We need to get away from the third-party-payer system; I think all of us are in agreement on that. And we need to get away from the bureaucracy and towards competition; I think we all agree on that.
The question is how to get there.
One way would be to just end Medicare. The problem with this is we simply don't have the votes, and most conservatives understand that shocks to a system rarely are constructive. You move carefully.
Another way is what this bill provides, namely short term costs for long term gains. Introducing competition. Cracking the third-party-payer vice-grip. And as a bonus, helping to bring seniors over to our side, so maybe we will have the votes in the future for more serious reform, especially after our trial ideas in this bill have proven to be successes.
Gingrich is right.
First of all, one reason we don't have the votes is that people like Gingrich refuse to endorse the notion of ending Medicare. If they would start pulling in the right direction, then it's far more likely that we would have the votes, if not now, then at least somewhere down the line.
But secondly, if we just wanted to concentrate on incremental solutions for now, then there are plenty of ways to do that without introducing new features to the system that'll just end up making it more entrenched down the road. For one thing, we can repeal the recently passed obnoxious legislation that prohibits providers from caring for Medicare recipients outside of the Medicare regime, even if they receive absolutely no Medicare funds. The federal government has absolutely no business passing that kind of law.
Beyond that, we should incrementally cut back Medicare funding and along with it, the Medicare payroll tax. States, charity organizations, and individual families can make up for the shortfall, as it's really their responsibility in the first place to take care of the elderly - not Washington's.