You’re right, Matt, and one can see this in Ryan’s original plan in which Medicare was NOT an option for seniors. If Ryan had his way completely, he would prefer to end Medicare sooner rather than later. As it stands now, the revised Ryan plan is designed to phase out Medicare gradually and substitute vouchers, though not explicitly stated as such. Hopefully, the voucher program will be successful enough that successive generations won’t miss Medicare. This may actually work but it is a risk for the people it will impact first, the “near-seniors,” who are the guinea pigs. If privatization of health care (one of the words Republican operatives have informed the candidates to avoid during the campaign like the plague) can work, then all is good; but if privatization fails, despite adjustments along the way, then people will likely be at even greater risk than they are currently. If it were up to me, I would support a single-payer system and get the for-profit insurance companies out of the health-care industry altogether, which was Hillary’s plan during the 2008 election. If others prefer to call that European socialism, then so be it. Of course such as change, in the opposite direction, would be even bolder than the Ryan plan and, FWIW, certainly against Ayn Rand’s economic philosophy!