You are correct in saying that the GOP has for the most part promised to preserve Medicare as it is today for current seniors, though the lack of specificity in the most recent Ryan plan leaves this somewhat vague.
However, there should be no doubt in anyone's mind that a voucher-based premium support program would "end Medicare as we know it."
Medicare is a single-payer system in which the government pays hospitals (Part A) and physicians (Part B) for services. It is a "defined benefit" system. Under Medicare, payments are made per-hospital stay for Part A based on the patients diagnosis (DRG). One hospital may perform twice the number of procedures as another to treat a patient with diabetes, but both will receive the same payment. No private insurance works like this. Payment for physician services pays more than private insurance does for basic, general office visits, and less for specialty care.
Further, the basic rate of increase year-to-year is set by Congress (the "doc fix"), another cost-limiting aspect of the systems.
Medicare also has much lower overhead (or "administrative") costs than private insurance (6-7% for Medicare; 15-30% for private insurance). This has kept the average increase per capita in the price of Medicare significantly lower than for private insurance:
http://wapo.st/...
Overall, since 1969, the cost of private insurance has increased much faster than the cost of Medicare:
http://nyti.ms/... (Krugman, 2011)
In brief, these features have helped contain the increase in per capita Medicare costs compared to private insurance.
Imagine now, what would happen if these older, sicker patients were given a voucher amounting to their current annual Medicare benefits. A voucher program is a "defined contribution" system, with the value of the voucher being based (initially) on the current annual Medicare benefit. THIS, according to the CBO, is what would happen:
http://bit.ly/...
Seniors' out-of-pocket medical costs would increase dramatically... if they could afford insurance at all. (Remember, now the Supreme Court appears about to decide the government cannot interfere in this market). And the cost will go higher since the value of the vouchers will be set at a constant rate of increase and not tied to inflation. Seniors will be left to fend for themselves. To me this is a dramatic enough a change as to warrant the metaphor "throwing Grandma off a cliff." But even if you don't like the metaphor, I hope you will acknowledge that this would indeed be "the end of Medicare as we know it."
For good reason, many people have lost faith in your fact checking service based on your not having adequately understood how radical the "voucher" plans are. You made it worse by doubling down and making it your Lie of the Year. The only way you can make it better is to correct your error along the misleading Pants on Fire rating.
Sincerely,