August 16, 2012


Medicare Myths, Debunked (PAUL WALDMAN AUGUST 16, 2012, The American Prospect)

You could easily just spend less on Medicare-give every senior a voucher for a couple of thousand dollars and be done with it. But that would do nothing to solve the larger health care problem, and would entail a spectacular cost in human suffering as millions of seniors go without health care in the way they did before 1965. That's why liberals want to use Medicare, the biggest player (and payer) within the health care system, to bring about system-wide changes that will bring down costs for everyone.

That then leads to the most significant practical difference in the approaches taken by Obama and Romney. Through the Affordable Care Act, Obama uses a variety of means-dozens of them, actually-to attempt to bring down costs within the existing program. But he does it while retaining Medicare's guarantee of coverage. Romney, on the other hand, explicitly refuses to entertain changes within Medicare itself. He doesn't propose changing the way Medicare pays for care, or suggest any pilot programs or any incentives to lower costs. Instead, he hopes that that competition with private insurers is all that's necessary to bring those costs down. If that doesn't work, his plan will shift more and more of the expense onto the seniors themselves. One approach says we can shape this program to make it work as well as possible and use it to leverage the kind of changes we'd all like to see in the broader health care market. The other says if we just get government out of the way, the market will produce optimal results on its own. can get as much soda as he wants and his mommy will pay for it; the other has to pay for his own soda.  In which system do we suppose the soda costs are higher?

Posted by at August 16, 2012 3:44 PM

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