Unlike Obamacare, what Republicans want really would change health care as we know it:
Republicans have wisely decided to attack Obamacare without committing themselves to an alternative because the alternative would be easy to attack. Ponnuru, for instance, suggests changing the tax code and stripping regulations to create “a market in which almost everyone would be able to purchase relatively cheap, renewable insurance policies that protected them from the risk of catastrophic health expenses.” Telling tens of millions of Americans they’ll lose their insurance that covers basic medical expenses and get bare-bones policies with thousands of dollars in deductibles is not a winning play.
Medicare retirement age: Raising Medicare eligibility age to 67 would cost patients twice as much as it would save the government—don’t do it. – Slate Magazine:
The Kaiser Family Foundation has found that lifting the eligibility age from 65 to 67 would reduce federal spending by about $5.7 billion in its first year of full implementation. But that would be offset by $11.4 billion in spending by other parties. That includes $3.7 billion in higher costs for 65- and 66 year-olds, $4.5 billion from employers through company-sponsored insurance, $0.7 billion from state governments, and $2.5 billion in higher average prices for third parties once younger seniors are shifted out of the Medicare risk-pool and into the general population.
That’s an absurd means of saving the federal government money—akin to raising $12 billion in taxes and then setting half the money on fire. The only people who actually benefit from this shift are health care providers who get to charge higher prices to 65- and 66-year-olds.
Rather than shrinking Medicare, we ought to be taking advantage of the program’s lower costs. One way to do that would be to lower the retirement age—potentially all the way down to zero—and bring more people into the program. That would reduce system-wide costs but require higher taxes or bigger deficits. A more viable idea would be to bring back the “public option” concept that liberals were forced to drop from Obamacare. The idea here was that the new insurance exchanges that will be set up in 2014 should have an option that’s linked to Medicare and its payment rates. The Congressional Budget Office says such a public option could save the government about $68 billion in reduced subsidies over 10 years, while also reducing out-of-pocket costs. Alternatively, you could structure the option as a formal offer to let non-seniors “buy in” to Medicare with the same mix of personal funds and government subsidies that Obamacare envisions being used for private plans.
More important than how much the government spends on health care is how much everybody spends on health care. If you take people who normally would be on Medicare and force them to continue using private plans, their costs will be much, much higher. The reality is that having everyone be covered by Medicare/a public option would cost everyone less overall.