I consider Medicare D odious. One more government bureaucracy with arcane rules providing a service for a lot of people when only a minority needs it, at huge expense. What’s not to like, eh? Like No Child Left Behind, it always struck me as exactly the sort of government fixit that George W. Bush learned at Bush 41’s knee: better and cheaper than what the Democrats were trying to sell - and trying to solve a problem that actually does exist - but still more bad than good.
It occurs to me however, that a tipping point in the opposition to Obamacare has come from seniors, who often follow closely the scary parts of legislation that affects them. Had Medicare D not been in place, that might not have played out the same way. Add medication insecurity to the intense AARP advocacy to support Kennedycare, seniors might have gone the other way.
There’s no way to play out the counterfactual, but it is at least plausible that Medicare D provided the necessary hedge of protection against complete government takeover. I’m changing the grade on that from F to “Incomplete” while I think about it.