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Opting out of medicare ?

The best option is probably to tie the size of Medicare benefits
to a person's lifetime income, which is relatively easily measured
and hard to game, rather than to one's income or assets in any
current year. In essence, higher earners would receive lower
benefits instead of facing the prospect of higher taxes, as current
trends predict.

-- Tyler Cowen

Economic View
Means Testing, for Medicare
By TYLER COWEN
Published: July 20, 2008
No matter who sits in the Oval Office next year, there won't be many degrees of freedom in the federal budget. The main problem: Medicare.

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