Publications on Medicare

Government analysts portray a bleak fiscal future as the retirement of baby boomers and soaring health costs push up expenditures on Social Security, Medicare and Medicaid much faster than projected tax revenues. Some argue that the analysts' economic growth projections are too pessimistic. This analysis argues that official growth projections are quite reasonable, but even if they are too pessimistic, faster growth will accelerate Social Security costs because of the program's structure and health costs are also likely to grow more rapidly. Faster growth will, however, ease the pain associated with necessary reforms.

Rising health care costs threaten financial security at older ages and lead many older Americans to delay retirement. Continued work reduces the risk of high out-of-pocket health care costs for workers receiving health benefits from their employers. Working longer also increases retirement incomes, making health care costs more affordable. This report shows that men with very high expected health care costs after age 65 retire 11 months later than those with very low health care costs. For women, the difference is 12 months.

Baby boomers have changed the nature of work, why not the nature of retirement? Options will multiply, retirement expert Richard W. Johnson writes in The San Diego Union-Tribune, if Medicare rules, payroll taxes, and age-discrimination and tax laws become more congenial to work.

Federal investment in children is likely to decline markedly within the next decade, according to a new Urban Institute study. The share of the federal budget for programs that enhance kids' future productivity or income is forecast to drop from 1.6 percent of the gross domestic product in 2006 to 1.3 percent by 2017, under current policies.

This brief charts U.S. federal spending on investment in total and for children from 1965 to 2017. Relative to GDP or domestic spending, total investment and investment in children—under almost any definition—fell over the 1965–2006 period, though with some recent rebounds. More important, projections of current policies show that overall government investment and especially investment in children are threatened to decline in relative and sometimes absolute importance, squeezed out mainly by faster, automatically growing programs that tend to favor consumption. These data raise the question of what relative priority the government should place on investment, and particularly investment in children.