mobility for members of demographically younger European countries more recently admitted to the EU (possibly including, a decade or so from now, Turkey) whose immigrants will shore up social support systems in the older countries. - Greater social willingness for benefits rationing in, e.g., end-of-life care, where most of the major increases in geriatric medical costs occur. - Political will to make temporary benefit cuts in periods of genuine funding crisis, and to adjust benefit programs to conform to demographic realities. For example, consider the experience of prototypical-welfare-state [Sweden](http://www.sweden.se/templates/cs/BasicFactsheet ____ 3978.aspx) in the tough economy of the 1990’s: > [@](#): > > After 1991 a deep economic crisis interrupted the long period of full employment that Sweden had enjoyed in the post-war period. Numerous cuts were made in the the social insurance system; qualifying days, when no benefits were paid, were reintroduced into the health and unemployment insurance systems, and the levels of benefits and the indexation of pensions were reduced for a time. The economic upswing of the last few years has however enabled the government to reverse and improve on many of these measures. […] > > A new pension system was introduced in Sweden in 1999. The main element of the new, contribution-determined system is an income-related pension based on lifetime income, up to a certain ceiling (annual income over 7.5 times the price base amount\* on which pensions are assessed does not count toward ones pension). […] The new pension system is closely linked to the state of the Swedish economy and the country’s demographic development. So I’d need to see a lot more evidence before I assumed with **Sam** that current European demographics are bound to lead to economic “disaster”. ---
**Author:** ![Sam\_Stone](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Sam\_Stone](https://boards.straightdope.com/u/Sam_Stone)\ **Post date:** [January 23, 2006, 8:04pm UTC](https://boards.straightdope.com/t/social-security-and-medicare-pose-the-greatest-threat-to-americas-global-role/341228/5 "2006-01-23T20:04:21Z")
Okay, let me qualify that - If present trends continue, Europe is heading for a big problem. I suppose it’s possible that Europe could institute drastic reforms and stave off the problem, but I don’t know how likely that is. In a couple of decades, there will be less than 2 workers per retiree on average in the EU zone. That’s not sustainable. So either there will have to be dramatic benefit cuts, or a dramatic increase in the retirement age, or a dramatic increase in immigration.