Medicare

Republicans Didn't Make the Case for Medicare Reform

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Oh yeah. Powerpoint time.

The conventional wisdom when it comes last night's special election in New York is that it served as an early referendum on Rep. Paul Ryan's Medicare plan. In New York Timesese, "Democrats scored an upset in one of New York's most conservative Congressional districts on Tuesday, dealing a blow to the national Republican Party in a race that largely turned on the party's plan to overhaul Medicare." The national implications of the election are murky, but in the specific case of New York's 26th district, it seems clear enough Democrats won over voters who typically lean Republican by warning them that the GOP was planning to gut Medicare.

Earlier this year, National Review's Ramesh Ponnuru argued that Republicans shouldn't take up entitlement reform this year (with the possible exception of Medicaid). Last night's election is why.

It's not that entitlements don't need reforming; they do. Instead, the problem is that the political groundwork for a Ryan-style overhaul hasn't been laid. Even in the most favorable possible circumstances—say, for example, that Democrats had declined to play the granny card and instead agreed that Medicare needs fixing somehow—no major Medicare overhaul was ever going to get through the Senate this year. And voters were almost certain to be nervous about any plan to substantially alter the system's basic functionality. But House Republicans went ahead and voted for the Ryan plan anyway, thinking that it was their moment, their turn. The sweeping Democratic victory in 2008 had paved the way for ObamaCare. Why couldn't the big Republican win in 2010 pave the way for RyanCare?

Here's the difference: It's true that ObamaCare was partially the product of a big electoral Democratic victory and a moment of liberal policy ascendancy. But it was also a product of years and years of argument and effort, not to mention countless donor dollars spent on think tanks and advocacy groups and polling and an entire well-funded policy infrastructure dedicated to building the case for an exchange-based, mandate/subsidize/regulate health insurance system. Republicans—aside from a few folks like Ryan, who has been diligently hammering away with all manner of Medicare reform explainers—almost totally failed to make any similar effort. Indeed, throughout the '90s and the early '00s, a number of prominent Republican politicians and conservative policy wonks were actively promoting the mandate-driven insurance system that led first to RomneyCare, and then to ObamaCare.

The situaton prior to ObamaCare, then, was that most Republicans generally ignored health care policy except for occasional small battles over things like S-CHIP. And of the few who didn't, some were working on a version of the same plan that ultimately gave their political opponents a major legislative victory. Democrats, on the other hand, spent lots and lots money building institutions that would eventually support and promote their vision of reform.

So when Democrats won big in 2008, they were ready to capitalize on their victory and the legislative power it gave them. They'd laid the foundation for ObamaCare, and it paid off. The big Republican victory in 2010, in contrast, followed a year in which GOP leaders rallied voters against ObamaCare because it cut Medicare, refused to discuss specifics about entitlement reform, and repeatedly distanced themselves from early iterations of Ryan's plan. Is it any surprise that most Republican politicians failed to sell the Ryan budget to the public? It was never clear that most of them actually bought it themselves.

Rep. Ryan, meanwhile, is still plugging away:

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48 responses to “Republicans Didn't Make the Case for Medicare Reform

  1. So who do they think is going to pay for the collapsing Ponzi scheme?

    And what do they think will happen when there is no money left for anyone, and no one will take
    non-paying government patients at all?

    Both processes are already well underway.

    1. “So who do they think

      That’s the problematic word, right there.

    2. Are referring to capitalism itself?

      Are you referring to our FIAT currency? We can just simply print the money since it’s all made up. FIAT currency is backed by a quarterly report.

  2. The back half of this article does a good job explaining the lack of Republican preparation.
    The front half saying that some pissant special election means anything is nonsense.

    1. I just can’t get over the media viewing every special election as a prediction of the future.

      1. You mean surburan Buffalo isn’t a microcosm of America?

      2. Scott Brown!
        Kristen Gillibrand!
        David Prosser!

        Seriously nobody cared about this election. Most people woke up and went “wait, what? Who cares?” The media do, but do not suggest bias, lest you be accused of working the ref.

        1. 21% voter turnout. That’s proof enough that nobody cared.

    2. Seriously. How many people actually knew about this election. Very few. And fewer cared.

      1. Nick Gillespie seems to imply elsewhere that the election could have been about the incumbent Congressman who got in trouble by “trolling on chicks via Craigslist.” I don’t know if this argument holds. Look at Nikki Haley, who replaced Republican Mark Sanford.

        I think the election was due in large part to the scare tactics of the Democrats and Ryan’s plan. As such, it offers a useful lesson to the GOP for either getting a better marketing plan for the Ryan budget, or switching the debate to a way to create jobs.

        The thing is, I think the massive debt and entitlement time bomb is having an impact on job creation and the stagnant economy. It’s just a hunch, as I’m not an economist.

  3. But it was also a product of years and years of argument and effort, not to mention countless donor dollars spent on think tanks and advocacy groups and polling and an entire well-funded policy infrastructure dedicated to building the case for an exchange-based, mandate/subsidize/regulate health insurance system.

    No it wasn’t. If it had been that, the majority of the coutnry wouldn’t have objected to it. It was the product of a fanatical devotion on the part of a single party and a run of amazing and probably corrupt Senate wins that allowed them to get to 60 votes.

    1. Hah ha, you implied statewide elections for Senators are corrupt, because they are Democrats, despite no proof of this. “But, but, it has to be corrupt, because the Wall Street Journal editorial page said so, despite the lack of proof and convictions!

      Can the commenters here stop pretending they are “libertarians” and just admit they are Republicans?

  4. The Democrat party’s argument seems to be, our actuaries tell us that Medicare won’t last beyond 2026 if we don’t do anything. So, lets’ not touch Medicare!

    The fact that the argument works to get them elected is not a lack of organization or effort on the part of Republicans, as you seem to argue. The simple reason is that the people who vote are some of the dumbest, laziest, greediest mother fuckers on earth.

    1. Danny acts as typical voter below!

    2. Which begs a couple of questions, rac:
      (1) Do you vote?
      (2) What’s your big alternative to all this stupid, shiftless, selfish voting?

  5. Claiming that the Republicans didn’t make their case for reform sounds all to familiar with the argument from the left when they lost the House. Only they said that Obama didn’t get his message and accomplishments out to the public due to Citizens United.

  6. I think this is bullcrap.

    Obama spent the entire 2008 primary season making the individual mandate radioactive, and punishing Hillary at every turn for supporting it.

    Once he was elected, he flip-flopped like he was doing parkour across the rooftops of Paris, and slammed the country with the very same individual mandate he had campaigned against. On health care, Obama and his team didn’t lay the groundwork for anything, except his own political toxification.

    The GOP, on the other hand, has made its position on Medicare utterly pellucid. They want to turn it into a voucher system and use the savings to make the tax code massively less progressive. Anybody who is paying even casual attention to politics knows that this is exactly what the GOP is striving for. And the voters hate it. They don’t want Medicare voucherized, and they sure as hell don’t want Medicare voucherized so as to make way for tax cuts for Alec Baldwin.

    The more the public gets to know the GOP’s Medicare agenda, the more they will hate it. The only “groundwork” the GOP can lay for its agenda is to spread obscuration and confusion about it. Honesty will only hurt them.

    1. Alec Baldwin?

      1. Maybe he got the wrong Baldwin borther.

    2. Wow, the only thing wrong about this is that it forgets to note Ryan’s voucher plan is an individual mandate, just like Romney care and the ACA.

      A rare bit of sanity in a Suderman comment section. Now, if only it could migrate to the Atlantic so Jane Galt could get a whiff of it

    3. Still, as Democrat talking to Republicans, I encourage you to “lay the groundwork” for this terrible cost shifting idea as much as possible.

      Could you also include the tax “loopholes” Ryan would close, so he could cut capital gains taxes, rich people’s income taxes, and corporate taxes? You know, like the childhood deduction, the mortgage deduction, and the childcare deduction or would that bit of admission cost Republicans the entire House? (not the libertarians here would care about what happens to Republicans, right?)

  7. Americans seem to have a very thick skin against the concept of “this is unsustainable.”

    “It’s unsustainable huh? I’m fucking over the next generation eh? Suck a dick!”

    I guess it means we are getting the government that we deserve.

    1. I propose an add showing 40 million aborted fetuses with the caption “These are the lucky ones…”

  8. People rarely vote to avert a crisis before it’s at hand.

    When the coming hyper-inflation happens, it will be interesting to see what the public reaction is. I’m guessing wage and price controls will be the first order of business.

    1. You can’t seriously be trying to predict the future stupidity of the American public!

      When hyper-inflation happens, get ready for Supreme Chancellor Obama!

      1. Nobody ever lost money by overestimating the stupidity of the American people.

    2. Sadly true, even while all the people who forecasted the hyper-inflation warn against price controls while the people in favor of the price controls are the ones that were warning about deflation.

    3. Just whip out your old “Whip Inflation Now” buttons!

    4. I’m guessing there is no super-inflation crisis….but, then again, I exist in reality, whereas you exist in Glenn Beck’s universe

  9. They say the D’s are the Stupid Party and the R’s are the Evil Party. This conventional wisdom is only half right; both are Stupid AND Evil.

  10. Mr Suderman, you do know what happened to the Dems in the first general election after they passed ObamaCare, correct?

    Groundwork shmoundwork. They had 60 votes in the Senate and control of the House and presidency, and they were going to pass as much welfare state crap as they could before the next election. The groundwork matters little.

    1. I tend to agree with this.

      Maybe I’ll get negative feedback about this but, I voted for Obama mainly because he seemed competent, and because I perceived the Republicans as being total warmongers. I truly was surprised (and dismayed) when he made this big push for health insurance reform. Maybe I was not paying close enough attention during the campaign, but I was expecting more focus on global warming and infrastructure projects. I never thought the Democrats would be able to pass a national health reform bill. And, the plan they created lacks legitimacy with more than half of the voting public, so how much of a mandate did they really have for it?

      1. “I voted for Obama mainly because he seemed competent,…”

        Could you please explain what about Obama’s minimalist record of accomplishment gave you that impression? How could he “seem” competent when he had not done anything of note other than win a senate seat running against no one, essentially (Keyes was a joke candidate in that race)?

        1. MJ, how pleasantly surprised you must be that he proved capable of leading the country out of a massive recession, passed more of his own political platform than a president in generations, and found Osama bin Laden, among many other instances when he has amply demonstrated his competence.

      2. Healthcare was a dominant issue in the primary and general election. Any dismay on your part is borne of ignorance.

        It doesn’t lack legitimacy with half the population, as it is law, it just lacks popularity with them.

        But not nearly as badly as the GOP healthcare plan. (Die, parasitic old people! Rich people’s taxes aren’t quite the lowest ever yet!)

  11. Hey, everybody! Look what I found in the Clue Basket:

    If you’re going to make classical austerity arguments (“unsustainable”; “Ponzi Scheme”; “crisis”), you probably shouldn’t be packaging your proposals with colossal tax cuts for the Kardashian sisters.

    Classical austerity arguments are best deployed in support of — y’know — actual austerity. Which means simultaneous spending cuts and tax increases to balance the budget and spread the pain across the whole society.

    Now, if what’s really motivating you is “F_CK YOU, MOOCHERS,” and you couldn’t give a rat’s azz about whether the wealth redistribution program at issue is “sustainable” or “actuarially sound,” then, yes, you can pair the program cuts for the working class with giant tax cuts for the $5M-and-up strata. Just expect that you are going to lose any election where the voters figure out what you are actually up to.

    Naturally, political distractions are in order. The twin specters of gay schoolhouse recruitment and recreational late-term abortions work well in the southern states. Other regions of the country can be more complicated.

    1. So I guess you would support spreading the pain across the whole society through a VAT or with a lump sum tax. Since these taxes distort the market the least.

  12. Besides fiscal discipline, what do voters actually get back in return from Ryan’s budget?

    I know it’s a silly question, but trying to understand the mind of the squishy uninformed voters, it’s pretty dense for smart people in general to keep thinking that ‘discipline’ makes good politics. For example, you just don’t say “let’s cut off unemployment riiiiiggght….NOW!” People want something in return, maybe along the lines of “Your unemployment check will be 3x as big and you keep it even if you landed a job but it expires in 6 months, no give backs. None of this 99 weeks shit. “

    1. I think the best way to sell fiscal discipline is to scare people about what will happen if we don’t do something. I think getting the message out that the entire country could end up like Detroit might persuade people.

      1. You can’t even sell that to Detroit voters. No one really cares about the future of his/her country enough to vote people in who care for the future of the country.

  13. Earlier this year, National Review’s Ramesh Ponnuru argued that Republicans shouldn’t take up entitlement reform this year (with the possible exception of Medicaid). Last night’s election is why.

    They had to do this. They promised the TEA Party that they would. If the GOP hadn’t gone after entitlement reform, they would have lost the 2012 election out of the gate.

    As it is now?

    I don’t think they’re doing badly. Large swaths of the country will remain loyal GOP voting blocks.

  14. The public likes the idea of being guaranteed healthcare in their senior years and they think, “its worked for 50 years, why can’t it still work for me?” They may be wrong, but you have to admit that the GOP is starting to sound like the boy who cried wolf given the decades they’ve spent talking about how SS and Medicare are on death’s doorstep. I just don’t think people believe it. That, and despite all the hatred of government spending, most people actually quite like it when the government spends money on them personally.

    Another aspect may be that people differentiate between spending and costs. Ryan’s plan leaves a lot to be desired on the costs front. It reduces gov’t spending, but not overall spending, as its mainly just a shift in who pays for it, not how much has to be paid. Maybe they’d like better answers on how to reign in costs.

    1. Very good comment.

      The GOP is not believable, as they expanded Medicare in 2003, and scared voters in 2010 that Obama was going to gut Medicare. Ryan himself voted for Medicare Part D in 2003. They are giving mixed messages.

      Plus, you’re right. Everyone has been talking for years about how both programs are going broke. Nobody believes it, including my highly educated 75-year old friend.

      Plus, many people believe that they are paying into their Medicare “account” and want that money back when they need it. They are either in denial or not aware that they likely will take out far more in health care spending in retirement than they paid into the system.

      And, does Ryan’s plan include anything that actually would reduce the costs of health care?

      1. Exactly right.

        The vouchers are supposed to reduce the cost, and they probably would. I don’t think people are convinced, though. If vouchers were that popular as a concept they would be widely used for school choice already.

  15. I’m almost more offended by the GOP’s political malpractice than their governing by radical incompetence. You can’t Frank Luntz your way out of “Republicans want to destroy Medicare.” As they fucking well know seeing as they ran on Medicare cutting hysteria in the very last election. I do not get it. All but like 9 GOP members of both houses of Congress have crafted for their future opponents one of the most effective attack ads imaginable. They were having so much fun losing minorities, young people and women that they felt like throwing old white people under the bus? I do not get it. I mean I know that they actually do want the apocalyptic hellhole their policy implies, and that they only have the courage to try to implement it when there’s a Democrat in the White House, but come on. Paul Ryan is probably a Randian true believer. But even the Tea Party overwhelmingly likes Medicare! There was always a glimmer of competence in Republicans–their ability to win elections despite themselves. Looks like even that’s being snuffed out. That’s what happens in the latter generations of inbreds. Same principle probably applies.

    Disclaimer: I believe in the GOP’s ability to win elections despite themselves even now. But what should concern us is that the only way they’ll be able to win the next election is by convincing people of blatant lies. So, same old same old.

    1. TONYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY!!!!!!!

  16. I think that the Republicans’ problem is that they tried to fix Medicare without 1st fixing the broken healthcare market in the US. Competition among health insurance providers may be a step in the right direction, but so far private health insurance providers haven’t done any better at reigning in the raising costs of health care than the government has. Let’s free up how health care is provided and improve price transparency and competition before we tell seniors that they are on their own.

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