In the Washington Examiner, Philip Klein takes issue with a National Review editorial praising Mitt Romney’s outline for a Medicare reform plan, which would offer seniors the choice between subsidies for privately-managed insurance plans and traditional Medicare:
One of the biggest potential problems is that it would be hard to create a level playing field between traditional Medicare and private plans, for many of the same reasons conservatives vigorously opposed a “public option” in Obamacare. But in some ways, creating fair competition would be even more difficult under Romney’s proposal.
Romney has not specified at what point his reforms would kick in. But as an example, in 2024, according to projections from the Centers for Medicare and Medicaid Services, there will be 71.2 million seniors enrolled in traditional Medicare, giving it market power to set prices and shift costs onto private plans.
About four million Americans turning 65 that year would be theoretically eligible to choose private coverage. How do you create a competitive market when one participant starts off with at least 95 percent market share?
Conservatives praising Romney should also recognize that any proposal inevitably gets significantly compromised through the legislative process. If Republicans were to start off with the Ryan proposal, and after a brutal fight, ended up with something closer to the Romney plan, conservatives may still be able to claim victory.
But the Romney plan has already moved the goal posts decidedly to the left. What would remain once it gets heavily compromised?
I share both of Phil’s concerns. And I wonder whether the good folks at National Review are too quick to buy what Romney’s selling.
Not that Romney’s plan is necessarily bad: depending on the details, one could even argue that a reform that gave seniors a choice between private plans and traditional Medicare could prove to be a better solution than the Paul Ryan premium-support model. Romney, however, hasn’t spelled out those details. There’s no reason to praise him, or even think that he’s not just leading conservatives on, until he commits to some specifics.