By Mark S. Mellman - 04/05/11 11:22 PM EDT
• It cuts Medicare benefits.
• It puts private insurance companies in charge of Medicare.
• It’s a bait-and-switch, as the GOP hid these plans from voters during the last election.
Today, seniors deal with their doctors, who are reimbursed by Medicare for services they provide. Ryan’s vision transfers all power to the insurance companies. They will offer the plans seniors must buy, and they will regulate the way doctors can interact with and treat patients, just as they do now for those who have private insurance. Indeed, if the Republicans have their way, these same insurance companies could return to denying coverage for pre-existing conditions.
Insurance companies give the power to make life-and-death decisions to bureaucrats who wear green eyeshades, not white lab-coats; bureaucrats who know how to save money for big corporate insurers but understand little about medicine. If an insurance company doesn’t want to cover a treatment or test your doctor prescribes, seniors just won’t be eligible for that test or treatment, even if Medicare covers it today.
This leads, inexorably, to cuts in Medicare benefits. The government will only pick up part of the tab for private health insurance, leaving individual seniors to pay the difference out of their pockets. Moreover, Ryan’s plan apparently ties increases in the rates insurance companies are paid to overall inflation, not to the rising cost of healthcare. Since healthcare costs are exploding faster than other expenses, the purchasing power of Republicans’ subsidy erodes quickly, increasing seniors’ costs dramatically.
Could anyone have known they were voting for this radical vision in November? No, because Republicans kept their plan carefully hidden behind claims that they were going to do exactly the opposite. I scoured the GOP’s 45-page “Pledge to America,” searching in vain for even the vaguest reference to this plan to end Medicare. Indeed, readers used to the plain meaning of words might well have come to the opposite conclusion. After inaccurately criticizing Democrats for cutting Medicare, the GOP pledged to “make the decisions that are necessary to protect our entitlement programs for today’s seniors and future generations. That means requiring a full accounting of Social Security, Medicare and Medicaid.” It seems they purposely and knowingly misled us.
How is all this likely to sit with voters? Not well at all. Republicans claim Medicare must be eliminated to reduce the deficit. Voters disagree. By 54 percent to 18, Americans told NBC/Wall Street Journal pollsters that it is not necessary to cut Medicare to reduce the federal deficit. And even if it were, 76 percent said cutting Medicare was an unacceptable way to achieve that important goal. To the contrary, a CNN poll found strong support for increased spending.
Seniors are a swing constituency that has been swinging away from Democrats. From 2004 through 2008, Democratic House candidates garnered the votes of 46 to 49 percent of those 65 and older. In 2010, that number fell precipitously, to 38 percent.
Just as the GOP pushed once-wavering Hispanics back into the Democratic column, the party’s dissembling about Medicare, along with the substance of its plan to cut benefits while putting insurance companies between doctors and patients, is likely to push seniors back into the waiting arms of Democrats.
Mellman is president of The Mellman Group and has worked for Democratic candidates and causes since 1982. Current clients include the Majority Leader of the Senate and the Democratic Whip in the House.