Mitt Romney's Not So Bold, Not So Specific Medicare Plan

A number of prominent Republicans and conservative outlets have praised Mitt Romney's half-baked, have-it-both ways Medicare plan. Not The Washington Examiner's Philip Klein, who today delves into why the former Massachusetts governor's plan is neither specific nor particularly compelling, and why that's a problem:

Like Ryan's plan, Romney's approach would transition to a system in which seniors are given subsidies to choose among a variety of health care plans. But Romney would also offer seniors the choice to remain in 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?

Romney's plan also promises that the price for seniors to buy into traditional Medicare would reflect the program's cost to government. But is it realistic to depend on future Congresses to raise premiums for seniors if necessary to cover costs? And what would be included in the cost calculation?

Private health care plans, for instance, have to pay for salaries, office space and other such administrative costs. Yet when it comes to Medicare, those costs are spread among the federal budget. Would they be included when setting premiums? If not, it's another unfair advantage for traditional Medicare.

Beyond the plan's lack of important specifics, Klein also points out that Romney's plan starts out as a watered down version of the most recent Paul Ryan plan (which itself was a compromised version of an older version of his own plan). Inevitably, any legislative process designed to push a plan like this through Congress would water the plan down further. Of course, that assumes that Romney's plan is designed to lead to actual legislation that he'll someday attempt to pass. Of that I am skeptical, to say the least. Instead, like so much of what he's put on offer, it appears to be designed to help him win the GOP presidential nomination without committing him to much of anything. 

More on Romney's vow to protect and preserve Medicare here.