August 16 2012
A funny thing happened on the way to Tampa: the campaign suddenly became about real issues, and the Romney-Ryan ticket may actually turn out to have, as Karl Rove puts it this morning, a Medicare Advantage.
The presence of Paul Ryan on the GOP ticket made Democrats giddy (or so they said) at the prospect of scaring the daylights out of older voters who depend on Medicare. Remember the infamous 2010 Democrat ad that featured a Paul Ryan look alike pushing a granny in a wheel chair over the cliff, a reference to Ryan’s proposals to reform Medicare?
But much of the public is coming to realize that, as Joseph Antos of the American Enterprise Institute said over the weekend, “The first thing to understand is that granny is going to be thrown off the cliff anyway, if we don’t make changes to Medicare.” So the question becomes which ticket has the better plan to reform Medicare.
The first thing Rove points out is that the GOP plan (which is the Romney plan, not the one Paul Ryan got passed twice in the House but never in the Senate) doesn’t cut Medicare. I guess my kneejerk reaction is: Well, why the heck not? But, in fact, there are millions of people who are dependent on Medicare, and it would be brutal to pull the rug from under them. Ryan’s budget is designed not to affect current beneficiaries.
The Obama administration, however, moving giant pots of money around on a vast federal chessboard, does cut Medicare by $716 billion, pouring this into its precious but vastly unpopular government takeover of healthcare. The GOP plan would repeal Obamacare and put that money back into Medicare.
The even more important question concerns what the two tickets would do to control the costs of Medicare in the future. Their approaches are starkly different. Rove explains:
Mr. Obama relies on a board of unelected bureaucrats—whose decisions cannot be appealed—to decide which procedures will be covered and at what prices. This will lead to rationing and slow down innovation in new therapies, procedures and devices.
Mr. Ryan's plan has a different approach. While there would be no changes in Medicare for those 55 or older, starting in 10 years younger Americans would have a choice. They could either pick traditional Medicare or use the average amount of money the government spends on each Medicare enrollee to buy private insurance. The reasoning is based on a reliable truth: Competition will lower costs by using market forces to spur innovation and improvement.
As Rove admits, many who see the need to reform Medicare have nevertheless been loath to have this discussion:
Some Republicans worry that fighting about Medicare takes valuable time from talking about jobs, growth and deficits. True, but this fight was coming anyway. Better to debate it now in ways the Romney campaign can control rather than see it raised in the campaign's final moments through under-the-radar robo calls and mailers to seniors by Democrats.
It is said that in politics, if you're explaining, you're losing. That's not always true. Sometimes when you're explaining, you're reassuring voters and undermining your opponent's credibility.
The simple truth is that we are going to have to make a choice about Medicare. I would prefer a voucher to make my own decisions to being pushed over a cliff in a wheelchair by a bureaucrat whose decision can’t be appealed everything.