>>> paul ryan kept up his criticism of the president and focus on medicare this morning in an appearance in pittsburgh.
>> medicare is important to each and every one of us. somebody in our family relies on this program or is about to rely on this program.
>> but which political party is more likely to rescue medicare from going off the cliff? " washington post " columnist robert samuelson joins us now. you wrote a column that said why ryan might be right about medicare . talk to us about why the ryan plan might actually be the best solution for preserving and saving medicare .
>> well, the real problem here is not just medicare . it is the uncontrolled nature of health care spending which if we allow to continue, will essentially crowd out most other functions of government simply because there are no limits on it whatsoever. and what this study that i reported in my column showed is that a kind of prototype of voucher plan that is already being used by medicare actually has lower costs than traditional medicare and that people seem to be equally satisfied with it. you have roughly 25% of medicare beneficiaries already in this program. so i would say it's not an open and shut case, but there's good evidence there that another approach might provide the same level of services at a lower cost and that's really what we need and because medicare is the largest insurance company -- insurance program in the country, what it does will affect the rest of the health care system .
>> this was a study from the journal of the american medical association , looking at the medicare advantage accounts. the criticism of that and help me if i'm wrong about this, is that the voucher system would cherry pick . it would take the seniors who are the least needing expensive medical procedures and leave those least able to take care of themselves for medicare so that medicare would be weighed down by those who are left behind. is that criticism valid?
>> right. the argument is that healthier seniors go into these programs and therefore, their costs are lower as a result of that. the study that these three economists did, all from harvard, tries to adjust for that. now, it's unclear whether the adjustment does a kind of complete cleansing of the differences between people, so you have this level of uncertainty, but the article seems to indicate to me, at least, that there's fairly strong evidence that the costs of medicare advantage are actually lower after you adjust for risk but again, this is an issue and it's one of the things we need to debate and find out. there is another example, however, of the voucher program that ryan proposes, succeeding in medicare , and that's part d , which is for drug benefits. went that was introduced in 2006 , it turned out that the costs were much lower than anticipated by roughly 30% to 40%. and again, one possible explanation is that voucher system sets in motion competition that forces these plans to become more efficient and hold down their costs. again there are other explanations for lower costs. you have some kind of confusion. there is some evidence that this voucher approach may work.
>> which is a very hot political topic. question political party outside of the numbers can actually explain this to the voters without it being such a third rail that the debate never gets engaged? robert samuelsson thank you for opening up the conversation. what political
>> medicare is important to each and every one of us. somebody in our family relies on this program or is about to rely on this program.
>> but which political party is more likely to rescue medicare from going off the cliff? " washington post " columnist robert samuelson joins us now. you wrote a column that said why ryan might be right about medicare . talk to us about why the ryan plan might actually be the best solution for preserving and saving medicare .
>> well, the real problem here is not just medicare . it is the uncontrolled nature of health care spending which if we allow to continue, will essentially crowd out most other functions of government simply because there are no limits on it whatsoever. and what this study that i reported in my column showed is that a kind of prototype of voucher plan that is already being used by medicare actually has lower costs than traditional medicare and that people seem to be equally satisfied with it. you have roughly 25% of medicare beneficiaries already in this program. so i would say it's not an open and shut case, but there's good evidence there that another approach might provide the same level of services at a lower cost and that's really what we need and because medicare is the largest insurance company -- insurance program in the country, what it does will affect the rest of the health care system .
>> this was a study from the journal of the american medical association , looking at the medicare advantage accounts. the criticism of that and help me if i'm wrong about this, is that the voucher system would cherry pick . it would take the seniors who are the least needing expensive medical procedures and leave those least able to take care of themselves for medicare so that medicare would be weighed down by those who are left behind. is that criticism valid?
>> right. the argument is that healthier seniors go into these programs and therefore, their costs are lower as a result of that. the study that these three economists did, all from harvard, tries to adjust for that. now, it's unclear whether the adjustment does a kind of complete cleansing of the differences between people, so you have this level of uncertainty, but the article seems to indicate to me, at least, that there's fairly strong evidence that the costs of medicare advantage are actually lower after you adjust for risk but again, this is an issue and it's one of the things we need to debate and find out. there is another example, however, of the voucher program that ryan proposes, succeeding in medicare , and that's part d , which is for drug benefits. went that was introduced in 2006 , it turned out that the costs were much lower than anticipated by roughly 30% to 40%. and again, one possible explanation is that voucher system sets in motion competition that forces these plans to become more efficient and hold down their costs. again there are other explanations for lower costs. you have some kind of confusion. there is some evidence that this voucher approach may work.
>> which is a very hot political topic. question political party outside of the numbers can actually explain this to the voters without it being such a third rail that the debate never gets engaged? robert samuelsson thank you for opening up the conversation. what political