Such a move became inevitable when Congress decided not to cut standard Medicare reimbursements as scheduled, cutting Part D subsidies instead. The decisive vote was cast by Sen. Edward Kennedy.
A Wall Street Journal analysis estimates the price of the plan will rise from $24-37 per month, but your mileage will vary. Notices are due to go out to current recipients October 31.
The technology impact of Medicare Part D, which is quite popular, is make payment systems run by big insurers more powerful, while they remain technically diverse. Drug technology remains strong, because (so far) seniors are not being denied the latest prescription drugs.
The insurance industry spin is that most premiums will not go up, but that seniors need to look at proposed changes carefully when open enrollment starts November 15.
The real issue is the growing budget crunch, and promises made by both sides. Republicans won big subsidies in creating a partly-privatized Medicare covering prescription drugs. Doctors once promised to cut their reimbursements but now resist that.
Inside all that, of course, is the deeper quandary. A universal plan gives each individual less than a private system in which many are priced out of the market.
Hard choices have to be made and, as we've seen this week, most politicians hate hard choices, because most constituents hate hard choices. Pointing fingers is much more gratifying.