Tyler raises the cash-grants versus Medicare question:

Nonetheless I propose a more modest version of the idea.  When people turn a certain age, allow them to trade in the current benefits package for a minimalistic package (set broken limbs and offer lots of potent painkillers), plus some of the rest in cash, doled out over the years if need be.  For some people, medical tourism will fill the gap.

Even if you believe that cash grants are a more efficient way to achieve whatever end Medicare does you should still be opposed to this idea.  Because Medicare will never go away forever.  You can “replace” it with cash grants but eventually people will notice again that old people want health care subsidies and then you will have both cash grants and Medicare.

Indeed, we already had cash grants in the form of Social Security when Medicare was introduced as a supplement to Social Security in 1965.