They are not all in the same category. Medicaid as currently structured is an important automatic stabilizer, like unemployment insurance. Medicare and SS are sensitive less to cyclical factors than to changes in demography. One logical response would be to adjust taxes as the population ages to keep the deficit (on average over the business cycle) at the desired level. Alternatively, if you think the current system is too generous to retirees, you could make some changes in outlays, such as across the board cuts to these programs (if you would not be bothered by an increase in poverty among seniors) or greater means-testing of benefits to reduce outlays for people who have ample private retirement benefits.