HONOLULU -
Fiscal Issues and the Federal Budget: "Social Security not a problem. The big problem is Medicare. It's a bear. The costs of medical care is rising much faster than inflation. Unless we get some control over medical costs we are going to find a larger and larger percentage of our personal and national budgets going to healthcare in a way that's also not particularly healthy."
The Health Care System: "You may say a rich, industrialized country should be spending more on health care because people want to live longer and longer. The problem, as many of you know, is that our health care system is one of the most inefficient in the world. We have health insurers that, because they are competing with one another, are trying to avoid sick people. What they want are people to insure who are relatively young and relatively healthy. What we ought to be doing is putting more and more money into preventive measures to avoid huge medical expenses later on. We are not investing in ways that help avoid a health care catastrophe. It's a crazy system and it needs to change."
The Tough Question: "Health care will be a larger and larger issue and technology, which is normally our friend. It has got to be somehow regulated because everyone wants to live forever, but we can't as a society spend a huge amount of our resources on the last week or month of a life."
The Likelihood of Change: "The AARP is a very powerful group. Can you imagine how much power they and the elderly will have when the baby boomers are in this group. This is at the same time when there are fewer younger people working and paying into the system."
Immigration: "Immigration is such a hot and important issue but it's rarely talked about in these terms. What's happening in the world is you have advanced countries, the U.S., Europe, Japan, that are graying very quickly, while you have other very poor, developing countries with many young people looking for work. They will find ways to get there whether the laws say they can get there or not. This is not a justification for illegal immigration; I'm just warning you that this issue of a huge migration is a huge one we will have to deal with inevitably."
