So I was talking with a friend of mine earlier today about health care, Medicare, and the Paul Ryan plan to privatize Medicare. One important point came up that I think should be discussed more because (i) it points out how dangerous the Ryan plan is to everybody, including those already 55 or older, and (ii) it provides a simple illustration why a single-payer system (
i.e., "Medicare for All") would actually do more to curb rising health care costs in this country than any other proposed health care reform. And that point is this: Medicare is entirely voluntary, not only for the patients being treated under the program
but also for those physicians who provide the treatment.
The way things stand, a lot of health care providers (physicians, private hospitals, HMO's, etc.) don't really look forward to treating patients covered under Medicare. This is because the government has limits on what it is willing to pay for any particular procedure, and these payment limits make treating patients covered by Medicare less lucrative than treating patients who have a private insurance plan. However, many - if not most - of the country's health care providers cover Medicare patients
anyway, simply because there are so many people in the country reliant upon Medicare. In other words, the health care providers make less per Medicare patient than they would treating patients covered by private health insurance, but there are so many Medicare patients out there who need treatment that it doesn't make financial sense to turn them away: "How can I sell these [health care services] so cheap? Volume!"
Now as to one reason the Ryan Plan is so bad . . . consider what happens to those currently 55 or older who would still remain eligible to participate in Medicare as it exists today. Everybody else would be forced to purchase private insurance in the market when they turned 65; Ryan's Plan would have the government give you a voucher to help defray the costs of that private insurance, but the voucher would be capped and -- even assuming you could find an insurance company willing to insure you at a rate you could afford after you turned 65 -- the voucher would be worth less and less each year as health care costs went up. Which means that, year after year, seniors would be forced to pay more and more just to have insurance coverage (which would not include co-pays or deductibles, which means the cost of actual health care would increase even more).
But for those 55 and over today . . . eventually, their even older cohort (say, those who are 70 and older right now) would die off. Which means that, with no additional people joining the Medicare ranks, the pool of Medicare patients needing treatment would inevitably shrink. At some point it would not be unreasonable to expect health care providers to refuse Medicare patients outright; they would be too small a pool of patients to justify the lesser charges the health care provider could expect. Which means, of course, that a significant portion of even those the Ryan Plan says could remain with Medicare as it is now can
still expect, before they die, not to have access to any entity willing to treat them under that plan.
