The Corner

Obamacare Changed Everything

Watching some of the Sunday shows yesterday and reading the usual suspects online, I was struck by how even knowledgeable liberals still do not understand what Obamacare has done to them. They have a sense that health care is no longer a good issue for them, that it might have cost them the 2010 elections and will hurt in 2012, but they haven’t grasped that Medicare — which for decades has been a trusty battering ram against Republicans in the contest for the votes of seniors and others — is also no longer their issue.

This becomes evident in part when you consider that the arguments the Democrats naturally fall back upon regarding Medicare are just false now. So for instance David Axelrod on CNN’s State of the Union referred to “Congressman Ryan’s idea that we should turn Medicare into a voucher program, shifting thousands of dollars ultimately onto the backs of seniors.” But that’s simply a lie — Ryan’s actual Medicare proposal (which Romney has backed) simply doesn’t shift costs to seniors.

But it’s even more evident when liberals try to confront what they themselves — the supporters of Obamacare — propose to do to Medicare. Thus we find Rachel Maddow like a deer in headlights when Rich Lowry asked her a simple question on Meet the Press yesterday: “Do you support $700 billion in cuts in Medicare over the next ten years?” Obamacare takes that amount out of the program and spends it on other things, especially its new exchange subsidies. Maddow literally refused to answer the question. At one point she even said she shouldn’t have to answer it because “I’m not running for anything,” even though her occupation, as I understand it, is to express her opinion. And in the end, her defense of the cuts (though she still never said she supported them) was that Paul Ryan’s budget actually keeps them in place, eliminating Obamacare’s spending but not its Medicare cuts.

It’s at least a bit odd for Democrats who say Ryan is the devil to defend President Obama’s raid on Medicare by saying Paul Ryan does the same thing — and what’s more, it’s not true. The Ryan budget puts those $700 billion into the Medicare trust fund, to shore up the program’s future and reduce the deficit, rather than spending the money on yet another new entitlement. And Mitt Romney proposes not to make those Obamacare cuts in the first place — keeping the money in Medicare’s operating budget and so leaving the program simply as it is for today’s seniors and starting his premium-support reform for younger Americans when they retire, beginning a decade from now. Both undo Obama’s raid on Medicare, and both support a plan to save Medicare from bankruptcy in the years ahead.

#more#I don’t think Axelrod and Maddow were just setting out to lie exactly — it’s worse than that. Listening to them, it seemed as if they really hadn’t realized until now the situation they were in. They’re used to a certain order of things on Medicare and have not stopped to grasp what Obamacare has done to them. They assume it must be true that Republicans want to cut benefits and Democrats want to preserve them. But it’s not true, not anymore. You could see that panicked realization slowly rising in Maddow’s eyes as she was pressed.

What she was probably recognizing was this: Obamacare changed everything. In the wake of that law, it is now clearer than it ever could have been before that the market solution is also the best one for seniors — that the conservative approach that would dramatically reduce the deficit is also the one that would avoid any disruptions for current beneficiaries and the one that would save Medicare in the longer run without shifting costs to future beneficiaries. And the Left can’t claim any of those benefits for its own approach to Medicare.

Even some conservatives haven’t quite realized this, and have been uneasy about criticizing Obama’s Medicare cuts — after all, aren’t we supposed to be for Medicare cuts? But this attitude fails to consider the nature of Obama’s cuts (an arbitrary raid of the system to fund a new unsustainable entitlement) and the nature of the Romney-Ryan alternative (a market solution that would turn recipients into consumers and make Medicare a model of how competition can create efficiency and reduce costs without undermining value or access). There’s a broad consensus in America that the elderly should have access to highly subsidized health coverage. Cutting the cost of the program does not need to mean cutting the level of that coverage — unless, that is, you think central planning is the only way to run the program. The Left apparently does believe that, and now they’ll have to face the consequences.

President Obama has put Democrats in the position of being the party that seeks to cut current seniors’ benefits (especially those in Medicare Advantage) and access to care (thanks to the IPAB) while still allowing the program to collapse in the coming years and so watching the deficit explode and bringing on fiscal disaster. And Mitt Romney and Paul Ryan have put the Republicans in the position of being the party that wants to protect current seniors’ benefits and make them available to future seniors while still saving the program from collapse in the coming years and so dramatically reducing the deficit and averting fiscal disaster.

Whether you’re now a senior and concerned about your health coverage, are younger and worry if you’ll have affordable coverage when you retire, or are most concerned about the nation’s fiscal health and economic future, the Democrats offer you a very bad deal on Medicare and the Republicans offer you a good one.

The Democrats still don’t see that, and think that turning to Medicare in the wake of Ryan’s selection will yield great political rewards. Perhaps Romney and Ryan should inform them of how the two parties actually stand on the issue. And they might think about informing some voters as well.

Yuval Levin is the director of social, cultural, and constitutional studies at the American Enterprise Institute and the editor of National Affairs.
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