Privatize Medicare – On the Agenda in Congress

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.

Author: Pat Kelleher

Pat Kelleher is Executive Director of the Home Care Alliance of Massachusetts.

2 thoughts on “Privatize Medicare – On the Agenda in Congress”

  1. If we end Medicare as it is currently constituted, we should do so for people born this year and beyond. That way, they have their whole lives to plan to become educated, get good jobs, and sock away the thousands and thousands of dollars it will take to satisfy the greed of private insurers. To tell people, at age 55, to just suck it up and pay, is not realistic given their expectations that this program would be part of their planning for health care in their old age. For someone that age, if they only work a modest job, you are asking too much.

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