Social Security kept 23.5 million Americans above the poverty line last year. Medicare covers 67 million. Medicaid covers 77.7 million and pays for 60% of nursing home care. These programs run at 0.7–1.7% overhead versus 12–20% for private alternatives. The solvency "crisis" is a revenue problem caused by inequality — not a reason to cut benefits. We fix it, expand it, and make it permanent.
Social Security, Medicare, and Medicaid are the most successful anti-poverty programs in American history. They work. They are efficient. They are wildly popular. The political project to undermine them is not about solvency — it is about ideology. This platform defends what works, fixes what is broken, and expands what is inadequate.
Ten pillars — one platform: Make Social Security solvent for 75+ years by lifting the payroll tax cap. Raise benefits $200/month for the bottom two quintiles. Switch to CPI-E and a 3% minimum COLA. Add dental, vision, and hearing to Medicare. End $76–84 billion/year in Medicare Advantage overpayments. Protect Medicaid from block grants and work requirements. Fix the disability system's 231-day average wait. Lower Medicare eligibility to 60. Expand drug price negotiation to every Medicare-covered drug. Make the 401(k) system progressive instead of regressive.
The problem is not that these programs are too generous. The problem is that they are not generous enough, poorly structured in places, and systematically underfunded by policy choices that benefit the wealthy.
US elder poverty stands at approximately 20–23% — roughly four times Denmark's rate. Only 6.8% of retirees have the full "three-legged stool" of Social Security, pension, and personal savings. Median retirement savings for ages 55–64: $185,000 — less than 15% of what is needed. For the bottom 40%, Social Security already provides 84% of total income.
| Country | Elder Poverty Rate | Context |
|---|---|---|
| Iceland | 3.1% | Universal pension + mandatory savings |
| Denmark | 5.0% | Guarantee pension creates effective floor |
| France | 6.1% | 74.4% replacement rate through public pension |
| Netherlands | 6.2% | 89.2% replacement — highest in OECD |
| Norway | 7.5% | Flexi-job and rehabilitation-first disability system |
| OECD Average | 14.8% | — |
| United States | ~20–23% | 49.4% replacement — among lowest in OECD |
Source: OECD Pensions at a Glance — oecd.org
Social Security benefits have lost approximately 36% of purchasing power since 2000. CPI-W underestimates senior costs because seniors spend far more on healthcare and housing — the two categories with the highest sustained inflation. A $1,000 monthly benefit in 2000 buys roughly $640 worth of senior-relevant goods today. The annual "raise" is not a raise; it is an incomplete catch-up that falls short every year.
Traditional Medicare is the only major insurance without an annual out-of-pocket maximum. It does not cover dental, vision, or hearing — hearing aids average $4,000–$6,000. Meanwhile, Medicare Advantage costs taxpayers $76–84 billion per year more than Traditional Medicare through systematic upcoding. In 2024, 4.1 million prior authorization requests were denied; 80.7% were overturned on appeal. Plans are charging taxpayers more, delivering less, and blocking care that would have been approved.
ALJ approval rates vary from 10% to 90% depending on the judge — the same case can succeed or fail based entirely on random assignment. Average SSDI benefit: $1,537/month. One in four SSDI recipients lives below the poverty line.
Source: GAO — gao.gov
The 401(k) system is deeply regressive. The top 10% of earners capture 60% of all retirement tax benefits. 43% of Americans ages 55–64 have zero retirement savings. The current system gives the same $24,500 annual limit to a worker earning $40,000 and a CEO earning $500,000 — a subsidy structure that maximally benefits people who need it least.
Sources: Federal Reserve SCF — federalreserve.gov · KFF Medicaid — kff.org · SSA — ssa.gov
The 1983 reforms set the payroll tax cap to cover 90% of all wages. Due to rising inequality, the cap today covers only approximately 82.5% — meaning roughly $475 billion in wages escaped Social Security taxation in 2024. The solvency gap exists because inequality pushed wages above the cap. Not because benefits are too generous. Not because the program is structurally flawed. Because high earners took an ever-larger share of total wages and the cap did not follow them.
Private-sector defined benefit pension coverage collapsed from approximately 50% in the mid-1980s to 16% today. The shift to 401(k) plans transferred all investment risk from employers to workers — and the bottom half of workers were largely left with nothing. This is inseparable from union decline (see Issue 13): unions negotiate pensions; without unions, pensions disappear.
| Country / Attempt | What Was Promised | What Was Delivered |
|---|---|---|
| Chile (1981) | 70% replacement rate | 38% — AFP fees consumed 20%+ of contributions |
| Sweden's Premium Pension | Market growth | 75%+ of savers lost 30%+ of value by 2002 |
| UK Thatcher-Era | Greater choice | 2.5 million people given unsuitable advice — mis-selling scandal |
| Bush 2005 Proposal | Better returns | 16-point approval drop during his own national campaign tour |
Arkansas implemented work requirements in 2018: 18,000 lost coverage, zero employment gain. The 2025 reconciliation law projects 4.8 million newly uninsured. Fourteen states still refuse Medicaid expansion, leaving 1.4 million people in the coverage gap — a gap that exists for no reason other than political hostility to the program.
Sources: SSA — ssa.gov · Urban Institute — urban.org · KFF Coverage Gap — kff.org
| Country | Net Replacement Rate | Elder Poverty Rate |
|---|---|---|
| Netherlands | 89.2% | 6.2% |
| Austria | 87.0% | ~8% |
| Denmark | 84.0% | 5.0% |
| Italy | 81.7% | ~9% |
| France | 74.4% | 6.1% |
| Germany | 52.9% | ~14% |
| United States | 49.4% | ~20–23% |
The correlation is direct: countries with higher replacement rates have lower elder poverty. The US replaces less than half of pre-retirement earnings. Countries that achieve low elder poverty do so through public pensions, mandatory employer contributions, and guarantee pensions that create an effective floor below which no one falls.
Specific models that work: Denmark achieves elder poverty of just 3% (vs. US ~20–23%) through a universal basic pension plus supplemental earnings-based benefits (OECD Pensions at a Glance 2023). Germany provides a 48% gross replacement rate through its statutory pension insurance, compared to the US average of approximately 39% (CBO). The Netherlands guarantees a 100% basic pension (AOW) to all residents regardless of work history — producing just 6.2% elder poverty. Australia combines a means-tested Age Pension with compulsory employer superannuation contributions (currently 11.5% of wages), ensuring nearly universal retirement coverage through a dual public-private system.
Japan has mandatory Long-Term Care Insurance for all citizens 65+ since 2000. Germany's Pflegeversicherung has been mandatory and payroll-tax-funded since 1995. Denmark delivers 90% of elder care at home. The US uses spend-down: seniors must exhaust virtually all assets before Medicaid pays. Other countries treat long-term care as a social insurance risk to be pooled; the US treats it as a personal misfortune to be survived.
Even after the IRA's negotiation provisions, Medicare pays 2.8–3.9× peer-nation prices. One in four US seniors spent more than $2,000 out of pocket on healthcare last year. US seniors are the most likely of any surveyed country to skip care due to cost. The price difference is not quality — it is negotiating power that other nations use and we do not.
Sources: OECD — oecd.org · Commonwealth Fund — commonwealthfund.org
Ten mutually reinforcing reforms. The solvency pillars fund the program. The benefit pillars serve the people. The systemic pillars fix the machinery. All ten are required — the weakest link in the chain is the one that fails the person who needs it.
The payroll tax cap ($176,100 in 2025) means a worker earning $50,000 pays Social Security tax on every dollar. A CEO earning $5 million pays on 3.5%. This is not fiscal necessity. It is an inequality subsidy.
For the bottom 40%, Social Security is not a supplement — it is the retirement system. 84% of total income. Benefits were never designed to carry that weight alone.
CPI-W is an index designed around working-age urban wage earners. Seniors have fundamentally different spending patterns — healthcare and housing dominate. CPI-E corrects this by tracking actual senior expenditures.
Traditional Medicare has no annual out-of-pocket maximum — the only major insurance without a catastrophic cap. Dental, vision, and hearing are not optional health expenses for older Americans. Hearing aids average $4,000–$6,000 per pair. These are medical necessities excluded for historical, not clinical, reasons.
MedPAC calculates $76–84 billion per year in MA overpayments — 17–20% excess beyond what Traditional Medicare would cost for the same patients. 4.1 million prior authorization denials in 2024; 80.7% overturned on appeal. Plans are profiting from delay and denial.
77.7 million Americans depend on Medicaid. Medicaid pays for 60%+ of all nursing home care. Block grants would convert a guarantee based on need into a fixed payment that fails when need is highest — in recessions and public health emergencies, precisely when enrollment rises.
30,000 people died waiting for SSDI decisions in FY2023. The program is not too generous — it is inaccessible. The 61–67% initial denial rate is not medical judgment; it is system design that assumes applicants will give up.
Ages 60–64 face the highest uninsured rates and the highest individual market premiums of any age group. They are too young for Medicare and often too expensive for affordable private coverage. This is an inflection point the original 1965 designers intended to revisit.
The IRA's initial negotiation on 15 drugs saved $12.5 billion. Medicare pays 2.8–3.9× peer-nation prices on the same molecules. Every other high-income country negotiates. The US uniquely prohibited Medicare from doing so for two decades. That prohibition ended. The scale must now expand.
The current system gives the same $24,500 annual limit to a worker earning $40,000 and a CEO earning $500,000. The top 10% of earners capture 60% of total retirement tax benefits. This inverts the purpose of a tax subsidy — the subsidy flows to people who would save anyway, and away from people who need it most.
| Household Income | Net Worth | Annual Limit | Multiple |
|---|---|---|---|
| Under $75,000 | Under $250K | $49,000 | 2× standard |
| $75,000–$125,000 | Under $500K | $36,750 | 1.5× standard |
| $125,000+ | Any | $24,500 | 1× (current cap) |
| Action | Detail |
|---|---|
| Solvency | Lift payroll cap entirely + investment income tax above $250K = 75+ years, no cuts |
| Benefits | $200/mo for bottom 2 quintiles; Special Minimum to 125% poverty; caregiver credits |
| COLA | Switch to CPI-E; minimum 3% annual adjustment guaranteed |
| Medicare Expansion | Dental, vision, hearing; $5K OOP cap; eligibility lowered to 60 |
| MA Reform | End $76–84B/yr overpayments; penalize prior auth abuse; Gold Card exemptions |
| Medicaid | Block all block grants and work requirements; close coverage gap; expand HCBS |
| Disability | 90-day decisions; eliminate benefit cliff; rehab-first model; 5-year extended Medicare |
| Drug Pricing | Negotiate all drugs; $35 insulin for all; $2K OOP cap; allow importation |
| 401(k) | 2× limit under $75K; 1.5× for $75–125K; refundable Saver's Credit; auto-enroll at 4% |
| Privatization | Blocked permanently — every experiment produced higher fees and worse outcomes |
This platform does not require new money from the general public. It requires ending subsidies to the wrong people — high earners who escape payroll taxes, insurance companies extracting MA overpayments, and pharmaceutical manufacturers pricing against a captive buyer. The funds exist. The question is where they flow.
| Revenue Source | Est. Annual Revenue | Notes |
|---|---|---|
| Lift payroll tax cap — all earned income | ~$200B | Closes the bulk of the 75-year Social Security shortfall in one step |
| Investment income tax above $250K | ~$80–120B | 12.4% on capital; closes remaining ~33% of SS shortfall |
| Medicare Advantage overpayment reform | $76–84B | Funds dental, vision, hearing expansion and OOP cap — redirects from insurers to care |
| Drug price negotiation (all Medicare drugs) | $100B+ at scale | IRA proved the model; scaling to all drugs over 10 years |
| Progressive revenue (Issue 2: Taxation) | Cross-reference | Wealth tax, corporate tax reform, and capital gains reform fund additional expansion |
Social Security solvency is achieved through payroll tax reform alone — no benefit cuts needed. Medicare expansion is funded by eliminating the $76–84 billion annual subsidy to private insurers through Medicare Advantage overpayments. The economics are not complicated: money currently flowing to insurance company profits is redirected to dental appointments, hearing aids, and eye exams.
Sources: MedPAC — medpac.gov · CBO — cbo.gov · CMS — cms.gov
Sources: National Academies (life expectancy) — nationalacademies.org · Urban Institute (Arkansas) — urban.org
The safety net does not operate in isolation. Each of these issues shapes who arrives at retirement, in what condition, with what resources — and what is waiting for them when they get there.
"Social Security is not a handout. It is a contract — wages withheld, contributions made, a promise exchanged across generations. Every worker who paid in is owed what was promised. We protect what works, fix what is broken, and strengthen what is inadequate. That is the contract."— The Common Good Party