Khimm: How GOP Could Win Entitlement Fight
Suzy Khimm writes at Mother Jones:
For Democrats, it seems like a gift from above. On the very day that President Obama officially launches his reelection bid, House budget guru Paul Ryan (R-Wis.) announces a plan to privatize Medicare. This latest GOP cost-cutting scheme amounts to a medical voucher system: Rather than paying for care directly, the government would help elderly Americans purchase private insurance. "It's going to end Medicare as we know it," says Nadeam Elshami, communications director for House Minority Leader Nancy Pelosi (D-Calif.), repeating the latest Democratic talking point.
It's also a politically risky move, effectively gutting one of the nation's most popular entitlements—one that Lyndon Johnson fought long and hard to enact back in 1965. To date, experiments in privatizing Medicare have fared poorly—take Medicare Advantage, by which private insurers now serve about a quarter of Medicare recipients: Due to waste and inefficiency, the program has ended up costing 14 percent more than Medicare itself would have spent. Ryan's proposal would allow Democrats to claim that the GOP is declaring open season on seniors. "This should be one they should hit out of the park," says Dean Baker, co-director of the left-leaning Center for Economic Policy Research.
But the GOP could be pitching a spitball here. Democrats did a poor job of defending their reforms the first time around (see 2010 elections), but simply attacking Ryan's plan without trying to defend—perhaps even strengthen—their own tough-love efforts to save Medicare might also put them at risk. "You can't just criticize the other guy, you've got to offer something," Rep. Jim McDermott (D-Wash.) told Mother Jones. "And I think we have something. Members shouldn't be the least bit ashamed to explain what we've produced."
The left began sounding the alarm as Ryan previewed his plan on Sunday's talk shows. The House GOP has "an ambitious new plan to effectively destroy the entire Medicare system," declared The Washington Monthly's Steve Benen. "Privatizing and voucherizing Medicare does nothing whatsoever to control costs…[savings] will come from denying medical care to those who can’t afford to top up their premiums," echoed Paul Krugman. "It's insane," says Michael Bocian, a principal at the Democratic polling and consulting firm Greenberg Quinlan Rosner. "I think they'll hang themselves on this." Given polls in which three-fourths of Americans say cutting Medicare for seniors was a bad idea, "it's hard to see why this would be a smart electoral strategy" for Republicans, he adds.
Democratic observers say they're confident that the GOP will pay the price come election time. "Saying Republicans want to take a meat cleaver to Medicare will resonate. The GOP sort of shot themselves in the foot," says Peter Harbage, a health care consultant and former Clinton administration official.
The best argument the GOP has going is that Medicare costs are spiraling out of control, putting America on a path toward fiscal doomsday. Of course, the Democrats have already taken unprecedented steps to rein in the cost of Medicare, and the overall health care system, through the Affordable Care Act (a.k.a. "Obamacare"). It's thanks largely to Republican fear-mongering that these cost-cutting provisions are among the least popular and most widely misunderstood elements of federal health reform. Given the Dems' track record in explaining their reforms to the public, the Democratic rank and file may be reluctant to give it another go. ...
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