SS is fairly easy to reform. We can make some slight changes to the computation and COLA formulae to make it sustainable. I favor personal accounts that will allow personal wealth accummulation and be less subject to government whim and blackmail. It would be supplemented by a small defined benefit program for survivors and the disabled. We should avoid the Faustian bargain, kick the can down the road solution that Reagan and Tip O'Neill reached in 1983 when SS went into the red.
Medicare is far more difficult to solve and will be more painful. It is also more lethal to the fiscal survival of this nation. There are a number of proposals to turn the cost arc downward. Without getting into the weeds, there is no doubt that medical care will have to be rationed in some way in the future. We have three entities that could act as the main instrument for rationing, i.e., the government, the insurance companies, or the individual. I favor the individual. Only when the customer is given the control over the resources and can link costs to the quality and need for services will the marketplace be allowed to work like it should. Right now, under Medicare, there is no incentive for someone to worry about costs. Someone else pays for most of the costs whether it is the USG or the insurance companies. 9 out of 10 people on Medicare have supplementary insurance.
The longer we wait to resolve these problems, the greater the likelihood that we will "yank" them away.