Medicare, medicaid, social security and other Government social programs should be opt-ins

Govt should have a seperate body where people can buy these services from. Only people who buy into those services should be taxed. If Govt wants to tax people on a sliding scale for those services, it can.

The fact is many people are going to object.. Why not all government services, including defense, military spending. Defense and military are absolutely essential for everyone. People don't have a consensus on if they want medical care from Government. A Govt hospital is going to be managed no differently than DMV. I , for sure, don't want to go to such a hospital.

Make all these social programs opt-in. If you opt-out even once in your life, you don't get the benefits. I think that's a fair model.