The federal budget proposed by Representative Paul Ryan, the Republican vice-presidential nominee, extols the benefits of "promoting true choice" for Medicare beneficiaries. In truth, though, the Ryan plan would substantially reduce choice for many people on Medicare—by cutting them off from their current doctors. Doctors see Medicare patients, despite the relatively low payments they receive for doing so, partly because Medicare represents such a large share of the healthcare market. If a substantial number of beneficiaries moved out of Medicare and into private plans, as Ryan proposes, doctors would have much less incentive to see Medicare patients.