Columns » Ernest Dumas

They come for oldsters



We are shortly to find out just how perceptive the American people are, or maybe just us oldsters.

The new Republican budget for 2012, which will rest on privatizing Medicare and maybe Social Security and shifting Medicaid to the states, should supply the truth of whether people can be sold one lie and then be made to like the lie they hated. Sound deceptive? It ought to be. The great deficit holy war is all about deceit.

All the tension in the new Tea Party-infused Congress has been over the House Republican effort to cut $60 billion from discretionary programs this year, as if that had anything seriously to do with the $1.4 trillion deficit. The deficit campaign so far is a ruse for halting health and environmental regulations that some Republican constituencies find objectionable. They couldn't win the battle by saying they wanted to protect mercury and greenhouse gas poisoning and cease the government's interest in promoting healthy pregnancies and family planning.

They may yet shut down the government over the discretionary budgets, but that will soon be over and Armageddon begins.

That is when the real deficit issues, medical care and defense, will be addressed. It affords the Republicans the best chance they have had for undoing the three big government programs the party always hated, Medicare, Medicaid and Social Security, and maybe the fourth, the Patient Protection and Affordable Care Act of 2009.

Rep. Paul Ryan's big budget reform, which the party shunned before the elections, it has now adopted. It will attack all four programs.

But back to the lies. You will remember the health-care battle. Frank Luntz, the Republican pollster and consultant, gave the party a memo saying that whatever the Democratic health-care bill did, tell people that it would take away Medicare benefits and be a government takeover of health care. His polling showed that those phrases really riled people, especially the elderly, who loved Medicare, so every Republican speech and scores of millions of commercials and mailers hammered home those points.

Never mind that the act did neither of those things. It improved Medicare coverage and it cracked down on health insurance, not medical care. But the campaign worked. Polls showed that people over 55 who were on Medicare or approaching the day overwhelmingly opposed the health-insurance reform, and that remains today the seat of most opposition. I've met with elderly groups. They like the new benefits they have seen but they still expect "Obamacare" to eventually scale Medicare back.

So what does the bold new Republican budget plan do? It shifts future health-care costs to them, and it will turn Medicare into exactly the kind of private-insurance mandate that the Republicans are suing everywhere to stop and getting Republican federal judges to condemn.

You say the Republicans would never be guilty of such perfidy? Here is how Ryan explains the plan: Medicare as we know it will end. The government will no longer pay medical bills. Instead, people will have to buy an insurance plan from one of the health insurance companies that would offer plans through an exchange run by the federal government. The federal government would supply a subsidy to help people buy the insurance and assure a good profit for the companies.

Sound familiar? That is "Obamacare," only Obamacare is for people too young for Medicare. If it passes (no chance in this Congress), will someone sue on the ground that it violates the commerce clause to require people to buy a commercial product or is beyond the implied powers of the federal government? Will the Republican legislature try to stop its implementation in Arkansas, as the GOP cohort did this spring?

The Republican Medicare reform is based on the party's 2003 prescription-drug law, the one that sent Medicare spiraling toward bankruptcy. It wrote the insurance companies into Medicare and supplied a hefty bonus of taxpayer money to be sure that the companies could match Medicare benefits and still reap a hefty profit. It costs the government and taxpayers about 14 percent more each time someone switches to a private Medicare plan.

The Affordable Care Act curtails spending and trims future deficits partly by rolling back the big subsidies. The Republicans characterized it as cutting Medicare benefits, but they won't apply that description to their own plan.

The theory behind it is the same as the Medicare Advantage plans of the 2003 law. Insurance companies should be better at holding down costs than the federal government, although all the evidence is exactly opposite.

Medicaid would be reformed under the Republican plan by turning it entirely over to the states and giving each a fixed block grant. When costs rose and the rolls grew, it would be up to each state to decide whether to kick people out of nursing homes, send the disabled home or cut off poor children.

Medicare costs—and the deficit—would balloon under the Republican plan but then presumably remain static. The elderly patients would begin to shoulder the extra costs either through rising and unsubsidized premiums or copays, the very prospects that people thought the new health-insurance law imposed.

But all those people who were so livid about Obamacare will rise up, won't they? Ryan takes care of that. Everyone on Medicare now or who will be eligible within 10 years will get the same good old government-protected Medicare that people have now. We will get around to that deficit thing sometime after 2020.

For now, it's just young people who have to worry, and they don't.

It's a cold-blooded, cynical political calculation, but they have gotten good at making it work. Frank Luntz is working on it right now.

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