With the nomination of Paul Ryan, Mitt Romney has guaranteed that the much needed debate about the future of Medicare will take place in the upcoming campaign. Leftists argue that Paul Ryan's voucher plan "guts" Medicare. Ryan argues that he plans to save Medicare.
Let's start with the fact that the Affordable Care Act (aka Obamacare) projects that the changes in the Act will "cut" (i. e. reduce the otherwise expected increase in Medicare costs) 500 Billion from Medicare. There is no real debate that the planned changes to Medicare are supposed to save money and supposedly will be used to fund the expansion of care to younger persons. Both the left and the right agree on that. What they disagree about is how that will happen. Supporters of the Affordable Care Act contend that they will achieve these savings through innovative payment plans, increased efficiency and elimination of fraud, waste and abuse of Medicare. One of the benefits, costs of being a senior citizen is that when someone tells a lie, you may have heard it before. Maybe they even believe it. What they have done in the Affordable Care Act is to create a bunch of panels, and particularly one which will have the job of deciding what medical care Medicare will pay for. We got a preview of the approach these panels will take when Obama talked about his grandmother's hip surgery. I have no opinion about that hip replacement surgery either way because I don't know all the facts. What I suspect is that such surgery will not be paid for under the Affordable Care Act. When they say eliminate "waste, fraud and abuse" they mean eliminate the provision of that medical care that their panel deems unnecessary.
Paul Ryan's plan takes a different approach. It is derided as a "voucher" plan. And it is. What they means to those of us covered by Medicare is that, rather than a panel of faceless bureaucrats making the decision as to what medical care our share of the government Medicare dollars will pay for, we will decide. The limit on our discretion is that we get the same amount of money to pay for our medical care as is spent now. We decide how that is spent.
Much of the hysteria you hear coming from what seems like the left in support of the current system is really coming from a bunch of government subsidized fat cats. Big insurance companies make money off of Medicare by being the processor of Medicare claims. And it is a big business. They don't want to see anything change it. Medical equipment manufacturers and people employed in providing services that you and I might not choose to pay for if we had to make a choice are not happy about the institution of a system in which patients start asking how much something costs and whether it is really necessary to their health. Just as an example: yearly mammograms for women over 40/ Huge cost associated with that, but when you start looking at the numbers and the science it is not at all clear that any lives are saved by doing it every year and no accounting is made of potential damage by the extra exposure to x-rays.
Ryan's plan will allow the individual Medicare participant to decide between plans that offer that benefit versus other benefits.
People being guided by their human nature will approach a free buffet (Medicare) and eat all they can. When you charge by the piece, they will scale back and eat only what they like or want or need. It's that simple. The question is, as Ryan asks in the linked video,