So there it is: the draft Republican platform says of Medicare and Medicaid,We are assured that any seniors who vote for Richie Rich/Ayn Rand this time won't lose his or her Medicare, just the rest of us. Of course some seniors have wives young enough to lose out on this deal, but they must be poor if they need Medicare so they don't count.
The first step is to move the two programs away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model.That means that instead of Medicare as we know it, which pays your medical bills, you’d get a lump sum which you can apply to private insurance — they’ll yell when we call it a voucher, but that’s what it is....
Bear in mind that health expenses will still have to be mainly paid for by some kind of insurance; that’s in the nature of medical care, with its high but unpredictable cost. So what we’re doing here is replacing government insurance with a program that gives people money to buy private insurance — that is, adding an extra layer of middlemen. Why would this save money? I guess the answer is supposed to be the magic of the marketplace — but we have the experience of Medicare Advantage, plus studies of Medicaid versus private insurance, plus the raw fact that America relies more on private insurance than any other nation and also has by far the highest costs. Nothing, absolutely nothing, in the record suggests that this will do anything other than make health care less efficient.