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Bring on the Bamboozlement

The Medicare system has been in place in the United States for a bit more than 40 years. The premise is simple: once you hit retirement age you move into a single payer health care insurance system in which Medicare takes responsibility for your care, regardless of the state of your health or income level. There are copays. No one's crazy about exactly how much is covered. Some doctors opt out. You've probably heard all of this at one point or another. But the key is that you're in the program. And for the rest of your life you're out of the private health insurance system. You're covered. Permanently and on the same terms as everyone else.

Now, this isn't just a good thing if you're a senior or have parents who are seniors or have anyone in your life who's a senior, which presumably means virtually everyone. It's also just necessary for pretty obvious reasons.

We all know about pre-existing conditions. You're a cancer survivor so no insurer will cover you. Or you have one of the myriad possible conditions that make you a bad risk. And no insurer wants to issue a policy for someone who odds say is likely to cost a lot of money. Well, guess what, people over 65 all have a preexisting condition: they're old!

Now, not that people aren't living longer and longer lives. And plenty of folks in their late 60s are in better health than folks 10 or 20 years younger. But by and large, we all know how this life thing works. When you hit your mid-60s or so, things start breaking down. And eventually, you die. That's a bald way to put it. But we all understand that this is true. The simple truth is that for all the problems with private health insurance for the young and working age populations, it just doesn't work for seniors.

We tried it. That's why we ended up creating Medicare.

Now, you might say, how is it that the President's health care reform has managed to ban insurers from denying coverage to people with pre-existing conditions? Well, good question. But there's a straightforward answer. Most younger and working age people don't have chronic health problems. So if you can make sure that everybody is in the health care system -- that's what the mandate is about -- you have enough revenues from premiums to offset the very high costs of the relatively small number with chronic conditions. But the same approach won't work with seniors. Because, again, as a group old people just aren't healthy enough. There are complicated health care economics ways of explaining it. But do the math. It's obvious.

The Ryan plan is to get rid of Medicare and in place of it give seniors a voucher to buy health care insurance from private insurers. Now, what if you can't buy as much as insurance or as much care as you need? Well, start saving now or just too bad.

Now, by any reasonable standard, that's getting rid of Medicare. Abolishing Medicare. Phasing it out. Whatever you want to call it. Medicare is this single payer program that guarantees seniors health care, as noted above. Ryan's plan pushes seniors into the private markets and give them a voucher. That's called getting rid of the program. There's simply no ifs or caveats about. That's not cuts or slowing of the growth. That's abolishing the whole program. Saying anything else is a lie.