The Republicans tell us that the way to repair Medicare (assuming that it needs repair) is to turn it into a system of vouchers, thus putting elder Americans even more at the mercy of the insurance industry than is already the case.  Any reasonable person pondering the ills of Medicare might come away with an idea that the ever-rising cost of pharmaceuticals, physicians, and physician's equipment could be to blame.  That this same triumvirate happens to contribute regularly to the campaign coffers of such holier-than-thou politicians as the Right Reverend Paul Ryan must be mere coincidence, not to mention the continuing beneficence of the insurance companies into congressional accounts.
The voter/patient pays for all of this because he has no choice; we all get sick, suffer injury, we all seek to postpone the inevitable arrival of the Grim Reaper.  What percentage of doctors do you think went to medical school out of a desire to heal the sick as opposed to an urge to become wealthy?  And do pharmaceutical companies seek to keep less expensive equivalent medications off the market based on any motivation other than greed?  How much elaborate testing is performed on patients with expensive medical equipment based upon legitimate diagnostic need as opposed to cover-your-ass fear of a lawsuit?  (I knew it!  It's the fault of the damn litigeous members of the Bar, the Ultimate Heavies!)
If it is true that costs of medical treatment is the primary reason that Medicare is in need of remedial attention, than the Republican idee fixe does no more than further complicate the scenario.  One might as well pass legislation making it a felony for a physician or a healthcare facility to treat tobacco smokers.  Or make tobacco production itself illegal.  Since billions of dollars are spent every year in health care related to the poison of cigarettes, we just might reap some savings down the line.