Mitt Romney and Paul Ryan have formulated their preemptive strike against the Democrats on Medicare. Their strategy is simple: Turn the Medicare issue away from debate over the proper role and structure of the program and into a pure generational war.
“You have to reform [Medicare] for the younger generation in order to make the commitment stick for the current generation,” Ryan said on Fox News Channel. “President Obama is actually damaging Medicare for current seniors.” Romney yesterday told a crowd, “He is taking your money to finance his risky and unproven takeover of the health-care system. He is putting Medicare at greater risk.” Romney and Ryan are looking out for current retirees. Younger voters, they say, should endure reforms so that they can be spared sacrifice. Obama is the threat to the elderly. Any subtleties in this message are utterly absent in Romney’s new Medicare ad:
The first word that appears on the screen is “YOU,” followed by the image of an old man. The narrator explains that “you” paid your taxes, so you deserve every dime of Medicare benefits. But Obama is taking that money and giving it to … them: “So now the money that you paid into Medicare is going to a massive new government program, that’s not for you.”
In point of fact, all this is not false, but it is misleading. Obamacare did cut several hundred billion dollars from the Medicare budget. But it does not cut anything from the standard Medicare package. It cuts the overpayments to private insurers in the “Medicare Advantage” program, which delivers the same thing as Medicare, through private insurance, at higher cost. And then it cuts reimbursements to providers, which was a tradeoff for the government subsidizing new paying customers who were previously uninsured.
For instance, hospitals must treat uninsured patients who arrive at the emergency room, and Medicare helps defray this cost. Since there will be 30 million fewer uninsured people under Obamacare, the law saves money by trimming back this payment. It is the position of the Romney campaign that spending money to insure people before they get sick rather than after constitutes theft from the elderly. Now, some conservatives argue that the reimbursement cuts from Medicare will harm current patients. But that case, which I don’t agree with, is, even if true, a much less sweeping claim. What’s more, Obamacare used some of its savings to fill in the “doughnut hole” in which Medicare recipients had to pay the full cost of their medicine. Repealing the law would thus increase costs on the elderly.
But the factual details of the case are one thing. The case Romney and Ryan have crafted is a textbook embodiment of the demographic anxieties of the party’s disproportionately old, white base that I wrote about in my “2012 or Never” piece in February. In the mind of the conservative base, not all government spending, and not even all social spending, is inherently suspect. Conservative voters draw a distinction between what they see as earned benefits (which tend to accrue to people like themselves) and handouts (which go to poorer, disproportionately less-white recipients.)
Romney’s utterly fabricated charge that Obama has eliminated the work requirement in welfare fits snugly into the theme. In my piece, I quoted a Theda Skocpol, who studied the tea party movement and wrote, “Along with illegal immigrants, low-income Americans and young people loom large as illegitimate consumers of public benefits and services.” In his heart, Ryan is a true principled opponent of social insurance for anybody at all. But the constituency for that kind of sweeping, anti-government message doesn’t exist. Republicans aren’t even trying to run against government per se; they are merely running on less government for Them, more for You.