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Wed Feb 27, 2013, 04:28 PM

Medicare Uncovered: What’s in a name? (the GOP prettifies vouchers)



Some brief history of vouchers, and how we describe them, is in order: Since economists Henry Aaron and Robert Reischauer called for voucherizing Medicare back in the mid-1990s, the concept has been painted with a lot of lipstick. Aaron and Reischauer dubbed it “premium support.” After all, the government would be giving Medicare beneficiaries money “support” to pay for a “premium.” But lipstick on a pig doesn’t do away with the pig. And a voucher plan by another name is still a voucher plan.

“Premium support” seemed less harsh than “voucher” and conveyed a veneer of objectivity. The wonk and foundation community liked the term. Sometimes those folks used the term “defined contribution.” That was really wonky, and most Americans had no clue what it meant. It was a term borrowed from the pension world, where Americans once had good “defined benefit” plans, in which benefits were determined by a formula based on age and years of service on the job. Those have been replaced by the less good “defined contribution” plans, like 401(k)s, in which employer contributions are optional, and workers’ own contributions determine the benefit they eventually get. “Defined contribution” in the context of Medicare means the size of the contribution the government makes determines how good the coverage will be.

In the late 1990s and afterwards, voucher supporters, notably conservatives and Republicans, used the term “Medicare privatization.” The term meant that private insurers would have a larger role in providing Medicare benefits, on the theory they could provide benefits cheaper than the government. That has not necessarily been the case. Currently, private insurers provide the prescription drug benefit for all beneficiaries, and they also provide all Medicare benefits for million or so Americans who have chosen Medicare Advantage plans. For the rest of Medicare recipients, the government still provides the benefits.

The idea of privatizing Medicare has not resonated with large segments of the public. Republicans—who mostly supported the concept—believe it is time for new language, as the National Journal reported. Testing showed that people think of the word “premium” as something high end, like a car, not insurance, and certainly not something low end like paying more for their healthcare. Sanger-Katz reports that the testing showed that the public likes the words “choice” and “competition.” Sounds a little like Frank Luntz, doesn’t it? So Republicans have banished “premium support” from their talking points in favor of the new term, “competitive bidding.”

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Reply Medicare Uncovered: What’s in a name? (the GOP prettifies vouchers) (Original post)
Bill USA Feb 2013 OP
southernyankeebelle Feb 2013 #1

Response to Bill USA (Original post)

Wed Feb 27, 2013, 04:35 PM

1. Well folks you know what they say about pigs. A pig can't smell its own hole. Just


saying the whole thing stinks to high heaven. Anything that comes out of a republicans mouth when it comes to healthcare I would not believe. I'm willing to think many don't trust them either.

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