In both cases — Medicare Advantage and vouchers — people are accepting a government subsidy in a form that allows them more choice than the default form. You're the one trying to make some kind of point based on that. I see it as evidence of nothing more than the fact that people like to have choices. I'm not arguing that it proves that they like the system as a whole; I'm just rejecting your claim that it somehow proves that they don't. I do tend to agree that a system that allows them those choices is better than one that doesn't.

> The program that they choose to use instead outperforms Medicare on every key performance indicator (medical outcomes, cost, patient satisfaction), while also underperforming the same private insurers on those same indicators.

Cost to whom? I don't see how Medicare Advantage can cost less to patients than Medicare; nor does it seem likely that the premiums for a private plan are less than the subsidized Medicare Advantage premiums. (Re the latter, I guess you didn't see my other reply to you: https://news.ycombinator.com/item?id=16979926)