The defined benefit versus defined contribution is a concept that has been used for PENSION PLANS, not health care.
Let's be clear. Defined benefit says the benefit you will receive, regardless of what happens to costs / investments etc.
Defined contribution says "This is how much you pay, but the benefit you get -- well, there are no promises. We'll let you know about that."
In the case of a defined contribution PENSION plan, that makes some sense because the main risks are inflation and performance of the underlying investments. You can reasonably expect that the investments will track close to inflation, so a defined contribution pension gives some reasonable expectation of the payout.
In the case of health care, those concepts make no sense at all. What they are saying is, "OK you pay $6000 a year (or whatever). We'll give you a voucher for that $6000. But we won't tell you what that voucher will give you in terms of benefits."
It is actually worse than that. What they are proposing is neither defined benefits nor defined contributions. They are saying they we'll give you a voucher of face value $x,xxx.xx. You can only use this voucher to buy a private insurance policy from the same oligarchy of 4 companies that carve up the under-65 market today. But we won't tell you what that policy will cost you, let alone what benefits it provides. What you do know is that as time passes, you will have to pay more and more out of your pocket. That is not a "defined contribution". It is an UNDEFINED contribution for UNDEFINED benefits. It isn't anything but a bag of air ultimately. Under this plan, everybody is on their own by the time the Republicans are done with us.
Don't say end Medicare "as we know it.". This plan is the end of Medicare, PERIOD, full stop.
= new reply since forum marked as read