I’ve frequently seen mention of the Republican plan to end Medicare in various medical newsletters but have been surprised that it has not received much attention in the mainstream media. After all, this is an idea which the Democrats should be able to receive support by attacking. The idea is basically to give people vouchers to purchase insurance instead of going on Medicare in ten years. Presumably the Republicans believe that people more than ten years away from Medicare do not think enough about their personal future to pay attention. There is an outside chance they might be right on this. Republicans are also hoping that seniors will not care if it doesn’t affect them, but seniors would be wise to see this as a threat. If young people are not going to wind up on Medicare, they’d have less incentive to see it protected today. Having a steady stream of new people on Medicare will help ensure that there is political support for maintaining this important and highly successful program.
The idea finally started attracting attention today with Paul Ryan writing about his plan in The Wall Street Journal. Apparently one Democrat did a poor job of criticizing the plan on Hardball but there will be many more opportunities. While the Democrats are frequently beaten by Republicans on the spin war, primarily because not being bound by the facts makes it easier to argue, this is one GOP idea which is so bad that even the Democrats should be able to successfully attack it.
The primary problem is that health care costs will continue to go up and vouchers are unlikely to allow seniors and the disabled to buy health care insurance which adequately covers their needs. Health insurance companies already do a terrible job of covering those over forty on the individual market in their efforts to avoid covering people who actually need health care coverage. The insurance companies do not want to cover people with pre-existing conditions, and this applies to a very high percentage of those on Medicare. The one exception where private insurance companies have insured the Medicare population has been Medicare Advantage plans, but many companies have already left this market after the subsidies to care for these patients were reduced. It costs about twelve percent more to cover people under private Medicare Advantage plans than in the government plan, showing how the private insurance industry is a poor alternative to the Medicare program.
