Providence Health and Services covers five Western states, New Mexico, Texas, and Hyderabad in India.” –
Niketas C.

I’m all too aware of that. My issue is that in this area we cannot doctor shop or choose our own doctors. Even if we could go to Seattle now, the health organizations will assign us a doctor. There is little choice – no competition. True of every specialty. I have a lot of skin cancer – I’ve been assigned to a dermatologist that I don’t really care for. I’d like to change but cannot.

We can no longer drive on the freeways, so we’re confined to the local area for medical care. And we are forced by these monopolies to take what they give us.

And speaking of Optum, the new owner of Everett Clinic. I never had an issue with billing before they took over. Three times in the last year I have had to wrangle with them over the fact that they fouled up the way they submitted a bill to Tricare for Life, resulting in Tricare rejecting the bill.

Creating these medical bureaucracies has driven doctors out of private practice decreasing choice and competition. Only the bureaucracies have benefitted from this.

Brian, this isn’t just economics. When the gov’t taxed me for them, the gov’t told me that social security and medicare were an annuity and a medical insurance program. I saw that to be the case for my parents, and so I trusted the gov’t. These programs are a big fraction of my relationship w/ the gov’t. Breaking them would break a big fraction of my remaining trust in the government.

What I said was the population pyramid is inverting. Critical difference there.

Simple matter of applying the actuarial tables to the population pyramid today.

It is in the process of inverting now and will be inverted in the future unless demographics quickly and radically change. Filling in with immigrants who don’t assimilate would change that quickly and radically, but brings other problems. Much higher TFR would change that but not quickly.

Ayn Rand took her bloody Social Security benefits.

Did she and her husband pay taxes? That part isn’t optional, as I recall. If they paid taxes, and already in it against their will, why should they have forgone the benefits?

I’d give up my benefits, if I’ll ever be offered them, if I got all my payroll taxes back with interest, which I won’t because the money was already spent on people who got their benefits.

When Congress enacted Social Security in 1935…

In 1935, a 25 year old male had only a 63% of surviving to age 65. In 2025, a 25 year old male is estimated to have an 84% of surviving to age 68.

In 1965, when that 25 year old from 1935 was retirement age, there were 4 people working to pay his benefits. In 2068, when the 25 year old from 2025 is retirement age, there will be an inverted population pyramid. 20% of the population will be 70+, only 59% of the population will be of working age, and at at typical labor force participation rates fewer than 40% of the total population could be assumed to actually work. Consequently for every retiree 70 and above, about 2 people or fewer would be working to support him. And those same people of course supporting children as well.

This is essentially an argument for no Social Security and letting people keep their money. I’d go for that.

But like I said, the population pyramid is inverting, so moot.

Reality Is Not Optional [in 3 ft high letters]
(Source: blogger LG, 2022)

We Probably Won’t Like What It Is [in 3 ft high letters]
(Source: blogger NC, 2026)

As it is, after paying regular tax rates on the 85% fraction of our SS income, plus taking out our Medicare premiums, we net about 40% of the nominally received (and COLA adjusted) SS amount. Fortunately we don’t really need that income so we gift the bulk of what is left to the kids and grandkids so they have a cushion for when the system collapses and the government comes looking at taxing their income to fix the mess. And luckily SS does not fall under the added 3.8% factor for net investment income tax (NIIT) passed as part of the Obamacare hoax [at least not yet!!].