Rep. Paul Ryan’s proposal represents a different way out of the crisis. He would not touch Medicare for anyone on the program today or anyone getting close to retirement. No one would be thrown off of the program.
But younger workers would transition to a new system, one in which they have more control over the money that Medicare pays and therefore the decisions about what benefits they would receive. They would receive a subsidy from the government to help them purchase private health insurance. Lower income seniors and those with higher health care costs would receive a bigger subsidy. Seniors could combine the government subsidy with whatever they wish to spend of their own money to buy an insurance plan that has a cost and benefits that best meets their needs. Instead of a one‐size‐fits‐all system, seniors would have many more choices than they have today.
Will it mean that in the future seniors will have to pay more of their own money or settle for a plan with fewer benefits, as Democrats have charged? Yes. But that is going to happen with or without Ryan’s plan.
Medicare cannot simply continue to promise paying for everything for everyone when it doesn’t have the money to do so. The question isn’t whether future seniors will have to pay more or get less. It is whether those choices will be imposed on them from above or whether they will be empowered to make those decisions for themselves.
What we have been doing hasn’t worked. Medicare is broke. Rep. Ryan offers a better way.