“This is the beginning of the end of Medicare as we know it.” Nancy Pelosi

“Most seniors will be worse off,” Representative Nancy Pelosi, the House Democratic leader, said on the House floor. “This is the beginning of the end of Medicare as we know it.”

Senator Tom Harkin, Democrat of Iowa, said: “We hear the claim that private-sector competition will drive down costs and save Medicare. Nonsense!”

Are Democrats at it again bashing Ryan on Medicare? Nope, these quotes are from 2003 when they were bashing the new private sector operated Medicare drug benefit that turned out to be 30% less expensive than predicted by the CBO and which provides about 25-30 plan choices for each senior…… and this is the benefit that Democrats improved in 2010 with no thought to bringing it under the government- run portion of Medicare… Ooops!

Before we jump for joy over the success of competition; buying and selling prescription drugs is not the same as receiving health care. The Part D plans dispense the drugs, they are not the ones ordering the prescription and prescribing what drug will be used or how it will be used and that’s a big difference. Further, these companies have tools not applicable to basic health care like generic drugs and formularies. On the other hand, a managed care plan under Medicare Part C that controls utilization because it is an HMO and health care provider may also be able to leverage pricing or even own expensive diagnostic equipment thereby controlling costs.

Competition in some aspects in health care has its place, but until the competition generated is among health care providers (doctors and hospitals) competing for our business, it is not the solution. For the foreseeable future providers are in the drivers seat and may be more so as demand for their services grows and the number in their ranks does not. Oh wait, free markets do work.

P.S. It is Pelosi and most other a democrats, including the President who tell us that competition among insurance companies in the health insurance exchanges will not only lower costs, but improve the quality of health care as well. Perhaps they didn’t read either piece of legislation.