The only reasonable policy is to look at both side of the economic equation, revenue and spending.
The bottom line is what services do we as a society want from our government and at what cost? We need to index the taxes paid by the upper income to help reduce the debt. Without do so, you can eliminate every government service and still not cover the interest payments on treasury bonds held by investors and social security trust fund.
What service now provided by government that can be provided by private enterprise at a lower cost, but at an equal access and equal to or better in quality than the government service, as well as at what cost.
What we have our government do is in response to what we to people have asked it to do have asked it to do.
Most of these services were created in the beginning of the 20th Century because of the problems with food that would kill people, water that was not drinkable unless boiled, lack of sewer, thus the spread of disease, the need for standardized roads and highways as automobiles filled the dirt roads, the need to control airplanes filling the sky, so on, and so on.
Social Security is in response the the high number of seniors who by a variety of circumstances did not have enough to live on and were dieing when they didn't need to if they had a minimal amount to survive.
The same for Medicare. Insurance companies would not insure seniors because the consume more resources than they can charge in premium dollars. What insurance was issued ended at age 60, regardless of health condition. Pres. Kennedy saw this need and started to process, Pres. Johnson carried the ball and got it passed.
Most people do not realize that Soc. Sec. is self funded. There is no budget item for it. However, the money paid into it by you and your employer is used to buy US treasury bonds, like any investor. So when it is paid the interest paid on the bonds, that money does come from the general budget, together with all the other bond holders, like 401(k) funds, mutual funds, etc. If they increased by one percentage point the amount that you and your employer pays in as well as rising the cap limit of income you by it, then it would be sound and would not have future funding issues for another century.
The same for Medicare. Increase the percentage by one point would increase the revenue. But they have to get spending for it under control. It is estimated that we are spending $700 billion in waste due to the impact of private insurance has on cost increases. Medicare only costs 5% of to spending for it. But healthcare providers have to have extra staff to deal with private insurance that increases their operating overhead, which is factored into what they get paid by Medicare and Medicaid. So it impact the increase costs.
If the profit taken by private insurance, the 15% to 20% taken off the top of the premium dollars for admin and marketing of pvt insurance, was removed. The total cost to the public for healthcare could be reduce by 40% with a single payer model. That would make it affordable for everyone. Since everyone pays in, everyone takes responsibility and no one gets it for free, unless you are disabled or certified poor.
Healthcare does not respond to typical market pressures as you do with any commodity, because you are not buying a single object. With healthcare you are buying a complex broad spectrum of services and protection for a potential major illness. Thus you as a consumer can not evaluate the value to make a choice that meets your current and future needs, since we all want everything available or maybe available in the future.