One weakness of democracy is that you can't get elected telling people what they don't want to hear, even if — or especially if — it's the truth. In the 2012 Obama campaign, on no point is there more dodging of reality than the future of American "entitlements", Medicare and Social Security.
A demographic I join in a decade, Americans over 65 will swell from under 50 million today to 80 million by 2030. Medicare (health insurance for the elderly) and Social Security (the state pension system), consuming 33.5 per cent in 2010, will eat half the federal budget by 2030 — more than double the cost of defence. Medicare will require Congressional refunding by 2024. In 2037, Social Security will run at a steady 25 per cent deficit a year. Meanwhile, 4.5 working-age Americans — that doesn't mean actually working — currently support one senior, but by 2030 the ratio will be 3:1. (FYI UK, your figures don't look any better.) When I consider the scale of rational resentment my boomer friends and I will draw from overtaxed younger people in the years ahead, I envision euthanasia booths every few blocks where there used to be postboxes.
Particularly if Medicare is still forbidden to consider cost in its coverage, the US government will never be able to finance the healthcare for 80 million seniors. This same enormous cohort cannot draw full Social Security — free ride for 35 years. Something's got to give. The retirement age will have to rise, and anyone who's earned anything is not going to get much back. In the decades to come, American entitlements are sure to be means-tested-i.e., no longer be "entitlements".
Look, I'm an Obama supporter, but do the Democrats ever say this? No. In his convention speech, Obama vowed to protect Medicare purely by reducing the cost of healthcare (how?), and to "strengthen" Social Security, whatever that means. Last summer, Obama admitted in an interview to being "open" to means-testing Medicare (it already is means-tested, a little — the thin end of the wedge), but you won't hear him repeating that slip on the stump. The Democratic platform addresses the sucking black hole of Medicare merely by promising to crack down on fraud. It claims, "We will find a solution to protect Social Security for future generations," without making the barest indication how.
So Republican VP candidate Paul Ryan's "vouchercare" solution to Medicare may not be the answer, but at least it's brave-brave enough to potentially lose electorally crucial, retiree-heavy Florida in November. Given the recent history of the stock market, Republicans' plan to privatise Social Security also seems dubious, but at least they have a plan, and thereby concede the problem.