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December 03, 2012 11:39 AM Telling Old Folks the Truth

By Ed Kilgore

I think we’ve all come to realize that the biggest Republican dilemma during the fiscal talks—as it’s been under the surface for years now—how to reconcile the fundamental desire to undermine Medicare as a safety-net program with the GOP’s heavy reliance on older voters—and its associated habit of Mediscaring seniors with claims of trying to save them from horrible cuts to the program by Democrats.

In an interesting if misleading piece for The Hill, Sam Baker and Elise Viebeck frame this as a choice between Romney’s and Ryan’s approach to Medicare—and suggest that the latter is beginning to prevail among congressional Republicans, buttressing the case for loud-and-proud advocacy of Medicare “reforms.”

During the campaign, candidate Romney repeatedly hammered President Obama for cutting $716 billion from Medicare as part of his signature healthcare law. Romney pledged to repeal those cuts in a break from his running mate, Rep. Paul Ryan (R-Wis.).
Ryan, the House Budget Committee Chairman, had preserved Obama’s Medicare cuts in two consecutive budget proposals that repealed the rest of the Affordable Care Act. Ryan is now back at work crafting his next budget, and Republicans on his committee say the $716 billion in Medicare cuts will likely survive….
Romney’s rhetoric rankled some conservatives and supporters of Ryan’s more dramatic Medicare overhaul, who feared Romney was making it harder to make badly needed spending cuts in the future.
When pressed about their differing positions during the campaign, Romney and Ryan simply said that because Romney was at the top of the ticket, his approach to Medicare would carry the day.
Now, though, Republicans are largely casting off Romney as a failed candidate with no real claim to the party’s political or intellectual future, while Ryan is still seen as a political star who could run again for national office. And among his fellow Republicans, Ryan’s approach to Medicare is also back on top.

Well, that’s sorta right. But putting aside the $716 billion, Ryan’s budget, like Republican “entitlement reform” proposals from time immemorial, grandfathered seniors and near-seniors. The implicit plea to old folks was that they’d get their Medicare benefits at the expense of the free-loading, free-loving, slacker generations behind them—not to mention those people whose “welfare” benefits would be cut much more significantly. And notwithstanding details, the unambiguous Romney-Ryan campaign message was that the real threat to seniors was Obamacare, which would directly or indirectly redirect tax dollars from current Medicare benefits to “a massive new government program that it not for you,” as one famous campaign ad unsubtly put it.

This “generational war over resources” message didn’t begin in 2012, either. It was a big part of the Tea Party message in 2009 and 2010, dramatized most vividly by Sarah Palin’s “death panels” claim, which suggested Obama wanted to kill off Medicare beneficiaries in order to use that money for his nefarious socialist schemes (presumably benefitting those people).

Now it’s entirely true that the problem with destroying Medicare’s original structure while protecting current beneficiaries is (as Jonathan Chait has pointed out) is that it eliminates most opportunities for short-range budget savings from Medicare. And that’s why Republicans want Democrats to be the ones to offer Medicare cuts that are more immediate than anything in the Ryan budget. But it’s not as though a brief bout of medagoguery by Romney is now giving way to Paul Ryan’s honest truth-telling to seniors. Pitting one group of entitlement beneficiaries against others has been part of the GOP game plan all along, and remains so today.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

Comments

  • boatboy_srq on December 03, 2012 11:48 AM:

    a brief bout of medagoguery by Romney

    It may be a typo, but I like that one. It's fitting somehow. Multiple Position Mitt really did misunderestimate his chances of becoming pResident.

  • nycweboy on December 03, 2012 12:00 PM:

    Part of the reason this "pitting the generations against each other" strategy is mostly doomed is that the idea - which is fairly common - that there is a bright line between easily defined "generations" is nonsense. The fact, I keep pointing out to those around me, that most marriages among older Americans are often between an older man and a younger woman means that the idea of a hard line between "traditional" Medicare and the Voucher Proposal is often the dividing line between husband and wife (Say, he's 63 and she's 54). That means this debate is not some theoretical question of you vs. those pesky annoying youths of today., but rather how your spouse - who may very well outlive you - would possibly afford care on a reduced income. And not surprisingly, many older women get this... as well as their husbands.

    What's dismaying is that I think some of this gets lost on younger liberals, who have, as Ed does here, worry excessively that somehow, someday, this strategy might work; the reality is, thus far, that the "generational war" strategy has failed, and is likely to stay that way. It can't help, for instance, that the economic downturn has put more families into the position, however uncomfortable, of several generations living together, or in closer proximity to one another. We're moving away from the "retirement village" notion that older people should be sequestered away from their descendants, and more adult children are in roles of caring for ill older relatives. That means, most likely, significant exposure to the issues of care and cost. That can't help the GOP case, either.

    Still, there's a pervasive unreality around all of this: if the "generational divide" approach won't work (and I think it's a dead proposal, too)... well, then what? There's a resistance to rethinking almost any and every aspect of Medicare, from reimbursement rates, to the idea of fee for service, to hospital based care... as each of these options comes off the table, there becomes less and less way to control costs related to Medicare. And then Republicans have a point - at some point, something has to give. And I think a lot of lefties resist the idea of having to admit that making a change in Medicare means pain in some form or another. Which brings back, I guess to the "single payer or bust" debates the left was having amongst ourselves during passage of ACA.

  • schtick on December 03, 2012 12:02 PM:

    I'm willing to bet if they took a closer look at hospitals, clinics, and insurance companies they could find a savings of double that amount in unnecessary procedures and charges, but then, how would they keep getting their PAC money so they can continuously run for office without doing the job they've been elected to do.

  • c u n d gulag on December 03, 2012 12:05 PM:

    'Divide, Con, and Conquer!'

    This has been the Republican game plan since Teddy put on moose antlers and ran against them.

  • bigtuna on December 03, 2012 12:17 PM:

    Good points. What none of the politicans have the guts to say, however, is:

    Everyone will die. In addition to ongoing cost savings that can be found in other parts of the system, Medicare needs to address "the end of life" stage - say, the last 6 mos. to a year. The system, and society, need to come to grips with the amount of money, and more importantly, the amount of pain, suffering, etc we subject the elderly to in the name of "care", and the amount of pain that families are subjected to, in the name of "care". I am not an advocate of assisted suicide, but having gone through this with both parents, I know that the "system" needs to be recalibrated. Sadly, politicians won't go near this, thanks in part to queen Sarah. But someday, they will all be in a crappy windowless "lounge" and they will feel the relief when a doctor finally says

    " we can do x, y, and z to your mom. That is what we would recommend for someone in their 60's. But frankly, x, y, and z might giver her another two weeks, and we will have her on a morphine drip the entire time so she won't feel anything. And then there will be the 4 times/day changing of bed pans, and the fading in and out of awareness that you mom will have. As a doctor I am obliagated to do taht treatment if you so ask; as a human, and a daughter, I want to ask you to understand the suffering your mom will have, and that you will feel, if we do this. Your mom is 89, and has a good long life. All life ends. Maybe this is her time".


    I just don't think that many people here this message, and we throw lots of procedures at people who are just at the end.

  • T2 on December 03, 2012 12:18 PM:

    of course, the main problem with Romney's Medicare story - Obama cutting 716 Billion from Medicare Benefits - was (as with most of Romney's stories) a LIE. Obama didn't cut benefits at all, he cut costs.
    Ryan's 716 billion may cut costs also, but it comes with a Voucher Plan effectively ending Medicare as it stands today and THAT is why Romney gave it the boot....he knew it would not play with old folks. And it won't. So they'll make up a lie to somehow put lipstick on that pig and try again. Remember, the GOP doesn't want to "fix" Medicare and Social Security, they want to eliminate them.

  • Mimikatz on December 03, 2012 12:20 PM:

    Schtick is right, as is NYCweboy. Moreover, many Seniors care about their children, and want to leave a safety net for them too. Overestimating other people's selfishness is a chronic GOP problem.

    There are clear ways to save money through more effective treatments and less deliberate or otherwise over treating. And eliminating some of the profit. That's why the BS Commission recommended waiting to see how the Obamacare reforms work out and do single payer if they aren't enough. Privatizing and shifting costs to beneficiaries won't work. And raising the Meicare age is the single worst idea going, given all of the problems with private insurance for older people.

  • Mimikatz on December 03, 2012 12:24 PM:

    And what big tuna said. Anyone who has dealt with a sick and dying parent knows this is where the savings are, but the GOP poisoned that well in 2009 with death panels, for which they should suffer mightily.

  • boatboy_srq on December 03, 2012 1:12 PM:

    the reality is, thus far, that the "generational war" strategy has failed

    I'm with you on everything else, nycweboy, but not this.

    The "generational war" strategy has failed - as a federal approach. As a per-state approach, however, it's doing rather well. The key difference is the taxation specific to each level. Income taxes hit everyone, and do a lot of good things for everyone, so that almost anyone not a Bircher can find something to like.

    STATE taxes, on the other hand, get broken out a lot more discretely, and things like schools, early childhood ed, daycare etc are far more visible at the state level, and far easier for folks who don't see a vested interest in the expenditure to resist. FL's low expenditure on schooling, children's services and other things are a consequence of that: too many elderly volk who can't be arsed to pay for other people's kids' eddycayshun. This isn't a Southern thing: most of the people resisting the new taxes are transplants from the Midwest and not especially attuned to the Auld South mentality before arriving.

    The mistake the GOTea made was to assume that resistance to property taxes, sales taxes and other revenue streams for specific purposes would translate into a general resistance to taxation in the absolute, and that the causes for resisting specific taxes were the same as resisting taxation on principle.

  • zandru on December 03, 2012 1:23 PM:

    "The implicit plea to old folks was that they’d get their Medicare benefits at the expense of the free-loading, free-loving, slacker generations behind them"

    This tactic presumes - probably correctly - that the geezers don't realize that the benefits they are currently receiving are being paid for by the 'free-loving slackers'. That they, the greedy geezers, paid for their parents, and not for themselves. And, even more tellingly, that the 'free-loading, free-loving' folks are actually paying for their parents and grandparents, but also for themselves - building up that SS "trust fund" to handle the outside "Baby Boomer" generation, an unexpected phenomenon which will probably never recur.

    The upshot is that the policies beloved by and promoted by the Tea-baggin' Republicans are designed to cut off this arguably most-deserving generation, the much-maligned "Boomers."

    As I resemble that remark, it offends me greatly.

  • hells littlest angel on December 03, 2012 1:23 PM:

    That's funny: Paul Ryan is the latest "not Romney." I guess he's a shoe-in for temporary front-runner in 2016.

  • Zak44 on December 03, 2012 3:00 PM:

    In seconding Mimikatz, I'd like to point out that the GOP strategy shows precisely how this issue should be framed by Libs and Dems:

    A. The people trying to cut Social Security and Medicare think you're selfish enough to deny your kids and grandkids the benefits that four generations have been able to expect.

    B. They also think you're stupid enough to fall for this con.

  • Marc on December 04, 2012 7:12 AM:

    Is this a secret strategy that the Repubs have for losing the geezer vote? They have lost almost every other constituency (pace religious right), and now seem poised to attack the old.

    Is Frank Luntz really a Democratic mole?