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New enrollees would be given "premium supports" to help them buy private insurance.
Alternatively, at the bottom, costs can be shifted to beneficiaries with premium supports to help them handle the burden.
To the Editor: David Brooks cites the Dutch health care system and Representative Paul D. Ryan's Medicare privatization scheme as examples of shifting the cost of care to beneficiaries with premium supports.
It analyzed the potential impact of lower premium supports paid to private companies that issue Medicare Advantage plans, popular alternatives to traditional Medicare with extra benefits such as gym memberships.
Romney's plan still has some holes in it (how fast would premium supports grow?), but it exemplifies the sort of big reformist vision that should be at the center of a serious Republican campaign.
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Premium support is out.
Serious analysis and testing of premium support are worth pursuing.
Hence the right's support for catastrophic coverage, health savings accounts, premium support for Medicare, etc.
Democrats have gone into demagogic overdrive calling premium support ideas "privatization" or "the end of Medicare".
Democrat Alice Rivlin and Republican Pete Domenici have co-authored a premium support plan for the Bipartisan Policy Center.
That should be a good test for anyone championing premium support.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com