The Problem With Medicare Vouchers

The House GOP is getting ready to blast us with their best ideas to reform government programs in their vision.  Only the Senate (thank goodness) and of course, President Elect Trump, stand in their way.  Since I do not trust Trump, we can only hope the Senate has a sufficient number of rational people to stand the House of Representatives down.

I have seen in the wake of Trump, many consider Speaker Ryan to be a reasonable policy wonk.  He is a policy wonk but what he wants is the out and out dismantling of federal government support for the social safety net:  Social Security, Medicare, Medicaid, and Food Stamps.

So today we review his plan for Medicare, which would give all old people a voucher to buy health insurance in the market place.  Sounds a bit like ObamaCare but they want to dismantle that.  If ObamaCare is not good for people under 65, why is it good for people over 65?

That is rhetorical question of course.  If Ryan knew of a politically viable way to end Medicare, he would, but he knows he can't do that.  So what he wants to do is end traditional Medicare, which is a PPO system with the Federal government setting the price it pays for each service.  This is the so-called Plan A & B combination and most people with money buy a supplemental policy to cover the holes in Ab& B.  What Ryan wants to do is make everybody only able to use Plan C.  He would give people a voucher to pay for a Plan C.

Plan C's are a private sector health insurance plans for people over 65.  They are generally cheaper to the citizen than a Plan A& B with a supplemental plans, but in a Plan C you are actually in an HMO.  If the Dr's in the HMO were constant, this might be OK, but the HMO's and Dr's are constantly in a battle over pricing and which Dr's are in a specific Plan C is in flux from one year to the next.  So you have a condition, you like your Dr and he suddenly is gone from your Plan C and you have to get a new Dr.  This might be OK at 65, but how many 85 year olds can manage this well.

What is wrong with Plan A & B? Nothing, except it is a Federal Government Plan that controls costs and allows people to go to the Dr of their choice, who accepts the price that the government will pay. This all works very well for most older people who do not want it to change.  If they do want a Plan C and an HMO, they go into Plan C.  If they are like my wife who likes her specific Dr.'s very well, you go into Plan A & B with a supplemental.

And what happens in the future if the cost of Plan C's exceeds the value of the vouchers?  The elderly citizens of America will have to find the additional $ in their budget to pay for health insurance.  And guess who will have to approve paying for new treatments or end of life care, the private insurance companies who did such a good job of controlling health care expense before ObamaCare.  These private sector insurance companies are also perfectly comfortable performing the Death Panel Role that Governor Palin was so afraid of in ObamaCare.  All these companies say is, "The Procedure is not approved,  good luck."

What the House GOP wants to do here is bad policy for the citizens of the country.