I don't think it's a ponzi scheme and I reject the notion it's unsustainable. Our social services are quite poor when compared to the rest of the developed world, and they seem to have figured it out.
I'm not saying we need to become Western Europe, but I am saying that it's certainly possible to have public services such as public healthcare support in the form of Medicaid sustainably.
Repeatedly, conservative fiscal voices proclaim we must cut social services in order to improve our quality of life and economic status. "Starve the Beast" has been the policy of choice for fiscal conservatives for many decades now. And, well, is it working? From where I'm standing, no. Nothing is getting cheaper. Everything is a little bit harder. And the private sector is decidedly not picking up the slack. And, I certainly do not have a lower tax burden. Why do we keep doing things when we appear to have decades worth of evidence that it does not work. I don't know, to me, it feels like insanity.
I think the most damning example is healthcare. We have private health insurance in this country and it's just bad. I don't even think we're at a point where we can humor people who say it's not that bad. No... it's bad, objectively, from every measure. We pay more per capita than any other country, including taxes, and our outcomes are consistently worse. It's losers across the board. But now we're going to be leaning into that even more with these Medicaid cuts. Which will, I'm convinced, greatly increase private insurance premiums. Sigh...