How Insurers Could Game Medicare Vouchers

washingtonpost.com — There are two tough questions facing the folks who want to remake Medicare into a premium support (or voucher) program. The first is that, despite decades of attempts, we don’t have a single good example of a competitive health insurance market driving down prices in a big way. Now some people think that perhaps it can work, and these efforts just got it wrong, somehow. I actually count myself in that camp, at least somewhat. But so far, the fact is that it just hasn’t worked. The second is that we do have evidence that a major way insurers compete is through trying to figure out who’s healthy and who’s sick and insuring the healthy people and turning away (or pricing out, or underserving) the sick people. And that’s a kind of competition we don’t much want.

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