Medicare and Social Security in a Time of Budget Austerity

DAY ONE: Thursday, January 31, 2013

9:30–10:15am  Opening Keynote: We Can’t Keep Meeting Like This: Time for Action, But What Action?
The election is over -- it is time to face up to some of the most difficult and perplexing policy challenges of our era. What are these challenges and what should we be putting on our public policy bucket lists? How do we move beyond talking at each other to working together to find common cause to address these challenges?

10:15–11:45am  Session I: Just the Facts, Ma’am: Demographics, Democracy, and the Public Budget
We’re not the country we used to be. How are changing American demographics affecting the challenges facing public programs, the dynamics of federal and state budgets, and public perceptions about the role of government?

12:15pm  Lunch

12:40–1:25pm  Luncheon Keynote: Budget Austerity and the Future of Revenues
Federal revenues have declined as a percent of GNP to unusually low levels. Can comprehensive tax reform raise revenues while lowering tax rates by broadening the base? Would the elimination of large tax exclusions and deductions reduce the incentives for private savings and private health insurance? What would this mean for retirement savings, health care coverage and the need for social insurance?

1:45–3:15pm  TWO TRACKS: Medicare and Social Security

Session IIa: A Reformed Medicare: Basic Principles
"Medicare reform" was a major issue in the election, but what does it really entail? What kind of health care system are we trying to promote? How do we build on the reforms in the Affordable Care Act? Can competition work in today’s health care markets? Would integrated delivery systems require a new approach to financing Medicare?

Session IIb: Strengthening Social Security: Adequacy and Equity
Social Security has held up well over time - but is it still optimally serving a greatly changed workforce? Is it time to rethink spousal and survivor benefits? What would it take to make it more effective and fairer? Can we do more to guard against poverty in old age and better address the needs of communities of color, the oldest-old, and other groups?

3:30–5:00pm TWO TRACKS: Medicare and Social Security

Session IIIa: Competing Medicare Reform Proposals — Are They Really That Different?
The election has forced proponents of Medicare reform into opposing camps. With the election behind us, we can ask: Are these approaches irreconcilable or are there common ideas and purposes that might point the way toward a broader consensus?

Session IIIb: Saving for Retirement – in Addition to Social Security
Americans are not saving enough, and certainly not enough for retirement. A large portion of the workforce is able to accumulate little or no pension or savings. What can be done to encourage or enable more retirement savings? Are there reforms that can expand the coverage and improve the performance of existing pension and retirement savings vehicles, even in the context of federal budget pressures?

5:00–6:15pm  Reception and Presentation of Heinz Dissertation Award
The Award recognizes outstanding research by new scholars addressing social insurance policy questions.

6:15pm  Dinner

7:00pm  Dinner Keynote: How Can We Get Consensus on Medicare and Social Security Reforms Post-Election?
Did all the campaign rhetoric help or hurt the public conversation about the future of Medicare, the Affordable Care Act, and U.S. health care in general? And what about Social Security? Has consensus become an impossible goal, or will the altered political climate of 2013 create new opportunities for bipartisan proposals and action?

DAY TWO: Friday, February 1, 2013

8:00–9:00am  Membership Breakfast

9:15–10:30am  Concurrent Roundtable Discussions:

  • Dual Eligibles: Care Coordination in the States
  • People vs. Pundits: A Disconnect in Public Opinion on Social Security
  • Opioid Use, Overuse and Abuse in Workers’ Compensation
  • How Has the Safety Net Fared in the Great Recession and Subsequent Recovery?

10:45–11:45am  Keynote: We Already Know How to Fix Our Health Care System, So Why Can't We?
There’s no great mystery about it: We know how to provide high-quality health care and obtain optimal outcomes with reasonable efficiency and consistency. So why don’t we? What stands in the way of scaling up our successes until the entire U.S. healthcare system operates at an acceptable level of quality, access, and cost?

12:00pm  Lunch

12:15–1:00pm  Luncheon Keynote: Treating the American Guilt Complex over Government Benefits
The most vocal critics of government assistance programs have received tax benefits for their IRAs, home mortgage deductions, federal student loans, or farm subsidies. Ninety-six percent of Americans have received government assistance; why do so many accept it for themselves, yet deny its value to others? How do we help Americans come to terms with a legitimate role for government in enabling success in our economy?

1:15–2:30pm  TWO TRACKS: Medicare and Social Security

Session IVa: Finding Consensus on Medicare Reform
Enough talk: We now see common elements in the major Medicare reform proposals. But can the differences be reconciled? How do we balance the need for new revenue and the need to contain costs? What should be the framework for developing consensus?

Session IVb: Living Longer, Working Longer — and Social Security
Americans are generally living longer, although longevity gains vary greatly. Some are working longer and increasing their Social Security benefits by delaying claiming them. But not everyone can work longer. This session will focus on the challenges of living longer and working longer – and on the policy choices for Social Security benefits and finances.

2:45–3:45pm Session V: No Benefits If They Won’t Pay for Them: What Young Americans Are Willing to Finance
All the talk about cutting Social Security and Medicare has the effect of undermining confidence in the future of social insurance programs among those who arguably have the most at stake: younger Americans. Are their fears justified? Can social insurance address the needs of increasingly diverse generations? If so, what should be done to reach out to younger Americans and engage them in charting the future of Social Security, Medicare, and other social insurance programs?


3:45–4:00pm Closing Remarks and Recap: We Can’t Keep Meeting Like This: Time for Action, But What Action?
We’ve talked about it, but now what should we do? It’s time to sum up the conclusions from two days of discussion, identify points of agreement and opportunities for common purpose, and chart a course of action.

Conference co-chairs: