The premium support will shift a lot of cost to fragile Seniors, who simply will go without care. A lot of Seniors simply are naive to Insurance, and will likely chose one which will be of no benefit to them. So Paul Ryan’s suggestion I really don’t like. It has not been explained in any great detail. My spouse and I simply can not pay anymore. The cost of insurance plus medications takes all be can afford now. Ryan’s idea would apparently shift considerable cost to Seniors. We would have to not get medication or simply do without care. That is what Obama and his IPAB have planned for us. I thought the Republicans would do better, but I guess not. By the way, I am a Republican. Dr. Berwick is a left wing loon. There is no telling what he dreamed up when he was writing Medicare regulations.