Commentary Magazine


Topic: Medicare

Presidential Longevity and Social Security

Today is George H.W. Bush’s 90th birthday. That is certainly an event worth celebrating, and may he enjoy many more. But it is also illustrative of a remarkable increase in longevity enjoyed by recent presidents (and the rest of us).

Before there were presidents there were English sovereigns. Not one of them lived to see his or her 70th birthday until George II, who died in 1760, aged 76. To be sure a few of them, such as Edward II, Richard II, and Henry VI, were assisted early into that good night for political reasons.

Of the first six presidents, four of them (Adams, Jefferson, Madison, and John Quincy Adams), remarkably, lived to be over 80 and John Adams lived to be 90 and 8 months, a presidential longevity record that would last into the 21st century, until Ronald Reagan surpassed him in 2001. But from John Quincy Adams to Herbert Hoover, more than a century later, no president made it to 80. Hoover lived to be 90 and two months. Harry Truman, who died at the age of 88, was the only other president to live to 80 until Richard Nixon.

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Today is George H.W. Bush’s 90th birthday. That is certainly an event worth celebrating, and may he enjoy many more. But it is also illustrative of a remarkable increase in longevity enjoyed by recent presidents (and the rest of us).

Before there were presidents there were English sovereigns. Not one of them lived to see his or her 70th birthday until George II, who died in 1760, aged 76. To be sure a few of them, such as Edward II, Richard II, and Henry VI, were assisted early into that good night for political reasons.

Of the first six presidents, four of them (Adams, Jefferson, Madison, and John Quincy Adams), remarkably, lived to be over 80 and John Adams lived to be 90 and 8 months, a presidential longevity record that would last into the 21st century, until Ronald Reagan surpassed him in 2001. But from John Quincy Adams to Herbert Hoover, more than a century later, no president made it to 80. Hoover lived to be 90 and two months. Harry Truman, who died at the age of 88, was the only other president to live to 80 until Richard Nixon.

But starting with Nixon, every president has either lived to the age of 80 or is still alive. Reagan and Ford each lived to be 93, and Ford holds the longevity record at the moment, dying at the age of 93 and five months. On October 1 this year, Jimmy Carter will also turn 90.

Living to 100 used to be exceedingly rare, but not anymore. Among the famous who have reached 100 in recent decades are Irving Berlin, the Queen Mother, Rose Kennedy, Brooke Astor, Bob Hope, and George Burns. I have a friend who is in robust good health at the age of 84. Her mother, in equally robust health except for being a bit deaf, is 109.

All this, while unreservedly good news for all of us, has profound policy implications regarding entitlement programs such as Medicare and Social Security. The latter program was instituted in 1935 and set the age for receiving benefits at 65. The reason 65 was chosen is that that was the life expectancy in the 1930s. Today, in the United States, it is 79.8 for women and 77.4 for men and rising quickly. That is no small part of the reason both programs are headed inexorably toward insolvency unless Congress acknowledges mathematical and medical reality.

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Rubio and the Modernization of the GOP

For the last several years the right has been very clear about what government should not be doing, or should be doing much less of. But it has not had nearly enough to say about just what government should do: what intellectually serious reforms it needs to make to improve the lives of (in particular) middle-class Americans.

That’s changing, thanks in good measure to people like Marco Rubio.

I’ve had some differences with Senator Rubio in the past. (For example, I strongly opposed the legislative tactic that led to the shutdown of the federal government last October.) But Senator Rubio–along with Senators Mike Lee and Rob Portman, Representative Paul Ryan, and Governors Bobby Jindal, Mike Pence, and Scott Walker, among others–is making an important contribution to the Republican Party by offering ideas on how to reform government to meet 21st century challenges.

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For the last several years the right has been very clear about what government should not be doing, or should be doing much less of. But it has not had nearly enough to say about just what government should do: what intellectually serious reforms it needs to make to improve the lives of (in particular) middle-class Americans.

That’s changing, thanks in good measure to people like Marco Rubio.

I’ve had some differences with Senator Rubio in the past. (For example, I strongly opposed the legislative tactic that led to the shutdown of the federal government last October.) But Senator Rubio–along with Senators Mike Lee and Rob Portman, Representative Paul Ryan, and Governors Bobby Jindal, Mike Pence, and Scott Walker, among others–is making an important contribution to the Republican Party by offering ideas on how to reform government to meet 21st century challenges.

On Tuesday the junior senator from Florida focused his attention on retirement security. In a speech at the National Press Club, Rubio offered a plan to open up to more Americans the Thrift Savings Plan (TSP) offered to every member of Congress and federal employee. The TSP allows federal employees to save pre-tax money for their retirement with fees lower than most private defined-contribution plans. Senator Rubio proposed that all Americans who do not have access to employer-sponsored plan be given the option of enrolling, which would boost Americans’ savings and help to supplement Social Security income.

“The twisted irony is that members of Congress – who are employees of the citizens of the United States – have access to a superior savings plan, while many of their employers – the American people – are often left with access to no plan at all,” Rubio said during his speech.

Other proposals include eliminating the 12.4 percent Social Security payroll tax for all individuals who have reached retirement age; eliminating the Retirement Earnings Test that can take away some Social Security benefits for recipients who continue to work (eliminating the RET would raise employment among early retirees); reducing the growth of benefits for upper income seniors; raising the retirement age for younger workers; and transitioning Medicare to a premium support system, which would give seniors a fixed amount of money to use for purchasing health insurance from either Medicare or a private provider.

There are several notable things about Senator Rubio’s speech. (I should say that in my position as a senior fellow at the Ethics and Public Policy Center I met with Senator Rubio and several policy experts prior to the speech and reacted favorably to an early draft of it.) The first is the educative quality of the address, laying out the case for reform in a calm, reasonable, and empirical way. The second is an admirable candor, with Rubio saying, “While [economic] growth is essential, growth alone will not be enough.” A third thing to note about the speech is that Senator Rubio spoke about wanting to strengthen and save, not uproot and eliminate, programs like Social Security and Medicare. He spoke in personal terms about the role those programs have played in the lives of his parents. Fourth, he attempted to put opponents of reform on the defensive, saying, “Anyone who is in favor of doing nothing about Social Security and Medicare is in favor of bankrupting Social Security and Medicare.”

Fifth and finally, Senator Rubio put a frame around this issue that is quite important. He explained that the retirement system we have in place does not line up with the needs and realities of our post-industrial economy. 

“In this new century, most people will live longer and voluntarily work longer,” Rubio said. “And many people will change jobs countless times, often in business for themselves or working for companies that do not offer retirement savings plans or pensions. Therefore, our retirement programs must be modernized and restructured to address the new economy that is here to stay.”

What Senator Rubio is doing, then, is putting the Republican Party on the side of modernization and reform in contrast to reactionary liberalism, which is sclerotic and brittle, out of ideas and out of energy. This is precisely what needs to happen if the GOP hopes to become the majority party in America. Senator Rubio–energetic, engaging, interested in ideas, and cheerful rather than resentful–is among the most persuasive advocates for his party.

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The Liberal Slandering of Paul Ryan

If you want to know how fearful the left is of Paul Ryan, consider the efforts they make to slander him. In the past, they’ve portrayed him as someone eager to (literally) throw grandma over a cliff. The reason? Ryan wanted to make eminently sensible and absolutely necessary changes to Medicare.

Then came Barack Obama, who, when describing Ryan’s budget, made recklessly untrue assertions, saying (among other things) that Republicans want the elderly and autistic and Down syndrome children to “fend for themselves.”

And now, as Jonathan Tobin has written, comes the latest attempted mugging of Ryan, this time for what he said on Bill Bennett’s “Morning in America” program last week. When discussing his forthcoming effort to combat poverty, the House Budget Committee chairman and 2012 GOP vice presidential candidate said this:

We have got this tailspin of culture, in our inner cities in particular, of men not working and just generations of men not even thinking about working or learning the value and the culture of work, and so there is a real culture problem here that has to be dealt with.

The left immediately attacked. Some, like Representative Barbara Lee, accused Ryan of mounting a “thinly veiled racial attack”–one that “cannot be tolerated.” Others, like New York Times columnist Paul Krugman, wrote that Ryan’s words amounted to a “racial dog whistle.”

These charges, and there are plenty of others like them, are grotesquely false. I have known Ryan since he was a colleague at Empower America in the 1990s. One of the reasons he was so close to both Bennett and Jack Kemp is because Ryan had a deep concern for those living in the shadows of society, including in America’s inner cities. He also believes Republicans have not focused enough on the problems plaguing the underclass. Both help explain his latest effort to offer conservative solutions to rising poverty. 

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If you want to know how fearful the left is of Paul Ryan, consider the efforts they make to slander him. In the past, they’ve portrayed him as someone eager to (literally) throw grandma over a cliff. The reason? Ryan wanted to make eminently sensible and absolutely necessary changes to Medicare.

Then came Barack Obama, who, when describing Ryan’s budget, made recklessly untrue assertions, saying (among other things) that Republicans want the elderly and autistic and Down syndrome children to “fend for themselves.”

And now, as Jonathan Tobin has written, comes the latest attempted mugging of Ryan, this time for what he said on Bill Bennett’s “Morning in America” program last week. When discussing his forthcoming effort to combat poverty, the House Budget Committee chairman and 2012 GOP vice presidential candidate said this:

We have got this tailspin of culture, in our inner cities in particular, of men not working and just generations of men not even thinking about working or learning the value and the culture of work, and so there is a real culture problem here that has to be dealt with.

The left immediately attacked. Some, like Representative Barbara Lee, accused Ryan of mounting a “thinly veiled racial attack”–one that “cannot be tolerated.” Others, like New York Times columnist Paul Krugman, wrote that Ryan’s words amounted to a “racial dog whistle.”

These charges, and there are plenty of others like them, are grotesquely false. I have known Ryan since he was a colleague at Empower America in the 1990s. One of the reasons he was so close to both Bennett and Jack Kemp is because Ryan had a deep concern for those living in the shadows of society, including in America’s inner cities. He also believes Republicans have not focused enough on the problems plaguing the underclass. Both help explain his latest effort to offer conservative solutions to rising poverty. 

It should matter that what Ryan told Bennett is true, as anyone who has spent time in America’s inner cities and working with kids there can testify. The reasons for the hardships facing those living in America’s inner cities are complicated and not simply cultural; they are economic as well. But to say that there isn’t a problematic culture that has taken root in America’s inner cities is a lie; and to attack those like Ryan who speak about it is to compound the lie.

Why are some liberals doing this? For one thing, they are intellectually exhausted. They know they cannot win the debate on the merits, and so they resort to ad hominem attacks. It is what some on the left instantaneously resort to. Mr. Krugman is a prime example of this. He is a man who seems to gain energy from nursing his political hatreds and takes delight in degrading political commentary. (The latter isn’t an easy achievement.) 

But as Jonathan points out, there’s something more fundamental going on here. Liberals who have complicity in the problems plaguing America’s inner cities are attempting to make an honest conversation about poverty impossible. They are signaling that they intend to try to take out Republicans who want to address some of the root causes, the behavioral causes, of poverty.

The danger here is two-fold. One is that by promiscuously invoking racism when it doesn’t apply, they are draining the term of real meaning. Many people already have stopped, and many more will stop, paying attention when the term is so carelessly bandied about.

The other is that some on the left not only aren’t focusing on the institutions, policies, and individuals who are responsible for exacerbating poverty; they are actually building a protective wall around them. For them the villain isn’t, say, the ruinous public school systems in Chicago, Detroit, and D.C. that are destroying the lives and future of hundreds of thousands of kids; it’s Paul Ryan, who among other things supports school choice for inner-city parents. This is what large parts of liberalism have been reduced to: the praetorian guard of corrupt, poverty-creating institutions and organizations.

Paul Ryan is among the most decent and admirable politicians in America. He’s also among the smartest. Which explains the obsession and hatred many on the left have with him. He’s a threat to their ideas, to their policies, and ultimately to their power. The viciousness of their attacks is a testimony to his effectiveness. What was said by those who supported Franklin Roosevelt can also be said by those who admire Paul Ryan: We love you for the enemies you have made.

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Government Waste … and Squirrels

Imagine that a health insurance company chose a random sample of payments made to its claimants and found that 10.1 percent of them should not have been paid at all, either through error or fraud. What do you suppose would happen?

First, whoever was in charge of accounts payable would be fired on the spot, his office contents on the sidewalk in cardboard boxes before the day was out. Second, a thorough overhaul of procedures would be quickly put into place to make sure the error rate was reduced to as near zero as possible. Third, a federal prosecutor would open an investigation into possible criminal activity. Fourth, a congressional committee would convene hearings and beat up the CEO for charging such high premiums when simply running his company properly would have allowed them to be drastically reduced. 

But when Medicare’s fee-for-services programs ran exactly this error rate, the result was … oh, look, a squirrel!

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Imagine that a health insurance company chose a random sample of payments made to its claimants and found that 10.1 percent of them should not have been paid at all, either through error or fraud. What do you suppose would happen?

First, whoever was in charge of accounts payable would be fired on the spot, his office contents on the sidewalk in cardboard boxes before the day was out. Second, a thorough overhaul of procedures would be quickly put into place to make sure the error rate was reduced to as near zero as possible. Third, a federal prosecutor would open an investigation into possible criminal activity. Fourth, a congressional committee would convene hearings and beat up the CEO for charging such high premiums when simply running his company properly would have allowed them to be drastically reduced. 

But when Medicare’s fee-for-services programs ran exactly this error rate, the result was … oh, look, a squirrel!

As the Fiscal Times reports, the Department of Health and Human Services in fiscal 2013 had exactly that error rate and paid no less than $33.2 billion that it shouldn’t have paid at all. Overall, HHS paid out $55.9 billion improperly. And what did HHS do about this?

Asked what the agency does to recoup improper payments, [Center for Medicare and Medicaid services spokesman Tony] Salters said CMS doesn’t even attempt to recover all of its estimated overpayments. When improper payments are identified in the random sample, he said, agency contractors attempt to recover it, and get “most” of that money back. However, the improper payments identified in the sample represent only a fraction of the total amount paid out incorrectly.

The Office of Management and Budget, an arm of the White House, estimates that in just 13 “high-error programs” in fiscal 2012, the government wrongly paid out a staggering $101.3 billion. That’s 2.86 percent of total federal spending that year, 9.3 percent of the budget deficit, and $16 billion more than the entire sequester for fiscal 2013 ($85.4 billion) that the Washington establishment proclaimed would be the end of the world if it went into force.

Insurance companies run far tighter ships, looking constantly for ways to cut costs and eliminate fraud and error, for the simple reason that it is in their interest to do so. Every penny of the money saved, after all, goes right to the bottom line. Any company with a 10.1 percent error rate would be in bankruptcy court in weeks. But the federal government can’t go bankrupt, so … oh, look, a squirrel! 

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The Middle-Class ObamaCare Conundrum

A funny thing is happening on the way to universal popularity and acceptance for the president’s signature health-care legislation. No, I’m not referring to the dysfunctional website that turned ObamaCare and Health and Human Services Secretary Kathleen Sebelius into a laughingstock. As bad as the website’s problems have been and continue to be, the growing coverage of Americans who have lost their coverage as a result of the new law, as well as the higher costs many, if not most of them are now facing, poses a far greater danger to ObamaCare’s supporters.

The key to understanding the strategy employed by the administration is their total faith in the idea that although the rollout might be problematic, once it is implemented the new benefits granted to poor Americans would become so popular as to make it untouchable. Like Social Security and Medicare, they reasoned that the reality of ObamaCare would render it invulnerable to criticism, let alone repeal. That was a belief shared by Republicans who feared the same thing and clearly impelled Tea Party supporters to back a government shutdown as a last-ditch attempt to derail the law. But the drip-drip of stories about those who are ObamaCare losers is showing that both liberals and conservatives may have been dead wrong about the bill’s staying power.

An example of this comes today from, of all places, the New York Times op-ed page where psychotherapist Lori Gottlieb writes about the misfortune of being a self-employed person whose insurance was dropped and then replaced with a new plan that cost her a whopping $5,400 extra per annum. As she writes, her new coverage is “better” as President Obama and his apologists keep insisting, but that comes with a few caveats:

Now if I have Stage 4 cancer or need a sex-change operation, I’d be covered regardless of pre-existing conditions. Never mind that the new provider network would eliminate coverage for my and my son’s long-term doctors and hospitals.

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A funny thing is happening on the way to universal popularity and acceptance for the president’s signature health-care legislation. No, I’m not referring to the dysfunctional website that turned ObamaCare and Health and Human Services Secretary Kathleen Sebelius into a laughingstock. As bad as the website’s problems have been and continue to be, the growing coverage of Americans who have lost their coverage as a result of the new law, as well as the higher costs many, if not most of them are now facing, poses a far greater danger to ObamaCare’s supporters.

The key to understanding the strategy employed by the administration is their total faith in the idea that although the rollout might be problematic, once it is implemented the new benefits granted to poor Americans would become so popular as to make it untouchable. Like Social Security and Medicare, they reasoned that the reality of ObamaCare would render it invulnerable to criticism, let alone repeal. That was a belief shared by Republicans who feared the same thing and clearly impelled Tea Party supporters to back a government shutdown as a last-ditch attempt to derail the law. But the drip-drip of stories about those who are ObamaCare losers is showing that both liberals and conservatives may have been dead wrong about the bill’s staying power.

An example of this comes today from, of all places, the New York Times op-ed page where psychotherapist Lori Gottlieb writes about the misfortune of being a self-employed person whose insurance was dropped and then replaced with a new plan that cost her a whopping $5,400 extra per annum. As she writes, her new coverage is “better” as President Obama and his apologists keep insisting, but that comes with a few caveats:

Now if I have Stage 4 cancer or need a sex-change operation, I’d be covered regardless of pre-existing conditions. Never mind that the new provider network would eliminate coverage for my and my son’s long-term doctors and hospitals.

This complaint is acknowledged by yet another pro-ObamaCare editorial published by the same newspaper that finally acknowledged that millions of Americans are going to be adversely affected by the plan. The Times assures us that those who are being inconvenienced by liberal largesse are better off in the long run, but even if they are not, they are confident that “not all … will necessarily be upset” about it. But as the number of ObamaCare losers grows as the effects are gradually felt throughout the health-care system, that faith may prove to be misplaced. As more people like Gottlieb voice their grievances, the notion that the law is irrevocable may prove to be a myth.

Gottlieb, who clearly is part of a liberal milieu, complains that few in her circle are particularly sympathetic. Most seem to think that helping the poor is worth the cost of bilking those who are somewhat better off. Judging by the reaction of her 1,000-plus Facebook friends, her statement that “the president should be protecting the middle class, not making our lives substantially harder” isn’t getting much traction. But it would be foolish for anyone, especially those working hard to silence such complaints, to think that public opinion, which polls show has always viewed ObamaCare negatively, will react in the same way.

This is a critical point. So long as the discussion about ObamaCare was one pitting conservative complaints about an unconstitutional power grab by the federal government and the perils of moving a step closer to socialized medicine against the well being of the poor and the uninsured, both Democrats and Republicans were probably right to think that implementation would be the effective end of the debate. But, to the surprise of both the left and the right, the discussion has moved from economic and constitutional principles to something more visceral and far more dangerous to the president’s plans. Once those opposing ObamaCare are able to use that magic phrase, “protecting the middle class” in the context of opposing liberal projects rather than in defense of them, a tipping point may have been reached.

Lori Gottlieb’s liberal Facebook friends may not think her plight is worth caring about. But the critical mass of voters will always be moved to anger against anything that is perceived as an attack on the vast middle class that forms the majority of the electorate and the backbone of American society.

Americans are a goodhearted and generous people. That’s why the Times thinks they will absorb this blow without much complaint because creating a new federal “health care safety net” is worth it. But unlike previous federal entitlements that expanded benefits for many and hurt few, ObamaCare is predicated on a very different formula that may, despite the Times’s assurances, hurt as many, if not more, people than it helps. That is something very different from Social Security or even Medicare. Like the corruption and the social pathologies bred by the welfare state that liberals have also urged Americans to accept whether they like it or not, this makes ObamaCare a subject for permanent debate and possible repeal. Conservatives who acted rashly out of despair this fall need to understand that when Obama loses the Lori Gottliebs of this world, liberalism starts to lose.

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ObamaCare’s Crony Capitalism: Worse than We Thought

At times it seems like the sheer magnitude of bad news about ObamaCare can redound to its own benefit. It’s easy for individual pieces of bad news to get lost in the sea of failure that has characterized the Obama administration’s signature “achievement.” That might be the case with the most important story to appear about ObamaCare this week, from Tuesday’s edition of the New York Times.

The paper reported that the Obama administration has ruled that the federal health-care program be exempted from the category of laws considered “federal health care programs.” Now, this is obviously dishonest: the federal government is running insurance exchanges, funding health-care subsidies under the law, and employing federal workers to help manage the law–all of which are clearly “federal health care programs.” So why would the administration choose not to label them according to observable reality? Because, as the Times explained, this decision–believe it or not–exempts ObamaCare from kickback restrictions and anti-fraud protections:

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At times it seems like the sheer magnitude of bad news about ObamaCare can redound to its own benefit. It’s easy for individual pieces of bad news to get lost in the sea of failure that has characterized the Obama administration’s signature “achievement.” That might be the case with the most important story to appear about ObamaCare this week, from Tuesday’s edition of the New York Times.

The paper reported that the Obama administration has ruled that the federal health-care program be exempted from the category of laws considered “federal health care programs.” Now, this is obviously dishonest: the federal government is running insurance exchanges, funding health-care subsidies under the law, and employing federal workers to help manage the law–all of which are clearly “federal health care programs.” So why would the administration choose not to label them according to observable reality? Because, as the Times explained, this decision–believe it or not–exempts ObamaCare from kickback restrictions and anti-fraud protections:

The surprise decision, disclosed last week, exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare.

The main purpose of the anti-kickback law, as described by federal courts in scores of Medicare cases, is to protect patients and taxpayers against the undue influence of money on medical decisions. …

Under the Affordable Care Act, millions of people will be able to buy insurance from “qualified health plans” offered on exchanges, or marketplaces, run by the federal government and by some states.

Most of the buyers are expected to be eligible for subsidies to make insurance more affordable. The subsidies, paid directly to insurers from the United States Treasury, start in January and are expected to total more than $1 trillion over 10 years.

Ms. Sebelius said the Health and Human Services Department “does not consider” the subsidies to be federal health care programs. She reached the same conclusion with respect to federal and state exchanges, built with federal money, and with respect to “federally funded consumer assistance programs,” including the counselors, known as navigators, who help people shop for insurance and enroll in coverage through the exchanges.

This has two effects on the law: first, it encourages precisely the kickback schemes this statute was put in place to prevent; and second, it could easily produce an enormous financial burden on the government. The prescription drug “kickback” scheme is how federal law enforcement officials describe the practice in which drug companies give customers coupons to purchase their brand-name medications instead of lower-cost alternatives. The coupons reduce the cost for consumers, but not for insurers or government agencies paying out reimbursement costs. This creates a windfall for the drug companies at high cost to insurers and the government.

So why would the government actively facilitate corruption under ObamaCare, especially at the risk of ballooning its own costs and collapsing its budget estimates?

The answer has to do with the revelations of major drug companies’ cooperation with President Obama on shepherding ObamaCare to the finish line. In June 2012, the Wall Street Journal explained how this particular partnership formed. In 2009, drug companies were concerned that an Obama-led health-care reform effort would emphasize price controls and re-importation allowance–the latter being the process by which drugs sold cheaper abroad could be re-sold here, a case of foreign quasi-socialist health-care systems undermining the market forces in the U.S. that enable companies to be able to conduct the research and development that produces the drugs in the first place.

The administration worked out a deal with the pharmaceutical giants, but then Democratic Representative Henry Waxman demanded further concessions from the drug industry. The White House stepped in to protect them, and the drug companies responded with more pro-ObamaCare advertising.

That appeared to be the extent of the already-nauseating crony capitalism at the heart of ObamaCare. But the Times story suggests otherwise. And the inconsistency is the giveaway: the Justice Department is prosecuting high-profile companies (like Johnson & Johnson) for a practice the government plainly considers an illegal kickback scheme. And yet now that same government is giving the green light to the practice, which will be a financial boon to the companies that helped ObamaCare pass in the first place.

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Liberalism’s Desperate Comparison

One of the life rafts liberals are reaching for these days, in the midst of the disastrous rollout of the ObamaCare exchanges, is that the rollout of President Bush’s prescription drug plan was just as problematic.

That charge is silly and false. 

People can go back and read contemporaneous accounts for themselves, but what they’ll find is that the open enrollment window was much shorter, it basically worked, and when benefits started there were only a few minor snags that got cleaned up in a matter of weeks. The Medicare prescription drug plan was nothing like the Affordable Care Act’s rolling disaster.

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One of the life rafts liberals are reaching for these days, in the midst of the disastrous rollout of the ObamaCare exchanges, is that the rollout of President Bush’s prescription drug plan was just as problematic.

That charge is silly and false. 

People can go back and read contemporaneous accounts for themselves, but what they’ll find is that the open enrollment window was much shorter, it basically worked, and when benefits started there were only a few minor snags that got cleaned up in a matter of weeks. The Medicare prescription drug plan was nothing like the Affordable Care Act’s rolling disaster.

Now this needs to be added: The Medicare Part D rollout started with the huge advantage of an existing program, with existing and ongoing communications with the beneficiaries. Part D could be built on top of that infrastructure, which was not possible with the Affordable Care Act. That said, the free-market reforms put forward by President Bush in Medicare worked (for the reasons why, you might take a look at this piece James Capretta and I wrote a few years ago). The same thing, I’m venturing to guess, won’t be said about ObamaCare at a comparable period. 

Desperate liberals reach for desperate comparisons. This is one of them.

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Medicine and Market Forces

One of the clearest signs that market forces are being stymied is a wide spread between the top and bottom price for a commodity. Nowhere is this more conspicuous than in medical services. The price of treating, say, a simple fracture of the arm can, and does, vary by hundreds of percent. A simple remedy for this would be to require medical service providers to post prices for routine procedures. Market forces would immediately begin to cause those prices to converge toward the bottom end.

Would it be a panacea for all that’s wrong with American medicine? Of course not. But would it be a powerful inducement to cut costs and make medicine more efficient, lowering prices further? It could hardly help but be so. And, like that sovereign remedy for all that ails us—chicken soup—it can’t hurt. A big plus would be that it wouldn’t cost government a dime.

Now’s there’s evidence from a clinic, the Surgery Center of Oklahoma, that it actually works (h/t Instapundit). It started posting prices, which turned out to be far lower than other facilities, and people started coming from far and wide to take advantage of the lower prices. One of the local TV stations in Oklahoma City did a story on the clinic last week. It’s worth watching.

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One of the clearest signs that market forces are being stymied is a wide spread between the top and bottom price for a commodity. Nowhere is this more conspicuous than in medical services. The price of treating, say, a simple fracture of the arm can, and does, vary by hundreds of percent. A simple remedy for this would be to require medical service providers to post prices for routine procedures. Market forces would immediately begin to cause those prices to converge toward the bottom end.

Would it be a panacea for all that’s wrong with American medicine? Of course not. But would it be a powerful inducement to cut costs and make medicine more efficient, lowering prices further? It could hardly help but be so. And, like that sovereign remedy for all that ails us—chicken soup—it can’t hurt. A big plus would be that it wouldn’t cost government a dime.

Now’s there’s evidence from a clinic, the Surgery Center of Oklahoma, that it actually works (h/t Instapundit). It started posting prices, which turned out to be far lower than other facilities, and people started coming from far and wide to take advantage of the lower prices. One of the local TV stations in Oklahoma City did a story on the clinic last week. It’s worth watching.

As one of the founders explains:

“When we first started we thought we were about half the price of the hospitals,” Dr. Lantier said. “Then we found out we’re less than half price. Then we find out we’re a sixth to an eighth of what their prices are. I can’t believe the average person can afford health care at these prices.”

There are two things of particular interest in this story. One, the first non-local people to come to the clinic were from Canada. Why would people come from the single-payer paradise of Canada and pay their own money for a procedure they could get locally for free? That’s easy. Unless the condition is life threatening (and even if it is, if the patient is “too old”), you have to wait on line in Canada for elective procedures. And wait and wait and wait. Rationing is how Canadian medicine—totally devoid of market forces—keeps down costs.

Two, while the clinic accepts private insurance, it doesn’t take Medicare or Medicaid. Why? Those government programs forbid posting prices. One can only wonder why. It could be simply that bureaucrats love to promulgate rules, whether they make any sense or not. But I suspect it is because the real, ultimate goal of government health programs is to take control of one-sixth of the American economy. Anything that would make that harder, such as lower costs, is to be discouraged if not forbidden.

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The Political Implications of the Increase in Life Expectancy

The new, April, issue of National Geographic has maps of life expectancy for each county in the United States for 1989 and for 2009. (Apparently the digital version allows you to click on any particular county and get the local information, once you shell out $19.95 for a digital subscription.)

The story emphasizes the fact that life expectancy for men has increased more than it has for women over these 20 years and suggests that this may be due to inadequate treatment for women with high blood pressure and cholesterol. But it seems to me (though I am no epidemiologist) that that discrepancy might be due to the fact that women live longer than men and thus have less upside potential.

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The new, April, issue of National Geographic has maps of life expectancy for each county in the United States for 1989 and for 2009. (Apparently the digital version allows you to click on any particular county and get the local information, once you shell out $19.95 for a digital subscription.)

The story emphasizes the fact that life expectancy for men has increased more than it has for women over these 20 years and suggests that this may be due to inadequate treatment for women with high blood pressure and cholesterol. But it seems to me (though I am no epidemiologist) that that discrepancy might be due to the fact that women live longer than men and thus have less upside potential.

To me, the most startling fact in this data dump is just how fast life expectancy has increased for both sexes: 4.6 years for men and 2.7 years for women. That’s a 6.4 percent increase for men and a 3.4 percent increase for women in just two decades.

There was a similar leap in life expectancy in the early 20th century, but that increase was due to much lower infant and childhood mortality thanks to vaccines against such child-killers as whooping cough and diphtheria and the mandated pasteurization of milk, which eliminated the horrendous number of infant deaths caused by impure milk.

This latter-day increase comes at the end of life. Partly it is due to medicine’s greatly increased ability to cure or manage such killers as pneumonia, heart disease, and cancer. Partly it is due to a greatly improved environment, especially in cities and factories. And partly it is due to improved life styles, with more exercise and less fat, alcohol and tobacco.

There is no reason to think that this increase in life expectancy will abate any time soon. Indeed, it may accelerate. And that has tremendous public-policy implications with regard to Social Security, Medicare, etc. And as the percentage of old people increases in the population, their political clout will increase with it.

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The Strange, but Revealing, Budget Process

I suppose it says something about Washington that the act of voting on a federal budget is now a symbolic exercise with relevance only to the next congressional election’s various campaign advertisements. But we are now represented by a Congress which approaches the budget process with no intention of enacting an actual budget. The only measure of true bipartisan agreement is that President Obama’s ideas are terrible, unable to muster any support on either side of the isle.

So the president has apparently given up. Among the many budget-related stunts and shenanigans this week was a House Republican demand for a vote on President Obama’s 2014 budget–which is currently nonexistent, and therefore a blank page. The Senate, which is controlled by Democrats, has been unwilling and unable to pass a budget; the House, controlled by Republicans, passed a budget today, as they do each year (a novel concept Democrats still don’t seem to understand). Both parties in the House presented budgets they knew wouldn’t pass before approving the GOP budget. That resulted in a frightening moment for the party in power, when they risked accidentally passing a budget produced by their own party that was not the one they actually wanted to enact. As the Hill reported on a Republican Study Committee-produced budget yesterday:

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I suppose it says something about Washington that the act of voting on a federal budget is now a symbolic exercise with relevance only to the next congressional election’s various campaign advertisements. But we are now represented by a Congress which approaches the budget process with no intention of enacting an actual budget. The only measure of true bipartisan agreement is that President Obama’s ideas are terrible, unable to muster any support on either side of the isle.

So the president has apparently given up. Among the many budget-related stunts and shenanigans this week was a House Republican demand for a vote on President Obama’s 2014 budget–which is currently nonexistent, and therefore a blank page. The Senate, which is controlled by Democrats, has been unwilling and unable to pass a budget; the House, controlled by Republicans, passed a budget today, as they do each year (a novel concept Democrats still don’t seem to understand). Both parties in the House presented budgets they knew wouldn’t pass before approving the GOP budget. That resulted in a frightening moment for the party in power, when they risked accidentally passing a budget produced by their own party that was not the one they actually wanted to enact. As the Hill reported on a Republican Study Committee-produced budget yesterday:

Democrats voted present to force more Republicans to vote against the Republican Study Committee’s (RSC) budget. Democrats hoped that by getting their members to vote present instead of against the budget, it might be approved by the House.

That would have allowed Democrats to train their campaign ads on the RSC budget, which would boost the Social Security age to 70 and cut Medicare benefits, including for people now 59 years old. The RSC blueprint would balance the budget in four years.

That is, for better or worse, our current budget debate in a nutshell. Democrats think the budget is terrible for the country, so they want it to pass; and though it does more to fix entitlements and balance the budget than any other GOP plan, Republicans wanted it to fail so they could then pass a budget that does those things less effectively but more palatably. The latter budget–Paul Ryan’s budget–passed this morning.

The Ryan plan sets the federal government on the path to a balanced budget and preserves Medicare. The Democrats in the Senate will respond with their own budget, which will increase spending and taxes and endanger entitlements by leaving them on an unsustainable path. Democrats are happy with both budgets, because they won’t have to worry about enacting their own plan and the fiscal ruin it is designed to bring upon the country, but they also think Ryan’s plan to save Medicare is unpopular and will hurt Republicans in the next midterm elections as Democrats ramp up their demagoguery and scare tactics.

On that note, Sean Trende has an edifying column today in which he cautions Democrats that they may be right about the Ryan budget, but they are taking much more of a leap of faith than they think. Democrats base some of the triumphalism on the belief that the Ryan budget, and more generally the talk of reforming entitlements and practicing austerity, cost the GOP votes in November. But Trende adds some context. The whole thing is worth reading, but Trende notes the exit polls showed the public trusted the GOP ticket on the economy more than Obama; that the claim that Republicans only held the House due to redistricting has been debunked; that demographics played a role in helping re-elect Obama that was unrelated, to a certain degree, to austerity plans; and that there were more supporters of Democratic candidates than of liberal policy objectives, among other insights into the polling data.

Additionally, Democrats had far less traction with this issue among key demographics than they expected. As the Palm Beach Post reported in August of last year:

But two Florida polls conducted since Ryan’s selection suggest that voters who are 65 and older support Ryan and his budget plan more than younger voters do. A third Florida poll released this week doesn’t include an age breakdown, but finds the state’s voters agreeing more with Ryan’s description of his budget and Medicare plan than with Democratic criticisms that it would “end Medicare as we know it.”

Democrats may think that bringing up the Ryan budget every year is going to pigeonhole Republicans as the party that wants to “end Medicare as we know it,” but it’s possible that the Democrats’ dishonest Mediscare tactics may lose their already questionable potency through exaggeration and obnoxious repetition.

Additionally, it will continue to draw contrast between the Republicans’ debt-cutting agenda, which is less popular than the GOP hoped but more popular than Democrats expected, and the Democrats’ steadfast refusal to take issues of debt and deficit seriously. After all the budget machinations this week, one thing remained constant: Republicans passed a budget with a plan to fix the nation’s finances, and Obama produced a blank sheet of paper. Both parties seem willing to take that message to the voters.

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Entitlement Reform and Common Ground

In a New York Times op-ed, my Ethics and Public Policy colleague Yuval Levin offers a simple, excellent idea that offers a way out of our current political impasse on entitlements.

He argues that Medicare and Social Security should be means-tested (e.g., allocating benefits according to need) and explains, with typical intelligence and clarity, why that’s something both Democrats and Republicans should be able to agree on. He writes:

Some on the left might complain that curtailing our entitlement programs’ universal character would undermine their social purpose and political support. But targeting benefits to those who most need them is surely better than reducing payments to providers (many of whom will drop out of Medicare), as President Obama’s 2010 law does. Some on the right might complain that such reforms would punish success. But surely rewarding achievement with government aid is no one’s idea of conservatism.

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In a New York Times op-ed, my Ethics and Public Policy colleague Yuval Levin offers a simple, excellent idea that offers a way out of our current political impasse on entitlements.

He argues that Medicare and Social Security should be means-tested (e.g., allocating benefits according to need) and explains, with typical intelligence and clarity, why that’s something both Democrats and Republicans should be able to agree on. He writes:

Some on the left might complain that curtailing our entitlement programs’ universal character would undermine their social purpose and political support. But targeting benefits to those who most need them is surely better than reducing payments to providers (many of whom will drop out of Medicare), as President Obama’s 2010 law does. Some on the right might complain that such reforms would punish success. But surely rewarding achievement with government aid is no one’s idea of conservatism.

I simply want to add that Levin’s proposal not only would save money, which is urgent in and of itself; it would also alter the way we think about entitlement programs. As Levin puts it, means-testing Medicare would begin to treat it “less as a universal earned benefit and more as the transfer program that it effectively is.”

One of the hardest things to do in politics is to alter the way the public perceives things. But it can also be essential, the sine qua non for future reforms. And no institutions are more in need of reforms than our entitlement programs, which is why I hope this idea gets traction. 

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Ryan Has Options, But Has He Already Made His Choice?

Paul Ryan’s role in the 2012 presidential election was, from the standpoint of some congressional Republicans, perfect. Because Ryan is the author of budget-cutting legislation that seeks to reform entitlements, especially Medicare, his proposals are controversial. Republicans in Congress may be supportive of such legislation, and indeed voted for it in large numbers, but it opens up an easy line of attack for their opponents. But they also want to rein in debt, support their fellow (popular) conservative reformer, and stay in the good graces of the party’s grassroots–as Newt Gingrich found out when he criticized Ryan’s plan in harsh terms and earned the ire of conservative voters when he ran for the GOP nomination.

Gingrich backtracked, but he was in an unenviable position: he wanted to appeal to both the center and the base; he didn’t want to appear timid by backtracking and deferring to Ryan, who wasn’t running. But he also couldn’t embrace a plan he had genuine concerns about, both philosophically and with regard to electoral politics. This is where many in the party found themselves on the issue of trying to win local and national elections–caught between prudence and their reformist instincts. Ryan chose not to run for president, which prevented the party’s candidates from having to spend an entire election season defending that one proposal. And because he was picked up as Mitt Romney’s vice presidential nominee, his own plans were overshadowed by those of Romney–the top of the ticket. Thus, had the GOP ousted President Obama in November, Republicans would have arrived on the cusp of major conservative reform in a relatively quiet way.

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Paul Ryan’s role in the 2012 presidential election was, from the standpoint of some congressional Republicans, perfect. Because Ryan is the author of budget-cutting legislation that seeks to reform entitlements, especially Medicare, his proposals are controversial. Republicans in Congress may be supportive of such legislation, and indeed voted for it in large numbers, but it opens up an easy line of attack for their opponents. But they also want to rein in debt, support their fellow (popular) conservative reformer, and stay in the good graces of the party’s grassroots–as Newt Gingrich found out when he criticized Ryan’s plan in harsh terms and earned the ire of conservative voters when he ran for the GOP nomination.

Gingrich backtracked, but he was in an unenviable position: he wanted to appeal to both the center and the base; he didn’t want to appear timid by backtracking and deferring to Ryan, who wasn’t running. But he also couldn’t embrace a plan he had genuine concerns about, both philosophically and with regard to electoral politics. This is where many in the party found themselves on the issue of trying to win local and national elections–caught between prudence and their reformist instincts. Ryan chose not to run for president, which prevented the party’s candidates from having to spend an entire election season defending that one proposal. And because he was picked up as Mitt Romney’s vice presidential nominee, his own plans were overshadowed by those of Romney–the top of the ticket. Thus, had the GOP ousted President Obama in November, Republicans would have arrived on the cusp of major conservative reform in a relatively quiet way.

But they didn’t win. And that meant the party faced the prospect of a new cycle of political fights over Ryan’s reforms, since he is the House budget leader. But he could also not be easily overlooked, since he returned as the party’s (unsuccessful) vice presidential hopeful. That’s why in today’s Politico story analyzing Paul Ryan’s competing paths to power, this particular segment stands out as possibly the best harbinger of what to expect from the rising conservative star:

Ryan associates say he has been surprised at how central his governing role has been among House Republicans since returning from his failed run for vice president. He was instrumental in cooking up the GOP’s new debt ceiling strategy and will craft a budget plan that sets the direction for the GOP caucus on virtually every consequential issue. With this in mind, he now calculates that naked national ambitions would only dilute his growing power as Speaker John Boehner’s unofficial wing man.

At the same time, Ryan continues to cultivate a national political and financial network that would serve him in any role. A top GOP source said Ryan recently huddled with Spencer Zwick, Mitt Romney’s fundraising guru, who made plain much of the 2012 donor base stands ready to back him if he were to ever warm again to a White House run. Ryan also made a fundraising trip to Texas last month for his Prosperity PAC. He was hosted by top Romney donors who urged him to run, convinced he has been totally vetted and passed the readiness test.

There are three nuggets of information in those two paragraphs, and they basically summarize Ryan’s current predicament. First, major party donors like him and want him to run for president; second, his instinct is not to run, and instead stick to policy; and third, that the GOP House caucus’s embrace of Ryan when he returned from the campaign played a fairly important role in all this.

Ryan understood that although he is young, losing a national race can halt anyone’s career momentum, and it can leave the impression that the losing candidate is an also-ran. Those perceptions are difficult, though far from impossible, to reverse. And Ryan would have one advantage: no one blames him for the election result, since he was not at the top of the ticket. His selection, in fact, energized grassroots conservatives. Nonetheless, as a candidate for the White House in a close election Ryan had one foot out the door of the House chamber. The fact that House Republicans welcomed his return as a congressional leader says a lot about the value House Republicans place in Ryan, and the confidence he instills in them that they can win with his agenda.

Though Ryan is a fine public speaker and a solid debater, he was always more at home writing policy than on the campaign trail. If he wanted to compete for the 2016 Republican presidential nomination, he surely could, and he would have something of a head start on his rivals with both the base and party donors. But the lesson of Bob Dole’s run for president in 1996 looms large: it is difficult–Dole found it impossible, actually–to be a congressional leader and presidential candidate at the same time. Ryan may very well be the most influential Republican in the House already. Though he could certainly make a play for being even more, he appears to be relieved to have his old role back, for the time being. The party’s base has reason to be relieved, as well, that Ryan’s colleagues didn’t lose their resolve to fight for real reform in his brief absence.

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Barack Obama Is No Lyndon Johnson

On “Fox and Friends” this morning at 7 a.m. came the news that President Obama and Speaker Boehner had had a phone call last evening, content not disclosed.

That shouldn’t have been news—these are the leaders of each party trying to avoid a governmental disaster that could come in less than a month, and should be talking 10 times a day. But it was news, and that’s troubling to say the least.

As Daniel Henninger makes clear in today’s Wall Street Journal, “Where in his career did Barack Obama ever learn the art of the political deal? Nowhere.” He writes:

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On “Fox and Friends” this morning at 7 a.m. came the news that President Obama and Speaker Boehner had had a phone call last evening, content not disclosed.

That shouldn’t have been news—these are the leaders of each party trying to avoid a governmental disaster that could come in less than a month, and should be talking 10 times a day. But it was news, and that’s troubling to say the least.

As Daniel Henninger makes clear in today’s Wall Street Journal, “Where in his career did Barack Obama ever learn the art of the political deal? Nowhere.” He writes:

Recall the famous Blair House summit he called early in 2010 amid the legislating over Obamacare. Lamar Alexander, Tom Coburn, Paul Ryan and other Republicans talked about wonkish compromises. All of it, every single idea, blew right by the president. Naturally the legislation got zero GOP votes. A kid running for high-school president could have gotten more opposition votes than that.

Obama negotiates with Congressional Republicans the way General MacArthur negotiated with the Japanese on the deck of the USS Missouri on September 2, 1945: Here’s a pen, sign your surrender. But the Japanese were powerless at that point; the Republicans are not today–they hold the House.

Compare that with how Lyndon Johnson got Medicare through Congress in 1965. Johnson was vastly more politically potent in 1965 than is Obama today. Johnson had just carried all but six states in the presidential election and with a higher percentage of the popular vote than FDR achieved in 1936. The Senate was 68-32 Democratic (as compared with 53-47 right now), the House was 295-140 Democratic (as compared with 241-191 Republican).

But Johnson treated Congress as a part of the process, not an annoying obstruction to his will. “I am not for denouncing Congress all the time,” he told a historian that year. “I am not like . . . writers who think of congressmen as archaic buffoons with tobacco drool running down their shirts. . . . I got up at seven this morning to have breakfast with them. I don’t have contempt for them.”

As James T. Patterson explains in a new book, “LBJ spent hours on the phone with congressmen and senators, held frequent one-on-one meetings with leaders, and hosted regular Tuesday morning breakfast gatherings at the White House.” No wonder he got 13 Republican votes in the Senate and fully half the Republicans in the House to vote for Medicare. In contrast, the first time Barack Obama bothered to meet with Mitch McConnell, the minority leader in the Senate, for a one-on-one chat was in July 2010, sixteen full months into his presidency. He’d had time for dozens of rounds of golf by then.

Obama’s utter disdain for any ideas but his own is going to be the ruin of this president and that ruin might not be that long in coming. Too bad it is the country, along with his place in history, that has to suffer for his hubris.

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Is Romney Losing the Medicare Argument?

Although today’s Washington Post/ABC poll gives Mitt Romney no reason to panic–he’s down just one point among likely voters–it should at least raise a red flag: Romney does not seem to be pulling away on the economy, the centerpiece of his campaign. But even more frustrating for the campaign may be that Romney picked a fight he now seems to be losing: Medicare. According to the poll, he’s trailing the president on that question too.

Before Romney picked Paul Ryan as his running mate, Gallup’s polling showed that few were thinking about Medicare heading into the election. Think of it as the opportunity cost–which was raised at the time–of diverting the campaign messaging away from the economy. But you can divert attention from the economy if it’s to an issue voters care about, and if you can win the argument over it. Here’s Gallup’s mid-August chart of the “non-economic” issue voters thought presented the “most important problem” (most recent results from left):

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Although today’s Washington Post/ABC poll gives Mitt Romney no reason to panic–he’s down just one point among likely voters–it should at least raise a red flag: Romney does not seem to be pulling away on the economy, the centerpiece of his campaign. But even more frustrating for the campaign may be that Romney picked a fight he now seems to be losing: Medicare. According to the poll, he’s trailing the president on that question too.

Before Romney picked Paul Ryan as his running mate, Gallup’s polling showed that few were thinking about Medicare heading into the election. Think of it as the opportunity cost–which was raised at the time–of diverting the campaign messaging away from the economy. But you can divert attention from the economy if it’s to an issue voters care about, and if you can win the argument over it. Here’s Gallup’s mid-August chart of the “non-economic” issue voters thought presented the “most important problem” (most recent results from left):

 

See “care for the elderly/Medicare” way down there? It went from 1 percent to zero percent. Now, obviously introducing it as a major campaign theme will increase its importance. The New York Times claimed it had become a key issue in swing states, but their poll was so thoroughly discredited as to be useless. And if Romney does succeed in making Medicare a top voter priority, he has another problem: Gallup found two weeks ago that voters give Obama a 12-point advantage on that issue. (Today’s poll has Romney within five points on the question.) That may change, but it seems Romney may have mimicked, rather than learned from, Obama’s health care mistake. Even after Obama passed health care reform, making it by far the most talked-about issue, it remained low on the list of priorities for voters heading into the following election. With time, health care rose on that list of priorities–in part because voters hated the new law so much they resolved to get rid of it.

Obama made two mistakes: he ignored more important issues in favor of health care, and then lost the argument over it once he elevated it in voters’ minds. Romney has the winning argument on the economy, but he’s elevated an issue that just a month ago was far from voters’ top priority. If he loses the Medicare argument, he’ll replicate both of those mistakes.

This is not to say that Medicare shouldn’t be reformed. Indeed, entitlements need reforming even if it’s not too popular politically, and the Democrats’ Mediscare tactics are designed to uphold an unsustainable status quo and strike a devastating blow to the reform agenda in the service of maintaining their hold on power.

Which brings up another challenge for the Romney campaign: to succeed, they must convince voters that if Obama is re-elected, and then chooses to do nothing, entitlements will bring on a fiscal disaster.

It’s a worthy and responsible argument to make, but until voters develop that same sense of urgency, their campaign has shifted from facts (unemployment is high) to speculation (Obama will let Medicare go bankrupt). As I wrote after the Ryan selection, voters were enthused about having “a choice, not a referendum,” as the popular refrain went. But giving voters an argument isn’t good enough; Romney will have to win that argument too. Today’s poll is another indication that he’s struggling to do more than break even on this issue.

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Dems Show Progressive Means Status Quo

Heading into this week’s Democratic National Convention, the party knows the country isn’t really better off than it was four years ago. They also know that President Obama can’t count on a repeat of the wave of messianic expectations that swept him into office in 2008. But they seem united on one proposition: the Republicans and their ideas for changing Washington must be stopped. Though most of those who gather in Charlotte dub themselves “progressives,” that word, which once evoked the liberal call to transform America into a more egalitarian society, now means something very different. In 2012, to be a progressive means above all to be steadfast in favor of maintaining the status quo on a wide range of issues. It is a credo of not of progress but merely in defense of the power of the state that generations of Democratic politicians have built.

The best of example of this came over the weekend as Vice President Biden, whose value as the administration’s rabid attack dog has never been more apparent, denounced Republican plans for reforming Medicare so as to enable it to survive despite the overwhelming demographic and budget disaster that looms over it. Biden’s battle cry claiming: “We are for Medicare; they are for Vouchercare,” contained no nuances about dealing with problems. Indeed, Biden, citing his own mother’s experience, gave a straightforward pitch for paternalistic government in which he said older Americans were too befuddled to make their own choices and needed to be told what to do by Washington.

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Heading into this week’s Democratic National Convention, the party knows the country isn’t really better off than it was four years ago. They also know that President Obama can’t count on a repeat of the wave of messianic expectations that swept him into office in 2008. But they seem united on one proposition: the Republicans and their ideas for changing Washington must be stopped. Though most of those who gather in Charlotte dub themselves “progressives,” that word, which once evoked the liberal call to transform America into a more egalitarian society, now means something very different. In 2012, to be a progressive means above all to be steadfast in favor of maintaining the status quo on a wide range of issues. It is a credo of not of progress but merely in defense of the power of the state that generations of Democratic politicians have built.

The best of example of this came over the weekend as Vice President Biden, whose value as the administration’s rabid attack dog has never been more apparent, denounced Republican plans for reforming Medicare so as to enable it to survive despite the overwhelming demographic and budget disaster that looms over it. Biden’s battle cry claiming: “We are for Medicare; they are for Vouchercare,” contained no nuances about dealing with problems. Indeed, Biden, citing his own mother’s experience, gave a straightforward pitch for paternalistic government in which he said older Americans were too befuddled to make their own choices and needed to be told what to do by Washington.

Biden’s speech was a shameless partisan distortion of the plan put forward by Republican vice presidential candidate Rep. Paul Ryan, who seeks a transition that will not change Medicare for anyone current receiving it. This is in keeping with the “pants on fire” style of Democratic campaign rhetoric we’ve been hearing lately. But it is also indicative of a belief that nothing, not even the impending collapse of these entitlement programs ought to be allowed to justify new ideas about government.

This isn’t the only important theme of the week for Democrats. We will hear a great deal about the “war on women” that Democrats falsely claim Republicans are waging. But at the core of that is another defense of big government and entitlements such as the right to free contraceptives, for which poster child Sandra Fluke will advocate again this week.

To the extent that we will hear new ideas this week about support for the environment or fear of global warming, they will all revolve around greater government involvement in the economy via cap and trade or restrictions on development of resources. At their core they are all about defense of an ever-expanding federal bureaucracy that must be fed by more taxes to pay for more spending.

If the Democrats can get more of the electorate to fear Republican reforms like Paul Ryan’s plan or to buy into the myth of a war on women, they may win. But if they do, it will be accomplished by a campaign oriented solely toward keep things as they are. We’ve come a long way from the hope and change of 2008.

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Ryan’s Star Turn Shows GOP Ready to Rumble on Medicare

When Mitt Romney chose Rep. Paul Ryan to be his running mate Democrats rejoiced. They were sure that the elevation of the author of the Republican Congress budget plan that called for reform of entitlements like Medicare guaranteed the president’s re-election. They had already been planning to run hard against the Ryan budget no matter who was on the GOP ticket. But having Ryan as their piñata seemed like a dream come true.

But tonight at the Republican National Convention, as Ryan got his prime time spot accepting his nomination, the rest of the country began to understand why conservatives have been so devoted to him. Ryan’s speech was not merely well executed but an example of how he earned his reputation as the intellectual leader of his party. Even more important, he showed that he and the man at the top of the ticket plan to run on the reformist ideas that Democrats think work to their advantage. Far from shying away from the Obama campaign’s Mediscare tactics, they are ready to rumble on a platform aimed at saving entitlements against the status quo policies of the administration.

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When Mitt Romney chose Rep. Paul Ryan to be his running mate Democrats rejoiced. They were sure that the elevation of the author of the Republican Congress budget plan that called for reform of entitlements like Medicare guaranteed the president’s re-election. They had already been planning to run hard against the Ryan budget no matter who was on the GOP ticket. But having Ryan as their piñata seemed like a dream come true.

But tonight at the Republican National Convention, as Ryan got his prime time spot accepting his nomination, the rest of the country began to understand why conservatives have been so devoted to him. Ryan’s speech was not merely well executed but an example of how he earned his reputation as the intellectual leader of his party. Even more important, he showed that he and the man at the top of the ticket plan to run on the reformist ideas that Democrats think work to their advantage. Far from shying away from the Obama campaign’s Mediscare tactics, they are ready to rumble on a platform aimed at saving entitlements against the status quo policies of the administration.

Ryan came across as he always has in his Congressional campaigns: as a likeable man who was capable of bold attacks as well as smart ideas. The Democrats may think they can demonize the congressman but anyone who saw this speech knows that is highly unlikely. Far from being the guy who pushes granny off the cliff in the Democrats’ attack ads, Ryan was appealing–not scary or extremist, as liberals allege. But even worse for the Democrats is Ryan’s ability to turn the tables on the president. Rather than playing defense on Medicare, the GOP veep candidate made it clear that the Republican approach will be to brand ObamaCare as the greatest threat to that program. Liberals may argue that the raid on Medicare to fund the health plan is not an issue, but given the unpopularity of the measure, this is a talking point that Republicans will drive home to their advantage this fall. Instead of weak point, Ryan’s reform ideas may turn out to be the GOP’s best selling point.

Coming as it did after Condoleezza Rice’s brilliant and inspiring address to the convention as well as another strong speech by New Mexico Governor Susana Martinez, there might have been some fear that Ryan couldn’t pull off a triumph this evening. But he did just that, mixing humor and sharp attacks on the president with touching evocations of the American dream. Ryan isn’t just a rising GOP star, this evening he showed that he is a major asset to Mitt Romney’s hopes of being elected president.

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Romney Gets Bounce in FL, WI

Mitt Romney is closing the gap in Florida and Wisconsin, according to today’s Quinnipiac/CBS/NYT poll. According to Quinnipiac, this seems to be a mini-bump from the Paul Ryan pick:

Matching Obama against Romney among likely voters in each of these key states shows:

  • Florida: Obama at 49 percent to Romney’s 46 percent, compared to Obama’s 51 – 45 percent lead August 1;
  • Ohio: Obama edges Romney 50 – 44 percent, unchanged from August 1;
  • Wisconsin: Obama at 49 percent to Romney’s 47 percent, compared to Obama’s 51 – 45 percent lead August 8.

Ohio is the one state polled where Romney’s numbers have remained flat. The poll was also taken between August 15 and August 21, so it may not reflect any negative impact from the wall-to-wall Todd Akin coverage (though abortion issues don’t rank anywhere near a top concern with swing-state voters, according to the poll).

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Mitt Romney is closing the gap in Florida and Wisconsin, according to today’s Quinnipiac/CBS/NYT poll. According to Quinnipiac, this seems to be a mini-bump from the Paul Ryan pick:

Matching Obama against Romney among likely voters in each of these key states shows:

  • Florida: Obama at 49 percent to Romney’s 46 percent, compared to Obama’s 51 – 45 percent lead August 1;
  • Ohio: Obama edges Romney 50 – 44 percent, unchanged from August 1;
  • Wisconsin: Obama at 49 percent to Romney’s 47 percent, compared to Obama’s 51 – 45 percent lead August 8.

Ohio is the one state polled where Romney’s numbers have remained flat. The poll was also taken between August 15 and August 21, so it may not reflect any negative impact from the wall-to-wall Todd Akin coverage (though abortion issues don’t rank anywhere near a top concern with swing-state voters, according to the poll).

While senior citizens seem to view Ryan positively, one potential obstacle for Republicans is the general opposition to a “voucher-type” Medicare system in all three swing states:

Voters in each state say Obama would do a better job on Medicare and reject by wide margins a voucher-type Medicare system: 62 – 28 percent in Florida, 64 – 27 percent in Ohio and 59 – 32 percent in Wisconsin, the survey by Quinnipiac/CBS/The Times finds.

Obviously a big part of the Obama campaign’s Mediscare strategy will involve hammering in the idea that Romney and Ryan want to “voucherize” Medicare.

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Seniors Really Like Ryan (So Far)

I don’t want to be too optimistic about these numbers, since there’s still two and a half months of Mediscaring to go, and Democrats haven’t even gone full-blast on it yet. Still, this WaPo-ABC News poll (via the Fix) is pretty promising for Paul Ryan:

Grandma isn’t scared of Paul Ryan.

A new Washington Post-ABC News poll shows 41 percent of Americans view the new GOP vice presidential nominee favorably, while 37 percent rate him unfavorably — slightly improved from last week’s polling.

Among seniors, though, the numbers are even better for Ryan: 50 percent favorable and 35 percent unfavorable. Fully one-third of seniors say they have a strongly favorable view of the Wisconsin congressman, while one-quarter have a strongly unfavorable view.

The numbers suggest Democrats’ attempts to turn Ryan’s Medicare proposal against the GOP haven’t stuck yet among the most pivotal group: seniors. If a Medicare attack was working, after all, seniors would likely be the first group to start deserting Ryan.

It’s not just that the attempts have failed to stick. The fact that 33 percent of seniors (a plurality in this poll) say they hold strongly favorable views of Ryan suggests that this group a.) has probably taken time to think about him and made a relatively well-formed decision, and b.) is less likely to be swayed into the negative camp. That will make it more difficult for Democrats to spread misinformation about Ryan’s positions on Medicare.

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I don’t want to be too optimistic about these numbers, since there’s still two and a half months of Mediscaring to go, and Democrats haven’t even gone full-blast on it yet. Still, this WaPo-ABC News poll (via the Fix) is pretty promising for Paul Ryan:

Grandma isn’t scared of Paul Ryan.

A new Washington Post-ABC News poll shows 41 percent of Americans view the new GOP vice presidential nominee favorably, while 37 percent rate him unfavorably — slightly improved from last week’s polling.

Among seniors, though, the numbers are even better for Ryan: 50 percent favorable and 35 percent unfavorable. Fully one-third of seniors say they have a strongly favorable view of the Wisconsin congressman, while one-quarter have a strongly unfavorable view.

The numbers suggest Democrats’ attempts to turn Ryan’s Medicare proposal against the GOP haven’t stuck yet among the most pivotal group: seniors. If a Medicare attack was working, after all, seniors would likely be the first group to start deserting Ryan.

It’s not just that the attempts have failed to stick. The fact that 33 percent of seniors (a plurality in this poll) say they hold strongly favorable views of Ryan suggests that this group a.) has probably taken time to think about him and made a relatively well-formed decision, and b.) is less likely to be swayed into the negative camp. That will make it more difficult for Democrats to spread misinformation about Ryan’s positions on Medicare.

There are two immediate problems for Democrats. First, Romney and Ryan have been fairly successful at spreading the news that the Medicare reforms wouldn’t impact anyone over the age of 55. As long as seniors know that their own current coverage won’t be touched, they can look at the reforms with much more open minds.

Second, Paul Ryan just isn’t scary. He’s the kind of guy grandparents usually love. Democrats are going to find it hard to convince retirees that he wants to destroy Medicare because he hates the elderly and wants to give all their health care money to rich people. It’s just not believable to any rational person who’s listened to Ryan talk for more than five minutes.

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The Party of Status Quo

The Washington Post editorial board argues that Joe Biden’s comments on Social Security the other day were far more disturbing than his “chains” gaffe:

On the same trip to southern Virginia, Mr. Biden wandered into the Coffee Break Cafe in Stuart. According to the White House pool report, when a diner there said, “I’m glad you all are not talking about doing anything with Social Security,” Mr. Biden responded: “Hey, by the way, let’s talk about Social Security. Number one, I guarantee you, flat guarantee you, there will be no changes in Social Security. I flat guarantee you.”

Why is this so depressing? Because, as Mr. Biden knows, Social Security is going broke. If “no changes” are made, then by 2033 the program will not be able to pay benefits as promised.

The Post pressed the White House on whether Biden’s comments reflected official policy, and were given the brush-off:

In response to our inquiry, White House officials said that Mr. Biden’s “flat guarantee” was not meant to convey a change in administration position, which they said is best understood from Mr. Obama’s 2011 State of the Union address, which called for “a bipartisan solution to strengthen Social Security for future generations.”

That speech was hardly a profile in courage: Mr. Obama opposed “slashing” benefits for future retirees. But that presumably (if tacitly) left room for trimming benefits. The president went further in failed negotiations with House Speaker John Boehner last summer, putting on the table changes in the way Social Security cost-of-living adjustments are calculated.

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The Washington Post editorial board argues that Joe Biden’s comments on Social Security the other day were far more disturbing than his “chains” gaffe:

On the same trip to southern Virginia, Mr. Biden wandered into the Coffee Break Cafe in Stuart. According to the White House pool report, when a diner there said, “I’m glad you all are not talking about doing anything with Social Security,” Mr. Biden responded: “Hey, by the way, let’s talk about Social Security. Number one, I guarantee you, flat guarantee you, there will be no changes in Social Security. I flat guarantee you.”

Why is this so depressing? Because, as Mr. Biden knows, Social Security is going broke. If “no changes” are made, then by 2033 the program will not be able to pay benefits as promised.

The Post pressed the White House on whether Biden’s comments reflected official policy, and were given the brush-off:

In response to our inquiry, White House officials said that Mr. Biden’s “flat guarantee” was not meant to convey a change in administration position, which they said is best understood from Mr. Obama’s 2011 State of the Union address, which called for “a bipartisan solution to strengthen Social Security for future generations.”

That speech was hardly a profile in courage: Mr. Obama opposed “slashing” benefits for future retirees. But that presumably (if tacitly) left room for trimming benefits. The president went further in failed negotiations with House Speaker John Boehner last summer, putting on the table changes in the way Social Security cost-of-living adjustments are calculated.

Why won’t the White House get into specifics? For the same reason Senate Democrats have declined to take up a budget plan, and President Obama has declined to offer a proposal to keep Medicare solvent and reduce the deficit. Because of the political risk involved. It’s much easier to attack the Republican plans than to offer new solutions. The Obama campaign prefers to propagate the myth that Republicans are callously trying to target the poor and the elderly with their plans, rather than acknowledge that reform is hard — and that any solution will require tradeoffs.

The Obama campaign also wants to have it both ways; attacking Romney and Ryan for their “radical” proposals, while simultaneously mocking the idea that Ryan’s reforms are bold or courageous.

Of course the Ryan plan took courage. If it didn’t, Obama would have proposed his own detailed response a long time ago. Instead, during the White House press briefing today, Jay Carney refused to specify when, if ever, the president would give more details on his plan to keep Medicare afloat.

When the media wonders why Romney’s VP choice hasn’t resulted in an elevated debate, the answer is clear. The country can’t begin the serious conversation that Obama claims he wants until he puts more details on the table.

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Romney Gets Poll Bounce in Swing States

Via the Purple Poll, Mitt Romney has seen gains in Ohio and Pennsylvania since choosing Paul Ryan as his running mate. While President Obama has made some inroads in Colorado and Florida, Romney still leads by a 1-point margin in the latter:

Romney has seen the largest gain in Ohio, a state we have seen bounce between the campaigns over the last few months. Today, the GOP ticket leads by 2 points (46% to 44%), compared to July when President Obama led the state 48% to 45%.  Romney also gained ground in Virginia – today, he and Paul Ryan hold a 3-point advantage in the race (48% to 45%), while Romney trailed by 2 points in July.

However, President Obama has seen improvements in Colorado and Florida. In Colorado, the Obama-Biden ticket now leads 49% to 46%, an increase from a 1-point lead in July. In Florida, the Democratic ticket trails by just 1 point (48% to 47%), compared to a 3 point deficit in July.

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Via the Purple Poll, Mitt Romney has seen gains in Ohio and Pennsylvania since choosing Paul Ryan as his running mate. While President Obama has made some inroads in Colorado and Florida, Romney still leads by a 1-point margin in the latter:

Romney has seen the largest gain in Ohio, a state we have seen bounce between the campaigns over the last few months. Today, the GOP ticket leads by 2 points (46% to 44%), compared to July when President Obama led the state 48% to 45%.  Romney also gained ground in Virginia – today, he and Paul Ryan hold a 3-point advantage in the race (48% to 45%), while Romney trailed by 2 points in July.

However, President Obama has seen improvements in Colorado and Florida. In Colorado, the Obama-Biden ticket now leads 49% to 46%, an increase from a 1-point lead in July. In Florida, the Democratic ticket trails by just 1 point (48% to 47%), compared to a 3 point deficit in July.

The bounce can either be chalked up to Ryan (a sign that the choice is already paying dividends), or to momentum that was with Romney before the VP announcement (which would contradict speculation that Romney only chose Ryan out of desperation).

There are also some interesting numbers on Medicare inside the poll. In Florida, Romney-Ryan and Obama-Biden are in a virtual tie on the question of who will best protect Medicare. More Floridians also describe the Romney-Ryan budget plan as “reduc[ing] the deficit/help[ing] the economy and Medicare” as opposed to “tax breaks for the rich/end[ing] Medicare.”

Interestingly enough, Romney-Ryan are also viewed as the candidates most likely to bring “real change” to Washington. Apparently voters don’t hold out hope that a second Obama term will be much different from the first.

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