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The Battle over Medicare Reform Begins Today

In addition to the lessons from Tuesday’s special election in NY-26, Republicans and conservatives face four consequences regarding Medicare in the aftermath of that defeat:

(1.) Medicare wasn’t the only reason Republicans lost the seat, but it was the most important reason—and the loss should act as a warning shot across the GOP bow. Right now Republicans are losing the political debate on Medicare, and unless they are able to substantially alter public opinion, the results in NY-26 will be writ large across the country.

(2.) Republicans face essentially two choices. One is to abandon the plan put forward by House Budget Committee chairman Paul Ryan, hoping the Emily Latella appeal, “Never mind,” works as a political strategy. It won’t. The vast number of Congressional Republicans, in both the House and Senate, are on record having voted for the Ryan plan. To jettison the plan now would be political calamitous, giving the GOP the worst of all worlds. Having cast a difficult but principled vote and then backing away from it or refusing to defend it would embolden Democrats, dispirit the GOP base, and disgust independents. Democrats are going after the GOP on Medicare with ferocious intensity regardless what Republicans do; GOP lawmakers therefore need to decide whether they’ll fight back or be eviscerated.

(3.) The other option is to defend the Ryan plan in an effort to reshape public sentiments. Now, I suppose it’s possible that even a perfectly executed PR offensive will fail, that the nation is unalterably opposed to reforming Medicare along the lines that Paul Ryan has sketched out, and that the public is wed to the system we have. But that type of fatalism is, I think, unmerited. American history if chock full of successful social reforms that many people once thought were pipe dreams. That doesn’t necessarily mean Medicare reform will take its place among them; it simply means that difficult tasks aren’t impossible ones. And Americans tend to be drawn to political movements and parties led by operational optimists rather than theoretical pessimists.

(4.) For those who don’t believe the outcome of this debate is preordained, it comes down to (a) the intellectual merits of the case for reform and (b) the ability to communicate in a compelling way to the public. I’ll deal with the former in a later post. For now, though, the mindset of the GOP needs to be that this debate can be won, which requires a robust defense of the Ryan plan (including countering the avalanche of lies about it); going on the offensive against the defenders of the status quo ante (who will, if they have their way, both destroy Medicare and do enormous damage to the lives of future seniors); and mapping out an comprehensive and intensive 18-month public education campaign.

Representative Ryan is far and away the best advocate for entitlement reform in America. But Republicans can’t simply rely on his appearances on Morning Joe, interviews on talk radio, and columns in the Wall Street Journal—as important as they are—to carry the day. Each Member of Congress and candidate for high public office needs to master this issue and the art of public persuasion and proclaim their message in every conceivable venue.

Those of us who don’t believe this particular battle is lost barely before it has begun shouldn’t kid ourselves about degree of difficulty we face. There is no politically successful precedent for the scale of entitlement reform Ryan is proposing; there are tens of millions of Americans who, at the outset of this debate, are uninformed or misinformed about the fiscal threat we face and Medicare’s role in it; and Democrats are engaged in a campaign to frighten seniors that is, even by normal standards, unusually dishonest and demagogic. Some issue like welfare, crime, and taxes play to traditional GOP strengths. Medicare does not belong in the category. The habits and reflexes of the public start out against the Ryan plan.

But I for one believe the public can be won over by those championing reform, if only because I’m convinced that we conservatives have the far stronger case on the merits, and in the end the American public will settle, as they usually do, on the right and responsible course. And who knows, they may even reward lawmakers for courage.

In any event, the results of NY-26 revealed what most of us (including, I would hope, Members of Congress who voted for the Ryan plan) already knew. The contours of a Medicare debate are well-established and won’t be changed easily or overnight. Which means the campaign to win the hearts and minds of Americans better begin in earnest today.



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