Full Circle

How Paul Ryan’s Medicare Plan Is Coming Back to Haunt Obama

The Democrats thought Paul Ryan’s plan was DOA. Now it’s coming back to hurt them. By Mark McKinnon.

Evan Vucci / AP Photos

Boom. That’s the sound of Team Obama getting hit with a boomerang of a messaging strategy.

Last year Democrats gleefully attacked Paul Ryan as a granny killer for daring to take on Medicare reform. They thought their point was won; Ryan was buried in an avalanche of ridicule. Americans typically don’t like their entitlements threatened; seniors and near-seniors—the groups most likely to turn out on Election Day—are particularly wary, as they should be.

But Mitt Romney pulled a surprise, nominating Ryan as his running mate. R-squared then launched a direct attack on the president’s cuts in Medicare spending. And “Boom!” The big stick just came back and hit the Dems: a recent poll in all-important Florida shows folks there are a bit more terrified right now—and seniors even more so—of the president’s health-care law and its affect on Medicare than of Ryan’s proposal.

But there are still weeks and onslaughts to go. Charges are already furiously flying back and forth. “Their plan ends Medicare as we know it” is met with “the president is raiding Medicare.”

Well, in politics, not all lies are all lies. And not all truths are complete.

Both the Romney/Ryan and Obama plans end Medicare “as we know it.” The program is running out of money as fewer people pay in than receive benefits. In just 12 years, Medicare’s hospital trust fund is predicted to become insolvent. And for the next 17½ years, 10,000 baby boomers will reach age 65 every day. So, it’s really just a question of when the end comes—for Medicare, Medicaid, and Social Security—and what happens next.

It’s also true that the president has cut more than $700 billion from Medicare and credits it toward the cost of Obamacare. While some of those cuts are admirable—everyone wants to see fraud reduced—other cuts are in payments to providers. And it’s a bit disingenuous of Team Obama to claim these cuts won’t affect benefits. In Texas, one of the few states to track doctor drop-outs, the number of physicians accepting Medicare patients fell from 78 percent in 2000 to 58 percent in 2012—because of cuts in payments, with more cuts to come. Punishing doctors with lower, sometimes below-cost fees for treating Medicare patients means fewer doctors, decreased care, and even—yes—the potential for rationing of care.

Ryan’s original plan also cut Medicare spending at a similar level, but through consumer choice, competition, and market forces, not punitive cost controls. And he planned to return those dollars to the Medicare trust fund. Sensing the shifting winds, Romney has stepped up the messaging battle, promising to restore the president’s cuts. Critics charge this will speed the program’s insolvency, but those arguments are moot if costs are lowered with the fixed-benefit, premium-support system he has proposed. Of course, the devil is in the details, and more are needed.

But at some point, folks will stop listening to all those confusing details about baselines and budgets, and all of the charges and countercharges. The decision will come down to a matter of trust. Who has earned it? Who has shown leadership? Sadly, all of this could have been avoided had President Obama simply led and acted on the 2010 Simpson-Bowles plan.

In politics, what goes around comes around. And Chicago better duck. Here comes a boomerang in a headwind.