The Medicare Morass

It’s too soon to render a definitive judgment, but I’ve got to hand it to Romney-Ryan: So far, they’ve done a really good job confusing the Medicare issue.

Once it was announced that the GOP ticket would feature the maestro behind Congressional Republican votes to end Medicare As We Know It, the next three-to-however-many-until-November-6 days were fated to be about the perhaps second-most popular entitlement in the country, and which Party was going to save/kill it. While recent polling may indicate that American voters’ old habits die hard, the reports I’ve seen thus far from the campaign are leading me to believe that Republicans may be able to shield themselves from the worst of the pro-Medicare blowback by talking incessantly of Obamacare’s $700+ billion Medicare cuts.

As is the case for Obama-Biden with white, non-college educated voters, Romney-Ryan need only mitigate their losses among the Medicare bloc to “win” the round.

Now, I must repeat: It’s way too early to authoritatively say that Republicans have indeed “won.” Paul Ryan is a household name for political pros and observers, but most Americans still don’t know who he is, and voters tend to initially give newbies the benefit of the doubt. My sense is that the facts of the matter — i.e., the public’s consistent, vehement opposition to a serious overhaul of Medicare — are simply too unfriendly to the GOP, and that Democrats will reap predictable gains after weeks-and-weeks of hearing anti-Ryan talking points. But much as I wished as a child, I never did develop “spider-sense,” so my instincts on this one could well be wrong.

If it turns out I am wrong, I’ll probably chalk it up to an often unacknowledged reality of Medicare politics: This stuff is confusing! Even Ed Kilgore, a guy who has spent decades immersed in health care policy and previously worked for the DLC, admits that he sometimes loses himself in all of the program’s arcana. If the folks whose livelihoods and careers depend on understanding Medicare reform are struggling, you can bet that most voters will feel as if they’re bumbling through a thicket on a moonless night. What makes pundits any better? Not much; they’re just paid to convince you otherwise.

Here’s an example of the Medicare thicket in action — a New Republic piece from Harvard economist David Cutler in which he exhorts Republican pundits to stop citing his work in defense of the claim that market competition will be cheaper for Medicare beneficiaries than the current system. Cutler goes into fine, if not granular, detail on what, exactly, his research has found; and how, exactly, it’s not what James Capretta and Yuval Levin report in The Weekly Standard. Then he cuts to the chase:

To put it a bit more plainly, it’s possible that the private plans are cheaper because they really do offer the same benefits at a lower cost. It’s also possible that the private plans are cheaper because the insurers are very good at attracting the best risks—that is, the healthiest seniors least likely to run up medical bills—or because they don’t also subsidize other parts of our health care system, such as medical education. In effect, they may be gaming the system. At this point, we really don’t know which answer is correct, although it’s entirely possible all three are true, to an extent.

To appropriate the late Christopher Wallace: If you don’t know, well… you still don’t really know.

In my eyes, this episode (of which, between now and November, there will be countless repeats) offers a great illustration of why Conor P. Williams is right to spend so much time urging the Left to change its rhetoric by foregoing wonky policy minutiae in favor of a clear, direct, and unapologetically moralistic appeal. Debating whether or not Obama’s cuts to Medicare are worse, better, or the same as Paul Ryan’s cuts to Medicare — that’s not only a waste of the Democrats’ time, but also a failed opportunity to underline, with a real-world example, the divergent philosophies between Dems and the GOP.

That’s not only good for Democrats; it’s good for voters, too. It’s no fun to feel in over your head, and it’s something far worse than “no fun” to feel that way while your future is, potentially, on the chopping block.

[x-posted]