>It's calculated that under the current system, insurance for an over-65 would be at least $30k annually. And healthcare costs have been rising 5 X as quickly as wages, so that's not the end of it. You and Andy might have no trouble building up an extra mill or two to cover your healthcare needs in retirement, but many others would struggle.
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>The only way to hold down costs is to include as many healthy people as you can in the insurance pool so you can use the surpluses from healthy members to help pay the costs of others. Medicare effectively does this by sharing its costs across most of the community. The insurers don't do this- they risk-shunt, trying to gather healthy customers to themselves and pushing sick or risky people elsewhere. That's the main form of "competition" between insurers, because it allows them to extract surpluses as profit rather than to cover care for people as they age or get sick and need care. So you'd need to legislate to prevent this sort of discrimination and as soon as you do that, you need individual mandate as well so people don't check in and out of insurance to cover healthcare needs as they occur.

Actually, the insurance industry has been making that same claim for years.

As for reform, it seems to be going the way of his other policies right now. The majority seem to think that it is a good idea to help those who are not economically in a position to help themselves and they are all for raising taxes on those who can afford it to accomplish it. However, everyone's idea of who those folks are whose taxes will get raised is always 'the other guy.' It's never them. No one thinks they can afford to have their taxes raised, but they want it done. They just want the other guy to pay for it.

Unless there is a universal health system which covers every single citizen of every age and economic status, there is no way we can even consider ending Medicare or even phasing it out. There is also the issue that people using Medicare today have spent their entire lives contributing to it. If they don't receive the benefits, then they should get that money back to invest in insurance. Now, if a universal system were to take effect, then those dollars contributed towards Medicare could be transferred to the new universal system as long as it covered every single senior citizen in this country.