To my knowledge, Ryan’s budget doesn’t attempt to reform the medical-care sector. It just has cuts. The hope is that those cuts will force consumers to be smarter shoppers and doctors to be more economical and states to be more innovative. But all that’s been tried, and it hasn’t been enough. That’s why the Affordable Care Act had to go so much further, digging deep into the delivery system ..
Jonathan Cohn, unsurprisingly, agrees:
[S]imply switching from public to private insurance doesn't actually make Medicare more efficient. If anything, the very opposite is true. Medicare has lower administrative overhead and so, benefit for benefit and person for person, it's actually cheaper than private insurance–which means that privatizing Medicare should increase costs, all else being equal.
Michael Cannon of Cato differs:
Because vouchers enable seniors to keep the savings, they will do what ObamaCare won't: reduce the wasteful spending that permeates Medicare. Seniors will choose more economical health plans and put downward pressure on prices across the board. Indeed, vouchers are the only way to contain Medicare spending while protecting seniors from government rationing.
Ryan Avent is more evenhanded:
Mr Ryan deserves credit for not dodging the long-term entitlement question. But this dramatic a shift could only pass with strong bipartisan support. Given that Mr Ryan has included much that will offend the Democrats and plenty that will cost him Republican support, it's hard to have much confidence in the ability of the GOP budget proposal to advance the conversation.
Tyler Cowen provides tips for evaluating Medicare reforms.