unless we're going to fund Social Security and Medicaid from general tax revenues,
Which we should.
Only if you want to kill or severely cut back the programs. Politically, they only survive long-term because they have the appearance of being pension programs instead of welfare programs. However, I think we'll eventually need to have a gradual increase in the full retirement age to 70. (The primary saving from that change would be to raise the age at which one can double dip, i.e., continue working full time and collect social security without penalty.)