In the midst of the near shutdown of the federal government, Rep. Paul Ryan (R-Wis.) launched an attack on Democratic-created safety net programs. He proposed an entirely new budget, calling for the privatization of Medicare and the devolution of Medicaid to the states, where Republican governors would be able to cut health care for the poor at will.
Now, given the general affection for Medicare, in particular, one might assume that this suggestion would be political suicide for Republicans. And, indeed, some Republicans are quite worried that once again, as in 1982, 1995 and 2005, Republicans are taking their electoral victory as a mandate to go after highly popular programs, like Social Security and Medicare, with severe political consequences to follow.
According to Ryan’s plan, the popular Medicare single-payer program would instead give older people vouchers to buy insurance from private companies. So Grandma gets to use her outstanding computer skills to search for the best possible corporate deal and then sit on the phone fighting with an insurance company. Lovely.
Democrats had three grand goals in the last century: Social Security, Medicare and national health insurance. Bolstered by the 1932 and 1934 congressional elections, Franklin D. Roosevelt signed the Social Security Act in 1935. After his 1964 landslide, Lyndon Johnson created Medicare (and Medicaid, for the poor) in 1965 as an amendment to the Social Security Act. Together, Social Security and Medicare guaranteed American seniors retirement security and medical coverage. After a more modest victory in 1992, Bill Clinton sought but could not achieve any traction on a version of national health care. It took Barack
Obama, after a big win in 2008, to push through that bill, in 2009. He did not create national health insurance, but what he and the Democrats established was a big step forward.
While conservatives fought these programs tooth and nail, they could not destroy them once they were in place. Now comes Ryan’s plan, which is a twofer. It would eliminate Obama’s health care plan and turn Medicare into a privatized system.
Democrats are excited by what they see as Ryan’s overreach, and they are itching for a counterattack. Perhaps they imagine television commercials featuring hard-pressed, especially older, Americans comparing their own situations to the line in Ryan’s report where he hopes “to ensure that America’s safety net does not become a hammock that lulls able-bodied citizens into lives of complacency and dependency.” With one out of six Americans on Medicaid (more than 50 million people), and with more than 45 million Medicare recipients, this is, to say the least, ill-advised language. Congressional Republicans are even attacking AARP, one of the nation’s most powerful interest groups, for challenging these priorities.
Democrats are thrilled Republicans are having to take a position on the Ryan budget. House Republicans endorsed the Ryan plan on April 15, with just four Republicans voting against it. No House Democrats crossed over.
But it’s worth noting that while the politics of Medicare favors Democrats, the math is not so simple. Medicare is a government-run program that provides health care and enjoys vast public approval. Older voters express extremely positive feelings about Medicare and Social Security. Seniors are the most active voters. So what did they do in 2010? They went out and helped Republicans take over the House of Representatives, putting in place the current attempt to privatize Medicare. And seniors continue to constitute the least favorable bloc of voters for the Obama administration.
Since the end of the New Deal, Democrats have had to learn the painful lesson that people can have all sorts of logical reasons to support Democratic proposals and candidates and then, at the end of the day, go out and vote Republican. They can even believe fervently in Medicare and Social Security while voting for candidates whose deepest political dream is to turn both of them over to the tender mercies of the insurance and banking industries. To win those votes, Democrats must clearly, confidently, decisively and dramatically demonstrate how each program works, and show what would be irretrievably lost if they were privatized. These truths are not self-evident. And Democrats need to be wary that to focus solely on Ryan’s Medicare proposal will allow his other ideas, such as redirecting tax burdens from the wealthy to the middle class, to slip by.
Republicans have been working the old folks since the 2008 campaign. The more Obama drew the support of younger voters, the more the Republicans refined their pitch toward seniors. When Obama launched his health care plan, he included savings from Medicare that would come out of the companies making profits in the program. Republicans told seniors that Obamacare would cut their Medicare and create “death panels” or, more colorfully, pull the plug on Grandma. They could not actually point to a provision in the health care bill that did this, but the insinuation worked anyway. And the lack of trust that older voters had in Obama and the Democrats made this distortion easy to pull off.
Ryan now is going to say he wants to save Medicare from the clutches of the government. This argument will appeal to those voters who are not even clear, according to polls, that Medicare is a government program now.
It might be useful to point out that when the Republicans held all three branches of government, they passed an unfunded prescription drug plan that not only fattened corporate wallets but also mandated that Medicare could not use its massive buying power to lower drug prices.
How different would the politics of Medicare have been if only Joe Lieberman hadn’t been such a jerk? During the final bleak days of the health care bill negotiations, a proposal was offered to allow Americans to buy into Medicare at age 55. An ABC News Washington Post poll in 2009 showed it drawing 2-1 support. But Sen. Joe Leiberman, who had previously supported the idea, killed it because, he reported, a liberal congressman, Anthony Weiner (D-N.Y.), spoke highly of it as a step toward a single-payer option. Had it passed, a whole new bloc of voters would have been brought into the system as paying customers, and it would have been harder than ever to break it up. Leiberman could have been a hero by providing the last vote needed to break a filibuster and open the doors of Medicare to millions more.
With all this in mind, I braced myself to be crushingly disappointed and demoralized by President Obama’s April 13 speech on the budget. I expected him to split the loaf, cleave toward the Republican side, and make pre-emptive concessions. I was sure he would give in to the punditry’s conventional wisdom that there is no worthy vision to challenge the Republican view. I was well-prepared to sadly lament this lost opportunity to make the case for a more just, fairer America.
Instead, the president knocked it out of the park. He not only defended Medicare and swore to protect it, but he set out the profound contrast between the Republican vision as embodied in the Ryan plan, and a more compassionate and thoughtful America as seen on his side of aisle. On this biggest of questions, which will define politics for this entire re-election period, Obama finally moved off the sidelines and took a stand. And he did it with some flair, highlighting the absurdity of throwing the health of our seniors into the hands of corporations and the foolishness of cutting investments in order to maintain tax cuts for the top 1 percent.
As we look back on the House vote on the Ryan plan, there is one more reason for Republicans to wish that that vote had never come before them. A politically skilled president has moved, at least for the moment, into the kind of stance that his role model, Ronald Reagan, utilized almost as his second nature — to contest the basic foundation of the political debate.
For too long, Democrats have tried to sell voters on their smart policy ideas. They have focused on what they would do. But nobody really cares about all these smart ideas. They really hear you when you say why you want to do things. It’s not what’s in your brain that gets through to people; it’s what’s in your heart. In the days to come, President Obama will be well served to consult his own speech when the details of policy seem about to overwhelm what the heart is saying.
Now that both teams are playing from their hearts, it should be a heck of an election year.
Raphael J. Sonenshein is chair of the Division of Politics, Administration and Justice at California State University, Fullerton.
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