Senior Power and the Medicare Trust Fund Crisis
Harvard Health Policy Review , Vol. 5, No. 2, pp. 133-142, Fall 2004
10 Pages Posted: 19 Aug 2006
Our system of government is predicated upon the belief that citizens can influence the outcome of political conflicts. Indeed, political participation is necessary for its proper functioning and the voices of these citizens must be equal so that the democratic ideal of equal responsiveness to the preferences and interests of all is not violated. Otherwise, political inequality exists and contradicts our desire for political justice. But what are the different forms of political inequality and how have they influenced our political institutions? While most of the work on political inequality has focused upon the distribution of money and its corresponding effects upon political influence, this paper seeks to explore the influence of another resource that is necessary for political participation: time. It is a disproportionate possession of time that has allowed the elderly to gain the political power that they currently possess and to rally collectively in order to increase the benefits that they receive from the government. Correspondingly, we find ourselves in a precarious situation whereby the Social Security and Medicare Trust Funds are rapidly approaching bankruptcy. What does a theory of political justice have to say about this situation and its potential solutions? This topic is explored throughout the paper.
The first part of this paper is devoted to a study of political inequality in its theoretical form by addressing certain definitional issues and identifying its causes. The second portion reveals the political dominance of the elderly and its subsequent effects upon the distribution of government spending and poverty rates in the U.S. The third section reveals how this political power has set the stage for the impending insolvency of the Medicare and Social Security Trust Funds. The fourth section seeks to address the question of whether or not this political efficacy indeed constitutes political inequality and then attempts to determine the mechanism by which this inequality has evolved. Finally, the fifth portion returns to a discussion of the insolvency of Medicare and Social Security in an attempt to address potential solutions according to their fulfillment of the principles of political justice and proposes an alternative that does indeed compensate for the political inequality that caused this crisis in the first place.
Keywords: senior power, Medicare, trust fund, political inequality
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