voted to abolish Medicare as we know it, over the next ten years. Wow. The audacity of that move is breathtaking, though perhaps understandable as a symbolic gesture, since the House Republicans know that their plan to scrap the current system has no chance of being enacted any time soon. If the House Republicans thought they were proposing something that might become law, it would be hard to put together a coherent picture of where they think they are heading with this idea. It's not about the deficit, because if they were serious about the deficit, they wouldn't be proposing huge tax cuts at the same time. It might not even be about spending per se either, for these same Republicans voted only a few years ago to dramatically expand Medicare coverage for prescription drugs. Republicans say it's not even about hostility toward Medicare or seniors either, since these same Republicans were screaming loudly about death panels and Medicare cuts when the Democrats passed comprehensive health care reform last year. So how did we get from hearing the Republicans try to scare people into thinking that Obama wanted to cut people's Medicare benefits, to Republicans passing a bill in the House sharply curtailing Medicare benefits over a number of years to the point where there would be no guarantee that the vouchers they propose handing out to seniors would be sufficient to cover their needs?
I have to assume the House Republicans do not have a death wish. Therefore, the only way I can tie all these actions together is by noting that they all favor private insurance companies and health care providers. The Medicare Part D prescription drug benefit turned out to be a boondoggle for pharmaceutical companies (and it hugely impacted the deficit), since Medicare is not allowed to use its tremendous purchasing power to obtain better prices for drugs. Opposition to the Affordable Care Act seemed prompted to a large extent by concern that private insurance companies would find themselves unable to compete with a proposed or potential public plan. And now the House bill to replace traditional Medicare with a voucher program opens up the possibility of greatly expanding the market for private health insurance companies. Under the Republican plan, this market would open up to them whether or not they are able to deliver better services for a cheaper price, because spending on Medicare would be held constant or decrease regardless of whether insurance was available for the voucher price. Those who can afford it will pay more out of pocket, and those who cannot will do without. Those who advocate market-based solutions should be upfront about the fact that that is how markets regulate supply and demand.