1. Social Security: increase the tax a few percentage on everyone and make the distribution means tested and age adjusted. Seems straightforward.

2. Healthcare: get Kaiser to set up statewide HMOs for every state. Give everyone access to a basic HMO plan with a reasonable deductible. Paid by employer if employed, paid by state if unemployed. But it's also means tested using both income, age and fitness. Young healthy people pay the least. Old rich people with three cancers pay the most. Sliding scale in between. A healthy 46 year old with no known health problem will pay $x amount, an unhealthy 46 year old with a history of diabetes will pay more, but up to the cap established by the sliding scale. Even the old rich boomer with three cancers won't pay too much out of pocket, maybe cap it to a low percentage of his annual income or a maximum amount. There will have to be death panels to reject the latest treatment to prolong your life by six months, it's inevitable.

Note: people can still take out private health insurance to cover any gaps they personally want and doctors can decide if they want to remain private. Employers can still offer fancier plans. BIGLAW attorneys who want doctors on speed dial for every time they feel heart palpitations can sign up for a concierge.

3. Political gerrymandering: get rid of first past the post for congressional elections and introduce proportional representation on a state by state basis. If your state has 10 seats and vote outcome is 55% one party, 45% the other party, divide the slate that way as close as possible, accepting that even one seat may be determined by a fraction of a fraction. Since parties will have a pretty good idea of the typical vote breakdown in that state, they will go into the primaries with a ranked slate of candidates. They'll have 10 candidates on that slate, knowing that they'll probably only get 5 or 6 seats. Then after the election, the parties divide the state by the seats in an agreement of who goes where so each area gets its representative and you can still keep some kind of local / regional connection to its congressman.

Just a few thoughts. Doesn't seem complicated.

(http://www.autoadmit.com/thread.php?thread_id=5901623&forum_id=2Reputation#50122867)

I think 2 is roughly a government option plan that I think would be a lot easier to transition to than single-payer.

The third idea is interesting. Never thought of that. I agree that a lot of our issues stem from the first past the post and non-parliamentary nature of our gov't.

(http://www.autoadmit.com/thread.php?thread_id=5901623&forum_id=2Reputation#50122899)

1. Most people treat social security as their pension when the program was never designed to be the pension. So make it the pension. Which means, yes, people would need to pay more. The conservative in me isn't keen on having 10% fund social security for everyone else. We all buy into it, we have a stake in it. And don't think you can raise enough taxes on the top 10% or 1% to address the crisis fully.

No 2 is my pet project. It is a government option that is run by a private companies in P3 partnerships. It's actually how some EU countries operate. Single-payer advocates ignore that a number of European countries operates on a hybrid public and private system. And it gives people choices while providing a floor to allow everyone access to decent healthcare. The way I ultimately see this approach playing out is that most people will take the Kaiser HMO and rely on internal PCPS and specialists. This skews the health sector to their advantage due to the sheer gravity of numbers and demand. But you can still have specialists and PCPs in private practice for people who pay out of pocket or take out private supplemental insurance. Kaiser regularly approves out of plan treatments for specialists for rare conditions and I see the same happening here. So it's not a question of nationalizing Johns Hopkins or the Mayo clinic but introducing greater efficiency in the healthcare sector.

Re 3, gerrymandering is a race to the bottom and needs to be fixed. It's poisoning the electorate and also allows extremists to flourish due to pandering to primary voters.

(http://www.autoadmit.com/thread.php?thread_id=5901623&forum_id=2Reputation#50122943)

As Consuela might point out, the entire point of the elections operating as they currently do is in part to keep people distracted while the looting goes on.

I haven't thought about your healthcare proposal in enough depth. But as someone who pays out the fucking ass for health insurance, I'd welcome just about anything other than the current setup (except for full single payer which would be a disaster IMO).

On social security, do means testing long before raising the taxes.

(http://www.autoadmit.com/thread.php?thread_id=5901623&forum_id=2Reputation#50122967)