The Republican platform was accidentally posted for a short time on Friday, and Politico got a copy before it was yanked. TPM reports on their plans for Medicare and Medicaid, confirming that the two programs would be so altered by the Republican proposal that they would no longer exist as the programs they are today.
“The first step is to move the two programs [Medicare and Medicaid] away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model,” the draft platform reads. “While retaining the option of traditional Medicare in competition with private plans, we call for a transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee’s choice. This model will include private health insurance plans that provide catastrophic protection, to ensure the continuation of doctor-patient relationships.”
The esoteric language gets to the heart of the change that ends the basic structure of Medicare. Since its inception in 1965, Medicare has been a government-run insurance program that directly pays medical bills for the elderly per their needs (i.e. “defined benefit”). Republicans want to turn it into a partially privatized system that pays seniors a fixed amount to buy their own health insurance (i.e. “defined contribution”).
In simple terms as applied to Medicare, defined benefits means that the government-run program covers medical bills of its patients, paid directly to the provider. You get sick, your care is paid for. What the rest of us who have private health insurance have is defined contribution, what they are calling “premium support.”