The Medicare Debate and How it Works to the Republicans' Advantage
by Tom Donelson on August 20, 2012 at 12:34 PM
Who would have thought that Medicare as an issue could possibly benefit Republicans? Conventional wisdom was that picking Paul Ryan would force Romney to defend Ryan's budget and Ryan’s Medicare reform, but the issue works to the Republicans' advantage simply because of Obama's own actions. By pushing Obamacare, Obama reshuffled the deck and many seniors got the shaft. It is not hard to understand why, since what Obama did was to shift 700 billion dollars from Medicare to fund Obamacare. The shifting of money takes money from seniors to put in the pocket of younger workers; shift money from one entitlement to another entitlement, both of which are underfunded. What is being set up is a generational war in which limited resources are being spread among a greater number of people. Nor did it help that the reduction of the FICA tax reduces the revenues for Social Security and Medicare. (One can make the case that the tax reduction was needed to help the economy but it doesn’t change the fact that this tax is reducing revenues for the entitlements.)
Obama and the Democrats can’t come off as saviors of Medicare when they are now defunding it, and Republicans can make the case that they are ones who will save Medicare. As National Review Richard Lowry noted, “Never before, though, have Democrats passed the largest Medicare cuts in history immediately prior to launching their tried-and-true assault. This time, it is a case of the pot calling the kettle a danger to America’s seniors.” What Democrats have called cuts in “non-essential portion of Medicare” are those cuts that fall on Medicare Advantage, for this option gave seniors private sector coverage options. It is a popular option, and it is hated by the left. After 2013, Medicare Advantage is essentially gone and Obama's tactic is to rely on reductions to doctors and providers to keep Medicare costs in line; so many seniors will see reduction in services immediately. With the IPAB board in place, bureaucrats will determine what care is allowed and this only adds to the reduction in care. Many physicians are preparing to retire, and this will only make it harder for seniors to find doctors. Obamacare increases demands for medical care services while the supply of providers declines. This is a recipe for disaster that is easy to see coming.
What the Republicans offer is a health care plan for seniors and the rest of America that is based on competition and patient’s choice while the Democrats depends upon rationing and price controls. What Ryan can state with certainty that much of his plan has been vetted and proposed by not just Republicans but Democrats, including most recently, Oregon Senator Ron Wyden. There has been a bipartisan support for much of Ryan has proposed for the past decade and half, whereas Obamacare never received bipartisan support, nor did the Democrats really try that hard to obtain bipartisan support. As Obama supposedly told one GOP legislator, “We won and you didn’t.”
Another aspect is the recent waivers allowed by the HHS to give states more flexibility dealing with 1996 Welfare reform, and while the Obama administration views these waivers allowing states to be more flexibe to increase work, the reality is that this was designed to weaken the 1996 law. Heritage Foundation Robert Rector has written on the loopholes that would essentially end the 1996 welfare law when he wrote, “Unable to eliminate 'workfare' legislatively, the Left now acts contrary to the law and employs a bureaucratic maneuver to gut the work requirements. The Obama administration claims authority to grant waivers that allow states to skirt these requirements …. Humorously, Health and Human Services Secretary Kathleen Sebelius even asserts that the administration abolished the TANF work requirements in order to increase work….This is false. The Obama administration claims authority to overhaul every aspect of the TANF work provisions (section 407), including definitions of work activities and engagement, specified limitations, verification procedures and the calculation of participation rates — in other words, the whole work program. Sebelius’s HHS bureaucracy declared the existing TANF law a blank slate on which it can write any policy it chooses.”
Can we trust Obama to follow up on a bipartisan approach to entitlement reform? By gutting past successful entitlement reforms through bureaucratic maneuvering, could a future Obama administration even be trusted to follow through on future reforms that could pass?
Republicans can win the Medicare debate because Medicare is tied to Obamacare as Obama is using money from Medicare to fund Obamacare. Seniors are starting to realize that Obamacare will weaken their care now. Since Obama and the Democrats have tied Medicare to Obamacare, the question that they are not answering remains how does this improve health care for all? Republicans, led by Romney, are making the case that it is the conservatives who are the savior of Medicare and have a better plan to provide better healthcare reform.