Tyler Cowen ruminates over Medicare vouchers. He also links to ruminations by Ross Douthat.

In my view, the question is not whether you like vouchers are not. Vouchers are inevitable, given the alternatives. Alternative 1 is to keep what we have, which is an open-ended commitment to reimburse health care providers for all procedures performed on people over the age of 65. That is not feasible–the budget blows up. Alternative 2 is to have government impose strong rationing of medical services to seniors. I think that is an unlikely alternative. It’s not just that I think that government would do a poor job. When it comes down to it, do politicians really want to be put in that position?

So, one way or another, we are going to get to a voucher system, in which seniors ration their own use of medical services. There are many potential problems with it, and it will take a lot of thought and a lot of trial and error to get to a system that balances collective risk-sharing and compassion with individual responsibility and fiscal reality. But in the end, it is the most realistic approach.

I wrote an op-ed making this point in 2008, which the Wall Street Journal accepted, but never printed. Not that I’m bitter about it or anything.