Throughout the healthcare reform debate, leading lawmakers such as Senate Finance Committee Chair Max BaucusMax BaucusChanging of the guard at DC’s top lobby firm GOP hasn’t reached out to centrist Dem senators Five reasons why Tillerson is likely to get through MORE (D-Mont.) said Medicare should be a key driver in transforming the nation's fragmented healthcare delivery system, by paying for episodes of care and quality outcomes instead of individual procedures for example. The law contains a number of provisions aimed at containing costs and improving quality, such as rewards for care coordination.
"The privatization proposal," Levin wrote, "overlooks the fact that when it comes to rising health costs, Medicare is part of the solution, not the problem."
Atul Grover, the chief advocacy officer for the Association of American Medical Colleges, agreed with Levin's premise.
Private payers are changing the way they pay for care, Grover acknowledged, but "the challenge is that it's all happening at the local level.
"It's being done differently all over the country," he said. "Medicare has the ability to do these kinds of things at a very different level."
But that's not the only, or even the worst, problem with Ryan's approach, Grover said. In addition to paying for care, he points out, Medicare is also a key source of investment into physician education and training - public investments that private health plans don't have much of an incentive to pursue.
"I'm not sure (private plans) will do that," Grover said.