Kaiser Health News tries hard to understand Mitt Romney’s Medicare plans and ultimately concludes it’s difficult to figure out what it all means. Not surprisingly, Romney is none too quick to get into specifics. And from his standpoint why should he? With a collection of extremists and perverts running against him, it doesn’t make sense to be too specific on an issue that’s likely to lose him backers. Still, it’s clear that Romney is proposing a version of the Paul Ryan plan that would turn Medicare from a defined benefit plan to defined contribution. He’d offer more “premium support” to those who are older and sicker and would probably push back the eligibility age a bit. He’d hope for competition among health plans to control prices. And –following the wishful thinking/let’s please everyone template of Rick Perry’s flat tax– he’d let those who like the current fee for service system to stick with it.
Romney’s plan won’t save much if any money, and he must realize it. To do that would require changes to the payment and delivery system that I’m sure Romney doesn’t have any appetite for.
I think Romney, Huntsman and Gingrich could have a serious and informative debate about Medicare policy if they wanted to. The optimist in me thinks maybe Cain, Perry, Bachmann and Paul will get out of the way to allow that to happen. Stay tuned.
November 8, 2011