Medicare as it is currently structured underpays docs and hospitals and other health care providers. One finds scammers trying to get extra money from the government by milking the system with unnecessary and fraudulent billings. This can be minimized if A0 the government paid in a timely fashion (6 months down the line doesn’t cut it) and B0 paid a reasonable rate to providers (one of the reasons docs won’t see medicare patients is because they can’t AFFORD to.)
Doctors don't want Medicare patients because Medicare doesn't pay enough. Patients know; we all know; that Medicare alone is not adequate for our health care. And yet Medicare is single-handedly bankrupting the country. That is all pre-Obamacare, which would just compound the problem: more spending and poorer care.
So Ryan presents a vague plan that gives the illusion of being market-driven, yet will, IMO, result in half the population, because of income, age, ill health, ignorance or fraud, selecting the government option; plus silver bullets like block grants and and an eligibility increase to sixty-seven in the distant future. All this will cost, they trumpet to put recipients' minds at rest, just as much as Medicare costs now, even though Ryan's March press release claimed an $800 billion saving over ten years.
How does this improve the quality of health care? It doesn't.
How does this slow us down as we hurtle toward the fiscal cliff? It doesn't.
The bigger problem is that it, once again, gives us false hope, the illusion of progress, like the debt limit. Meanwhile. the fiscal clock keeps ticking.