[Miss Marple]

This is a compromise between means-tested and universal.

1. It is voluntary.
2. Seniors who opt for this program and who have income above a certain level will pay higher premiums.
3. You can have either Medi-gap insurance or the Medicare insurance, not both. Many people, like my mother, will remain with their private coverage.

[Valentine_W]

"3. You can have either Medi-gap insurance or the Medicare insurance, not both. Many people, like my mother, will remain with their private coverage."

How many private companies do you think will just get rid of their prescription programs because the federal government already has one available?

[FirstPrinciple]

It is all about incentives. The cost of prescription drug coverage will no doubt increase in the future, more so because govt will pour in tons of money in it. As premiums rise, companies will cut off prescription drug benefits and force seniors into medicare plans. Just wait till the next miracle drug comes out. The present financing plan will break apart because now every senior would demand this new drug. The voluntary aspect will die within the next 10 years. I have heard that companies have already started doing so.

If Bush was serious about real Medicare reform, he would introduce medical savings account for younger workers right away, where young workers can put money and invest for future healthcare needs. Also, for needy seniors give tax-breaks to pharmaceutical companies in the amount that they donate free drugs to poor seniors. That way, govt doesn't directly affect the price of drugs and only allows the companies to deduct whatever is the market price of the drug. But, I am not sure this would have been popular for his re-election chances which politicians always worry about.