People are always wanting to means test things like Medicare. I suppose it's not a bad idea - you can let people lose their entire fortunes on medical bills and then let them qualify for insurance. But, why do they stop there? Why don't we means test police and fire protection? Why don't we means test public university tuition (aid formulas do that somewhat, but full tuition payers are still heavily subsidized)? All of these things, too, are "entitlements." Hey, how about we means test all government services, including national defense, by enacting a shockingly progressive tax system?
But, more seriously, all of these discussions about what to do about those expensive programs for old people are just fantasies. As I say over and over again, the reason that Medicare is going to get increasingly expensive is that a greater percentage of the population is going to be over 65. That also means that a greater percentage of the voting population is going to be over 65. If you think these programs are the "third rail"of politics now, just wait a few years. There will be more generous medical benefits. The only question is when and how we pay for it (before or after these people retire) and how it's administered. Seniors are going to get their Medicare and their prescription drug program. Odds are, they're going to get a whole bunch of other stuff too - huge expenditures on making communities more liveable for them. More expensive and better nursing homes. Free or subsidized taxi programs. A proliferation of golf cart paths. etc...
