Medicare's 'death spiral' under Romney/Ryan voucher plan confirmed in new study

Another study finds that the voucher system Mitt Romney and Paul Ryan envision for Medicare will cause the program's demise. TPM's Sahil Kapur reports on the study from Health Services Research, which used the model of the existing optional Medicare Advantage, the current subsidized Medicare alternative.

The study's conclusion: healthy seniors tend to gravitate to private plans and sicker seniors gravitate to traditional Medicare. That's because private insurers craft their plans to attract lower-cost patients and leave sicker, more expensive ones for traditional Medicare'a process known as favorable selection. [...]
'I think what that means for premium support is that fee-for-service Medicare would gradually be a dumping ground for the sickest people and the premiums would go higher and higher if they want to stay in their plan,' said Austin Frakt, a health economist at Boston University. 'And that's a huge concern for some people.'

That's, in microcosm, a huge part of the problem the private insurance system has seen, except seniors have the option of Medicare that has to accept them, and sicker people who aren't eligible for Medicaid are pretty much out of luck when it comes to finding affordable insurance. But in the case of Medicare, adding in private competition that markets to and selects the healthiest individuals means that traditional Medicare eventually becomes too expensive to sustain. That would lead to what Frakt calls the "classic adverse selection death spiral,' and the end of Medicare.

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