Seniors would enter the health care world the rest of us live in, with co-payments, deductibles and managed care. Eventually, cost control would require some tough decisions about end-of-life care and the rationing of high-tech treatments that have limited efficacy. But starting with a value of $15,000 per year, per senior—the amount government now spends on Medicare—Ryan's vouchers should provide excellent coverage. His change would amount to a minor amendment to the social contract, not a fundamental revision of it.
That's written by an alleged liberal, by the way, not some tea partying moron.
Most old people would be lost in "the health care world the rest of us live in" because if you are self-employed or unemployed, as retirees are, you'd have to "shop" for insurance, go through huge hoops to get insured, manage a complicated health care bureaucracy that you don't understand, even when you are sick.(Anyone heard of elder scams? Yeah, I though so. And just because they are illegal doesn't mean they don't exist.) Doing all that is difficult even for people who aren't aged, infirm and often very ill with debilitating diseases. Acting as though throwing those people into the pool is going to somehow be beneficial to the individual, much less the system as a whole, is nonsensical in the extreme.
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This is why all those average Americans are terrified of losing their jobs, millions of whom have recently done so, have been exposed to the vagaries of this individual market and will endure the tortures of the damned to avoid doing again. (Good news for employers, though ...)
For those of us who live the the world outside that employer covered system as this person suggests seniors should do, the idea that a sick old person of 70 could be covered for 15k a year is laughable. A good policy for a 50 year old with a health problem can cost that right now (and the health care reform isn't going to change it.) It's absurd on its face that sick senior citizens are going to be able to be "cost conscious." The assumption is that they are overusing the system, when the truth is thatthey are all in the rather immediate process of dying. So let's not kid ourselves that they are living in the same world we are as healthy adults. They aren't. And even those with good pensions won't be able to shoulder the high cost of senior medical care on their own. The only people who will have no worries at all under this are the upper 5%.
http://digbysblog.blogspot.com/2011/04/making-tough-decisions.html