Herewith some points to help understand House Speaker Paul Ryan’s proposal to overhaul Medicare:
His plan calls changing the program so that individuals eligible for Medicare would get a fixed contribution from the Feds to put toward buying private insurance.
The idea is to boost payer competition and encourage more cost- consciousness in beneficiaries as they select plans. The hope is that giving beneficiaries a choice of various health plans will lead payers to offer more competitive prices, leading to lower premiums.
Many Republican senators have said that they want to focus on “repealing” the Affordable Care Act and not touch Medicare for a year. But the tricky thing is that the ACA is interwoven with Medicare.
Meanwhile, Democrats senators strongly oppose privatizing Medicare.
And President-elect Trump himself may also present an obstacle for Medicare changes, which could be very, very unpopular with many voters. In the past, he has said that he would not cut Medicare, Social Security or Medicaid. Of course, he says wildly conflicting things all the time, so who knows?
His transition Web site includes a promise to “modernize Medicare, so that it will be ready for the challenges with the coming {it is actually already underway} retirement of the Baby Boom generation — and beyond.” His nomination of Tom Price, M.D., as secretary of health and human services, might signal Medicare reform; Dr. Price has said that Republicans could push Medicare reform through a “fast-track budget procedure” to would void a Democratic filibuster.
But are they willing to take the heat from millions of elderly people if they do?
