The effect on percent spend on hospital care if Medicare was privatizing would depend on what remnant of the Medicare plan remained. If the DRG reimbursement model went away and became a fee for service model with patients paying a percent of charges I think hospital spend would decrease. Given the fact the population covered is primarily on a fixed income, uncompensated care would climb. If the funding remained in place and program benefits remained similar and the primary change was in administration of the program, I think the cost could be decreased. Shifting to preventative care, use of patient centered medical homes to coordinate care, appropriate use of palliative care resources, could shift care from expensive hospital care to less