OK, so it's not give old people some money and tell them to go out and try to get insurance. Just kidding. That's EXACTLY what it is. Even Ryan says so. Oops.
Yest but..it will operate like Medicare part D which has consistently come in at lower cost (41% lower) than initial estimates. The reason is people pay attention to the cost of the premium getting the best price for their formulary, and pharmaceutical needs.
The money which will be provided by Medicare will enable the individual to shop for insurance with defined benefits, just like Part-d , and put unused portions of that money into an account to accumulate.
I'm on SS, Medicare, Supplemental insurance and Part-D. I shop for my Sup and Part D and get the best insurance product I can for my money. I also shop drugs within the limits of the plan. For medical services, I don't because virtually everything outisde of drugs is covered. Therefore for non drug medical services I don't pay too close attention.
I'm not rich (only a fraction of critical mass/wealth), and I would take the program which will be offered to those under age 55, or the theshold. I would do that because if we don't do something very much like the Ryan plan, Medicare will not be there for my 40 year old son and his wife, or perhaps you Rdean.
And Rdean, insurability wil be guaranteed, as well as the uniform structures of the array of plans to be offered. It will bring competion and customer oversight into the purchase of medical services, which is the only way to lower costs other than limiting services to beneficiaries through oversight panels who will decide who has adequate need and or cost to benefit ratios.