An annual report issued last week by the trustees of Medicare said the program won't have enough funds to pay full benefits by 2024, a full five years sooner than last year's estimate and one that may yet be even rosier than reality.

"Projected long-run program costs for both Medicare and Social Security are not sustainable under currently scheduled financing, and will require legislative corrections if disruptive consequences for beneficiaries and taxpayers are to be avoided," a summary of the report said.

Moreover, a statement issued with the annual report by Treasury Secretary Timothy Geithner said more must be done to boost financing for the program, such as "contain health-care costs," lest Medicare - and the government's other healthcare entitlement programs - become "unsustainable."

The truth is, the program has long since been "unsustainable," because for years it's been little more than a Ponzi scheme, as tax dollars from one generation are used to finance previous - and future - generations.

Investigative journalist John Stossel says what's really going on with Medicare is that the young are picking up the healthcare tab for senior citizens, even those who are financially well-off. And while today's Medicare recipients did, in fact, contribute to the program from their own paychecks when they were still working, experts Stossel says "the average Medicare beneficiary today collects two to three times more money than he paid in."

"We locked up Bernie Madoff for running a Ponzi scheme. Medicare is a bigger one," says Stossel.

Worse, the unfunded portion of Medicare is bad and getting worse. A 2008 assessment by the program's trustees found that Medicare's unfunded liability portion is $74 trillion, five times more than Social Security's unfunded liability. And the government only expects its healthcare outlays to grow.

One of the reasons why Medicare - and any government-run healthcare system, for that matter - is so expensive and an impediment to better healthcare in the first place is because it is a system that is inherently inefficient. And that built-in inefficiency is why so much Medicare money is wasted on entire industries like Big Pharma.

"While our health-care system has some of the most innovative treatments in the world, Medicare's payment system imposes many barriers to innovations in using those treatments efficiently and effectively," says John C. Goodman, president of the National Center for Policy Analysis. "In normal markets, cost efficiencies and quality improvements mean larger net revenues when an entrepreneur finds a better way to provide products or services. By contrast, entrepreneurial efforts under Medicare all too often find their greatest reward when they exploit the system by finding ways to bill more for more services, rather than improve it."

Goodman says studies show that patients - especially those who are chronically ill - "can often manage their own care as well as, or better than, conventional physician care, and at lower costs, when given the support they need."