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Why I believe that vouchers for Medicare won't work

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independentusa

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I worked in the health care industry for forty years before I retired. I now hear that Paul Ryan and many other GOPers in Congress and elsewhere want to tur Medicare into a voucher system. This means that those who are eligible for Medicare will be given a voucher and will have to buy their own insurance. Now knowing that if this happens the vouchers will become less each year, let us say that the vouchers are given to you in your state by the average that Medicare has been paying for the average patient in your state over the past year. In each state the amount of the voucher would be different and based on costs in your sate. If this sounds familiar to anyone old enough, it has already been tried. They were called Medicare Advantage plans. Private insurance companies told the government that they could provide the same or better coverage than Medicare if they were given the same amount that on average Medicare was paying for patients in a given state. Medicare proceeded to set up such plans in many of the states and true to their words the plans offered plans that did far exceeded plain old Medicare. Some offered totally free care without deductibles or co-pays. Some offered even dental and vision coverage. Of course within a year or two these companies were back at the Medicare program begging for additional funds. Eventually they were given an amount that was 15% greater than Medicare average costs. Even that was not enough and most of the plans folded. I see the same thing happening with a voucher system. Even if the government ruled that the insurance companies would have to accept the voucher as total payment or the Medicare share with the patient paying for a supplement, which the GOP would never allow, within a short period of time the insurance companies would be back asking for more and ever more, just like they did with the advantage plans. SO I see such a plan, vouchers, as just a way to eventually do away with Medicare.
 
Independent, I wish I knew more about it to make a comment but I want to say they still have Medicare Advantage in my state because I've seen commercials for it.
 
independentusa said:
I worked in the health care industry for forty years before I retired. I now hear that Paul Ryan and many other GOPers in Congress and elsewhere want to tur Medicare into a voucher system. This means that those who are eligible for Medicare will be given a voucher and will have to buy their own insurance. Now knowing that if this happens the vouchers will become less each year, let us say that the vouchers are given to you in your state by the average that Medicare has been paying for the average patient in your state over the past year. In each state the amount of the voucher would be different and based on costs in your sate. If this sounds familiar to anyone old enough, it has already been tried. They were called Medicare Advantage plans. Private insurance companies told the government that they could provide the same or better coverage than Medicare if they were given the same amount that on average Medicare was paying for patients in a given state. Medicare proceeded to set up such plans in many of the states and true to their words the plans offered plans that did far exceeded plain old Medicare. Some offered totally free care without deductibles or co-pays. Some offered even dental and vision coverage. Of course within a year or two these companies were back at the Medicare program begging for additional funds. Eventually they were given an amount that was 15% greater than Medicare average costs. Even that was not enough and most of the plans folded. I see the same thing happening with a voucher system. Even if the government ruled that the insurance companies would have to accept the voucher as total payment or the Medicare share with the patient paying for a supplement, which the GOP would never allow, within a short period of time the insurance companies would be back asking for more and ever more, just like they did with the advantage plans. SO I see such a plan, vouchers, as just a way to eventually do away with Medicare.
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The problem with vouchers is the same as any problem involving the private insurance industry -- it's just too expensive.

You make some other good points, as well.

We simply have to remove national plans, such as Medicare, from the realm of private insurers. That means shifting over to a govt. managed program with federal employees as opposed to private insurance companies. It's the only way to keep taxpayer costs down.

The voucher system will be abused, and most likely wrought with fraud. I was registered GOP until last year when I changed to "unaffiliated," because GOP representatives are getting farther and farther away from true conservatism. This voucher program is little more than crony capitalism - but so is the PPACA. There's simply no reason for us to continue to pay healthcare AND line the pockets of the insurance industry. The two are separable, but until we separate them we're going to see high taxes and insurance abuse.
 
Jeez. Why try and make health care as complicated as possible? Just have a taxpayer funded system. No vouchers, no insurance, no deductables, no pre-existing illness issues, no forms.
 
independentusa said:
I worked in the health care industry for forty years before I retired. I now hear that Paul Ryan and many other GOPers in Congress and elsewhere want to tur Medicare into a voucher system. This means that those who are eligible for Medicare will be given a voucher and will have to buy their own insurance. Now knowing that if this happens the vouchers will become less each year, let us say that the vouchers are given to you in your state by the average that Medicare has been paying for the average patient in your state over the past year. In each state the amount of the voucher would be different and based on costs in your sate. If this sounds familiar to anyone old enough, it has already been tried. They were called Medicare Advantage plans. Private insurance companies told the government that they could provide the same or better coverage than Medicare if they were given the same amount that on average Medicare was paying for patients in a given state. Medicare proceeded to set up such plans in many of the states and true to their words the plans offered plans that did far exceeded plain old Medicare. Some offered totally free care without deductibles or co-pays. Some offered even dental and vision coverage. Of course within a year or two these companies were back at the Medicare program begging for additional funds. Eventually they were given an amount that was 15% greater than Medicare average costs. Even that was not enough and most of the plans folded. I see the same thing happening with a voucher system. Even if the government ruled that the insurance companies would have to accept the voucher as total payment or the Medicare share with the patient paying for a supplement, which the GOP would never allow, within a short period of time the insurance companies would be back asking for more and ever more, just like they did with the advantage plans. SO I see such a plan, vouchers, as just a way to eventually do away with Medicare.
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Yes, and even I belong to a plan called an advantage plan, but they no longer receive the extra 15% they used to. At one time in my state there were 8 advantage plans, now there are still two called advantage plans and they were both part of the original Medicare Advantage plans. Both though are non-profit and not for profit insurance companies. Both are expensive, more so than other Medicare supplements. They also cover more and have lower deductibles and co-pays, but you pay more up front. I think any Medicare supplement plan can call itself an advantage plan.
 
Simple way to fix all of this is a single payer plan run by a Federally funded outside agency with extreme limits on the cost of administration. Right now the administration costs of private for profit insurance companies runs around 25%. If a private charity ran administration such costs we would have the Congress looking into it or the media yelling its head off about it, yet you never hear a peep about it from either. That is because the insurance companies put a lot into campaign funds for our elected officials.
 
independentusa said:
Of course within a year or two these companies were back at the Medicare program begging for additional funds. Eventually they were given an amount that was 15% greater than Medicare average costs. Even that was not enough and most of the plans folded.
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That's been corrected under the ACA. On net (there's some county-level variation), Medicare Advantage don't get more federal funds than traditional Medicare anymore. And despite predictions from the anti-ACA crowd that this correction would kill the program, it's thriving.

HowardBThiname said:
The problem with vouchers is the same as any problem involving the private insurance industry -- it's just too expensive.
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One key difference between Medicare Advantage and just giving seniors a voucher to try and find private insurance is that the private insurers participating in Medicare Advantage piggyback off of Medicare price-setting. So it's a "private" market, but those private insurers are generally paying doctors and hospitals at or near prices that are set by the government. That tends to help make sure the federal contribution to the premium doesn't fall behind the plan's costs leaving seniors increasingly holding the bag.
 
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