The Republican Mediscare

Reihan Salam points us to a National Journa l article about how the Democrats have used the Ryan budget to their political advantage.  The most important case mentioned in the article was an upstate New York Republican-leaning district where a Democrat won by attacking the Medicare cuts in the original Ryan budget.

The information is important but it matters what kind of choice the Republicans offer on Medicare.  The Democrats would prefer to offer a choice of Ryan the “Medicare cutter” vs. the status quo (at least implicitly.)  The Democrats could win that argument.  The good news is that the facts offer a very different choice.  Both the latest Ryan budget and President Obama’s budget grow Medicare spending by GDP + .5%.  Obama isn’t just a Medicare cutter.  He is a particular kind of Medicare cutter.  He wants to appoint a central board to allocate Medicare spending by cutting how much Medicare pays health care providers.  If that means that providers stop seeing Medicare beneficiaries, than seniors will lose.  Obama-model Medicare will give working-class and middle-class voters no choice but to live with the decisions of one centralized bureaucracy.  The wealthy will of course be able to afford better care.  The Romney-Ryan plan would offer seniors a series of choices for their health insurance.  Those choices would include current Medicare, but also private options.  If you could get better care at a lower price from a private option, then you come out ahead.  Either way, you get a defined-benefit (at minimum) and the possibility of something better.  If future seniors have a choice between centralized rationing on one hand, and choice and competition on the other, both at the same level of spending , it is a fair fight.

But the Republicans have more going for them than all of this.  Do you trust the guy who has presided over the worst recovery in seventy years and four years of unemployment above 8% to reform Medicare?  Would you trust the guy who promised to halve the deficit in four years and ended up giving us four years of trillion dollar deficits to responsibly restrain health care spending for the elderly?  Do you think the guy who brought us Solyndra can be trusted to appoint a board to determine what health care our seniors would get?  After presiding over four years of economic misery, after putting out a budget that raises taxes, cuts Medicare, and (as his minions admit) still leaves us on the path to national bankruptcy, do you think this is the guy to make sure we get the most out of the dollars we spend to pay for the health care of our elderly?

But the public must hear about this often, at length, and at high volume.