The House Republicans are putting forward a plan, drafted by Representative Paul Ryan, chairman of the House Budget Committee, to cut federal spending by $4 trillion over the next decade.
Central to that plan is a proposal to end traditional Medicare. It would turn Medicare for those currently under 55 into a “premium support” plan where beneficiaries would choose a private insurer and the government would provide vouchers to pay the premiums, about $15,000 a year, with bigger higher support for those who are poorer or sicker.
Writing on the New York Times “Room for Debate” blog, Princeton professor Paul Starr says: “Privatizing Medicare would enable the federal government to wash its hands of all the vexations of health-care cost containment and leave the elderly to deal with those vexations on their own.”
The competing opinion is offered by James Capretta, a former associate director of the US Office of Management and Budget who sees vouchers as a positive step toward giving beneficiaries “more control” over what they get: “The key is that the government’s contribution is set independently of the choice made by any one beneficiary. If Medicare participants choose a somewhat more expensive option, they will pay higher premiums. If they choose less expensive options, perhaps through a more efficient delivery system, they will pay less.”
Is the public or the Congress ready for such a radical step? Would it hold down costs? Or move Medicare from ” one size fits all” to a system of “haves” and “have nots,” in which some can only afford a less generous plan?
This is a discussion we all – as providers and citizens – have a stake in.