Samuelson’s odd defense of ending Medicare

Washington Post columnist Robert Samuelson had a curious piece in today’s paper. It appeared to be a defense of Rep. Paul Ryan’s radical plan to end Medicare’s current single-payer system and replace it with a voucher program for private insurance. But in defending Ryan’s plan, Samuelson admits that no one knows if it would work, and that if it doesn’t, health care costs would not only not be lowered, they’d go up a third more than under the current system and out-of-pocket expenses for seniors would more than double.

In other words, Ryan’s plan could well lead to a million personal catastrophes. Or maybe not. Though Samuelson’s description of how the plan might possibly lower costs seems pretty far-fetched to me:

Beginning in 2022, new (not existing) Medicare beneficiaries would receive a voucher, valued initially at about $8,000. The theory is simple. Suddenly empowered, Medicare beneficiaries would shop for lowest-cost, highest-quality insurance plans providing a required package of benefits. The health-care delivery system would be forced to restructure by reducing costs and improving quality. Doctors, hospitals and clinics would form networks; there would be more “coordination” of care, helped by more investment in information technology; better use of deductibles and co-payments would reduce unnecessary trips to doctors’ offices or clinics.

Suddenly “empowered”? That’s what Samuelson calls being given a voucher that will be nothing close to sufficient to buy private coverage? How many consumers can cut through the complexity of insurance offerings to figure out which is actually the lowest cost and highest quality? Even with the limited options offered to most people through their employers, it can be difficult to select the right plan. And, of course, Samuelson assumes, as Ryan does, that there will be lots of insurance companies eager to serve the oldest, sickliest segment of the American population – especially when they supposedly won’t be permitted to reject those with pre-existing conditions or try to cherry pick only the healthiest.

Samuelson fails to mention that, while no one has a clue if Ryan’s plan would work as advertised, more than 100 health care experts and economists believe President Obama’s approach – which Samuelson writes off as “tinkering” – would “slow the rapid projected increases in health care costs in the federal budget and to improve the delivery of health care. Increases in Medicare, Medicaid and the private sector could be slowed by giving providers greater incentives to adopt more cost-effective treatments and prevention interventions.”

Samuelson is right that uncontrolled increases in health spending represent an enormous threat to the United States, both the government and its citizens. But his confidence in Ryan’s “empowerment” methods seems grossly misplaced.

9 Responses to Samuelson’s odd defense of ending Medicare

  1. captain obvious says:

    It’s the ‘free-market’ piggy, All the way home.

  2. Burr Deming says:

    Actually, Mr. Samuelson offers the best defense of the Ryan plan that I have seen so far. Honest, consistent with the facts, with no shifty definitions. And it is devastating to any Republicans who support the end of Medicare.

    • Texas Aggie says:

      Actually it isn’t consistent with the facts. There are no facts that would indicate that either the insurance companies or the medical care delivery entities would in any way be pressured, forced, induced, rewarded, or anything else to reduce costs.

  3. Lucy The Wonder Dog says:

    I guess Samuelson and his defenders don’t remember the enormous problems seniors went through trying to navigate selection of a provider during the first year of Medicare Part D. Turning the entirety of Medicare into a voucher program would make that look like a cakewalk.

    On what planet do Samuelson and Ryan and supporters of vouchercare live that they think average Americans are in any position to “shop for lowest-cost, highest-quality insurance plans providing a required package of benefits”?

    Seriously? Are they kidding?

  4. ShadeTail says:

    Lucy: Some republicans are actually deluded enough to believe that free-market magic really works. More to the point, they are deluded enough to believe that consumers have equal bargaining power with businesses and can simply take their money elsewhere if they aren’t satisfied.

    Meanwhile, other republicans are not the least bit deluded. They know that this is a disaster waiting to happen and simply do not care, because their priority is showering more money on the ultra-wealthy (a class to which most of them belong, not coincidentally).

  5. rbe1 says:

    Samuelson is an unapologetic apologist for every Ayn Rand delusion that rolls by him.

  6. Bartender says:

    Vouchercare supporters are so blinded by the fact that the healthcare insurance system is the mother-of-all conflicts of interest regarding consumers. Unlike the single-payer government run healthcare system that most senior folks favor – Medicare – the insurance company will fight tooth-and-nail not to payout claims to the detriment of our seniors and THIS is the answer the right is promoting for our future medical needs? Does Medicare need updating? Absolutely, but let’s not throw grandpa out with the bath water just yet.

  7. Dan Casey says:

    Ryan’s plan is an asinine proposal. It ignores the fact that the goal of a health insurer is to find loopholes to deny or delay paying benefits for purpose of its own bottom line. It will lead to less care and more confusion for seniors.

    Let’s face it, insurers are bookies — middlemen who’s goal is to rake off a portion of the pot. There is little they can do to put downward pressure on healthcare costs that Medicare hasn’t already done — except to cut themselves in for a larger slice of the pie in the form of overhead and profit.

    Read the inside story of these outfits here: http://wwwjawbonecom.blogspot.com/2011/02/how-united-health-group-is-screwing.html

  8. james gilligan says:

    “…the goal of a health insurer is to find loopholes to deny or delay paying benefits for purpose of its own bottom line…”

    Really? May I suggest then that you suspend your auto insurance and drive often? The health insurer hedges his bet that you will not suffer a catastrophic illness. No more. No less.

    And a blogger with a full six followers has the inside story? No wonder you people are so bitter! You should listen to Ed Schultz more often.

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