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in 1964 with the Democratic Party’s landslide victory. When he signed the Medicare bill, Johnson said, “In 1935, when … Franklin Delano Roosevelt signed the Social Security Act, he said it was, and I quote him, ‘a cornerstone in a structure which is being built but it is by no means complete.’ … And those who share this day will also be remembered for making the most important addition to that structure.…”59 Johnson added, “Through this new law … every citizen will be able, in his productive years when he is earning, to insure himself against the ravages of illness in his old age.…”60 Like Roosevelt, Johnson understood the import of misleading the American people by packaging Medicare’s taxes and costs as insurance and dissembling about its economic viability. As Wilbur Mills, the chairman of the House Ways and Means Committee, told Johnson when informing him that his committee had passed the Medicare bill, “I think we’ve got you something that we won’t only run on in ’66 but we’ll run on from here after.”61 In 2010, Medicare covered 38.7 million people over age sixty-five and 7.6 million people with disabilities.62

Again, in 2010, the CBO estimated that unfunded obligations for Medicare and Social Security are $25 trillion and $21.4 trillion, respectively.63 Both programs are economically unviable.

An analysis by the Peter G. Peterson Foundation of the 2011 Social Security Trustees’ financial report found that Social Security is in a weakened financial position in the short run and in an unsustainable condition in the long run. “Social Security is now operating with a permanent, annual cash flow deficit. Within seven years, the Trustees estimate that Social Security will not be able to pay full disability benefits scheduled under current law. The Disability Insurance program will begin running permanent cash deficits. Its trust fund will be exhausted in 2018. Absent reform, Social Security will only be able to pay approximately 77 percent of scheduled benefits under current law after 2036. After this date, the program will only have the legal authority to pay benefits equal to the amount of revenue generated by the payroll tax and the taxation of some benefits.”64

The chief actuary for Medicare, Richard S. Foster, stated that the shortfalls facing Medicare are even worse than reported by the Medicare trustees. He wrote that “the financial projections shown in [the 2011 trustees’ report] do not represent a reasonable expectation for actual program operations.”65 The trustees had reported that Medicare will be unable to meet its obligations starting in 2024.66

The economic impossibility of these programs was never a utopian concern. Although cost-cutting, price controls, and benefit denials are instituted haphazardly, there can be no retreat from the overall mission and the centralized control and planning of the masterminds. Instead, further consolidation is nearly always the answer. Centralized control over health-care decisions in particular has been a utopian priority from the earliest for it maximizes government authority over the individual. In the Republic, only those who were otherwise healthy, but suffered either an injury or seasonal malady, were entitled to medical care. Those who were chronically ill, old, or infirm were of no benefit to the Ideal City and denied treatment (407d, 406b–c). In Utopia, magnificent hospitals were located near each city. “These hospitals be so well appointed, and with all things necessary to health so furnished … there is no sick person in all the city that had not rather lie there than at home in his house” (79). However, those who suffered from incurable diseases or fatal conditions were urged to kill themselves to alleviate their pain and their burden on society (107).

In America, for more than one hundred years, the utopians have insisted on the institution of government-run universal health care, promoting it in egalitarian terms. It was among the “rights” listed in Roosevelt’s Second Bill of Rights. Every person, he argued, has “the right to adequate medical care and the