Krugman on the case, as usual:
"Meanwhile, another proposal -- to force Medicare to compete with private insurers -- seems intended to undermine the whole system.
This proposal goes under the name of "premium support." Medicare would no longer cover whatever medical costs an individual faced; instead, retirees would receive a lump sum to buy private insurance. (Those who opted to remain with the traditional system would have to pay extra premiums.) The ostensible rationale for this change is the claim that private insurers can provide better, cheaper medical care.
But many studies predict that private insurers would cherry-pick the best (healthiest) prospects, leaving traditional Medicare with retirees who are likely to have high medical costs. These higher costs would then be reflected in the extra payments required to stay in traditional fee-for-service coverage. The effect would be to put health care out of reach for many older Americans. As a 2002 study by the Kaiser Family Foundation judiciously put it, "Difficulties in adjusting for beneficiary health status . . . could make the traditional Medicare FFS program unaffordable to a large portion of beneficiaries."
What's going on? Why, bait and switch, of course. Few politicians want to be seen opposing a bill that finally provides retirees with prescription drug coverage. That makes a prescription drug bill a perfect vehicle for smuggling in provisions that sound as if they have something to do with improving Medicare, yet are actually designed to undermine it.
Faced with adamant opposition from Democrats who understand exactly what's going on, like Senator Edward Kennedy, the Republicans are reported to have retreated a bit. The consequences of the crunch planned for 2011 will apparently be less drastic, and premium support will be introduced as an experiment -- albeit one involving millions of people -- rather than all at once. But this bill is still a Trojan horse."
http://www.nytimes.com/2003/11/14/opinion/14KRUG.html
Remember, this bill is not about perscription drugs, it is not about "saving" Medicare, it is about the right-wing's effort to privatize Medicare and then Social Security. They have always opposed these programs; their hidden agenda is to destroy them. That's the trojan horse.