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If the insurance company executives made coverage decisions to control cost, what would we have to say about them? If they began to "ration" coverage or "kill grandma" by tightening what end-of-life procedures would be paid for, or significantly increased deductibels or co-pays in an effort to keep you from going to the doctor when you thought you needed to, who would you complain to? Would you be happy talking to someone at an insurance company call center?
While I think I've made clear my dissatisfaction with the U.S. Congress and the way our democracy seems to be working these days very clear, at least we have a vote to replace them every 2-4-6 years. What recourse do we have against the corporate bureaucracies of a handful of insurance companies who either increase the cost or reduce the benefits of our health insurance? None that I can think of.
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It is my understanding that the Ryan plan calls for the private insurance companies to be approved by Congress just as the current Congressional health plan is administered. So, if the "rationing" and "killing grandma" occurs, you would complain to Congress just as you would have to if Medicare does these things. So, from that perspective I see it as a wash. The ironic thing is that in arguing for universal healthcare for all, the Dems repeatedly said that all Americans deserved a health plan similar to the one that members of Congress enjoyed. Yet, when Ryan proposes offering a similar plan to seniors, the Dems say he is throwing granny off a cliff. What duplicity!
The encouraging thing is that the use of competing private insurance plans is similar to the use of competition in the prescription drug plan for seniors. The net result of this competition is that the costs for the program are significantly under-running their projections.
What people need to understand is that Medicare is just a specific program that meets a generic need - health care for senior citizens. I'm not all that concerned about whether "Medicare" is continued to meet this generic need or if another, perhaps better, program is instituted - as long as it can provide the generic need of care for senior citizens in a fiscally sustainable manner.
We know that the current manifestation of the Medicare program fails miserably in meeting the above requirement. Paul Ryan and the Republicans should be congratulated for addressing this looming crisis - the Democrats should be ashamed of themselves for demagoguing the issue as a means to gain votes. It is their willingness to kick the can down the road that is the real peril to granny.