Madrick: My favorite plan is a form of Medicare for all, not just those 65 and over, with more controls over drug costs and provider reimbursement. In fact, I have little doubt that alone could save America. Rising health care costs are our biggest domestic problem, not Medicare and Medicaid per se. And I wish the people who talk about cutting back entitlements would put some of their vigorous effort and intelligence towards solving the health care problem.
Slate:What do people most commonly misunderstand about entitlement reforms?
Madrick: There are a lot of implications that somehow Social Security and Medicare actually caused our current budget deficit, which is not remotely the case.
Slate:So what are the causes of the deficit?
Madrick: The Bush tax cuts, the Great Recession, and the wars [in Afghanistan and Iraq]—those are the main contributors to the deficit problems we now have. We have to separate that issue, which is what's alarming everybody, from the long-term issues. They're very different.
Slate:As you've said, the cost of health care is rising every year. If we aren't able to overhaul the health care system, will we inevitably need to ration health care and treatments in the future?
Madrick: Let's not forget, health care is rationed now. Anybody who thinks that everybody gets all the health care they want is not living in this world. No. 2, we spend much too much money on what is commonly called "heroic" health care practices, one major test after another. Much of this is done late in life, and I think that whole system has to be reviewed. Hospitals and doctors make too much money performing these tests. Do we keep some people alive much too long? Or should we give people the choice to die more readily earlier? I think the idea of performing tests to keep people alive a few more days has to be examined.