Social Security/Medicare are at the center of our welfare state. With the huge number of senior recipients that we are going to have soon (relative to the number of workers), we will have to either base the benefits on the real need of each recipient or the programs are going to collapse. Obviously, it's soon going to be impossible to provide handouts to recipients not needing them. Seniors who can take care of themselves are just going to have to do so. Then, when this growing glut of seniors dies off, the country will have the opportunity to completely eliminate all of these welfare programs.
That's why I am optimistic about this country. When this huge generation of seniors evaporates, the wagon will become lighter for the workers who are pulling it.