No doubt Medicare has a problem. We are told the funds available are not enough to pay the benefits promised. So do we need to destroy Medicare (as it is) in order to save it?

Can we reduce costs without impacting benefits? You occasionally read about really big frauds being found. Do we need to do more about preventing those or at least minimizing damage? Private insurers seem less subject to this type of fraud. What is their secret? Can we make the medical system more efficient and less coslty.

If the American people think we should keep Medicare benefits, do we need to find a better funding mechanism? Obviously paying a small percentage of your salary while working and getting heath care benefits for life after 65 is not a viable model in itself. Do we want to supplement this from general revenues or add another dedicated tax. Increasing the taxes on gasoline consumption or adding a carbon tax seems appropriate. We need to decrease our dependence on oil and other carbon producing eneny sources so a tax seems logical to me.

Do we want to decrease benefits? That is the other possible solution. I don’t agree with Rep. Ryan’s plan but at least it has moved us a bit more toward a discussion on this.