For a year or more, Indiana's Republican governor, Mitch Daniels, has been telling anyone who will listen that if the country's political leaders want to fix Medicare, they're going to have to stop playing "the granny card." He's complained about Republicans playing it. He's complained about Democrats playing it. And he's even sympathetic, in a way. "I have to say, the granny card has been played so cynically against Republicans so many times, that I can certainly understand the turnabout there. But it is not a grownup attitude," he told the American Spectator's Philip Klein in 2010.
Grownup, it's not. But it is convenient, and does seem to be politically effective, at least in the short term—which is probably why you can find Health and Human Services Secretary Kathleen Sebelius accusing Rep. Paul Ryan of pushing a Medicare plan under which seniors will "die sooner." Here's the full quote, via Politico:
During testimony before the House Education and the Workforce Committee, she said seniors "will run out of money very quickly."
She continued, "If you run out of the government voucher and then you run out of your own money, you're left to scrape together charity care, go without care, die sooner. There really aren't a lot of options." [bold added]
In other words, Republicans are coming to kill Granny.
But of course, they aren't. Even if you don't like Ryan's premium-support proposal (I think it has a number of flaws), you can't say it would hurt today's seniors, or even tomorrow's. For better or for worse, the premium support system wouldn't fully kick in for ten year: Anyone currently enrolled in Medicare or within a decade of eligibility would be allowed to participate in the system as it exists today. So it's folks who are today in their early 50s who would be the first to interact with the new system—a system that would still provide broad, means-tested subsidies with which to purchase insurance.
Here's a thought experiment: What would seniors do without any form of Medicare at all? It's tough to run a controlled experiment, but we have something of a natural test: comparing the years before Medicare was introduced and the years after. And according to a 2007 study by MIT's Amy Finkelstein, "the introduction of Medicare had no discernible impact on elderly mortality in its first ten years in operation." And remember, Ryan's plan isn't to bulldoze the system and let seniors go it alone. Instead, he wants to overhaul the system in such a way that every senior still has access to taxpayer-subsidized health insurance, but in a way that requires the federal government to spend less money to keep the system running.
Would spending less on Medicare really be so bad for the health of America's seniors? Probably not, according to none other than the White House's economic team, which in 2009 asserted that "nearly 30 percent of Medicare's costs could be saved without adverse health consequences." Despite what Sebelius says, under Ryan's Medicare plan, Granny would be just fine.