Moving Costs down the Income Ladder

I've been hearing about Rep Ryan's budget proposal that would, among other things, eliminate Medicare.

I guess it's pretty typical for a Republican proposal: push as many costs as possible off of the government and onto the poor and working class.

In this case, it's ending Medicare and replacing it with a voucher plan. This is projected to save $5.8T over the next ten years, because the vouchers allowed can be set at a constant value over those ten years. Of course, that $5.8T will still need to be paid (and since Medicare's rates are lower than the rates for private insurance, the true amount will go up), and who will pay it. It will be everyone on Medicare. And of course every one of those people will have their share of the $6T or so to pay. Of course.

So this attempts to push the cost off onto the patients.

Who, mostly, will not be able to pay it. So the costs will be pushed back onto government when these people are coming into the emergency rooms for life-extending measures when they can't afford them. Or onto their kids. Yeah, that's an improvement.

And that's ignoring the GOP attempts to repeal the recent healthcare bill, which outlaws denials of insurance based on pre-existing conditions. If the repeal effort succeeded (it can't, for the foreseeable future, but stay with me for a minute, now), what happens to all those currently on Medicare who have pre-existing conditions? How many people on Medicare don't have something that can't be considered a pre-existing condition? I'm going to go out on a limb, here, and guess that it's significantly less than 10% of them.

So what good are the vouchers if you can't get insurance to begin with?

Granted, that lowers the government's initial obligation catastrophically, but it also results in a lot of dead people.

Having a heart, here, is actually good for the country. Keeping people alive, even if they're past working age, is still good for the nation.

And I've ignored another issue: jobs.

And I wrote the rest of this before seeing Krugman's take, but that backs up some of what I posited.