OP-ED

Earth to Republicans: You Are In Big Political Trouble Over the Ryan Medicare Plan

It should now be clear to Republicans they are in trouble over the Ryan Medicare plan.

Yesterday, they lost a seat in a solid Republican New York House district. Their candidate had benefited from lots of money and House leadership attention. The big issue was the Ryan Medicare plan.

All month, Republican Presidential candidates have been walking a tightrope over the Ryan plan–don’t embrace it but don’t criticize it either for fear of offending the base who will drive the primary outcomes next year. You only had to watch the Gingrich implosion to see what happens if you fall off that tightrope.

Next the Senate will take up the Ryan budget. Senate Democrats can’t wait for a vote on it and are making the Ryan Medicare plan the central issue. Already, at least three Senate Republicans have said they will not vote for the House budget over the Medicare issue. Leader McConnell, sensitive to its political vulnerability, has told Senators they are free to vote their conscience on this one.

Apparently, Republicans don’t understand that they didn’t win the 2010 elections so much as the Democrats lost them. Their fixation on appeasing the right wing of their party misses the critical point that it is independent voters who make the difference in winning or losing an election.

In 2006 and 2008, independents went Democratic. In 2010, they abandoned the Democrats for the Republicans out of concerns for where the Dems were taking the county—not the least over health care.

But an apparent arrogance among Republicans that their 2010 victory was more about them than a rejection of the Democrats quickly led the House to pass Ryan’s budget and Medicare plan with all but four Republican votes. They seemingly never considered the possibility that dismantling Medicare, as we know it, needed to be pre-sold to voters. Now, those House Republicans are hanging out on one giant limb the Democrats can’t wait to cut off in the next election.

That House vote has put Republican presidential candidates and Republican Senators in a really tough spot: Keep independent swing voters happy by backing way from the Ryan plan but offend the Republican base, or support the Ryan plan by giving those House members now out on that limb political cover for their ill considered vote and suffer their own longer-term political consequences?

Ryan’s Medicare plan has been called courageous and farsighted. It may be more foolish and hardly good policy.

Readers of this blog know of my criticisms of the Affordable Care Act particularly over its lack of cost containment—the fundamental health care issue we face.

Ryan’s Medicare plan is poor politics and it is poor policy.

It is poor politics because it is nothing but a cost shift strategy. It is poor policy because it is nothing but a cost shift strategy.

It is hardly courageous. Apparently Republicans have no more courage to face the cost issue—and the politically powerful provider community—than Democrats do.

Now, for those of you ready to criticize these comments for my “lack of understanding of defined contribution health care policy,” please read this first: Defined Contribution Health Care—The Conservatives’ Silver Bullit

Robert Laszewski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. Before forming HPSA in 1992, Robert served as the COO, Group Markets, for the Liberty Mutual Insurance Company. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog, where this post first appeared.

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Nate Ogden
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Nate Ogden

“the Ryan plan had some really crazy supply-side numbers and ridiculous economic assumptions”

True, do you think those are nearly as bad as the demand side projections and shortfall that the existing plan generates? Doing nothing means we need to come up with 40 trillion, and thats at today’s projections which always turn out to be well under the actual numbers.

MG
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MG

2012 elections are a year and half away. That’s a lifetime in US politics especially with all of the various foreign policy issues looming. Reading a lot into this particular special election is pretty erroneous at best. Yeah this particular election was about the Ryan plan but Romney has already backed away from it. I expect other serious GOP candidates including Huntsman to do the same. Besides dismantling Medicare, the Ryan plan had some really crazy supply-side numbers and ridiculous economic assumptions that were so easy to target, lambast, and criticize. Even Gingrich recognized the overall stupidity of the Ryan… Read more »

Basement
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Basement

As Mr. Ogden notes, there were other factors at work in this election. The Democrats are ALSO in trouble because they have the rep of being the party that doesn’t seem to give a hoot whether Medicare goes broke and causes a huge financial problem. As long as the sh hits the fan after 2012, we’re ok, right? Medicare is a big, brewing problem, and give Ryan at least some credit for trying to confront it. He may not be exactly right, but let’s have a serious debate and discussion rather than the kind of political c rap that this… Read more »

Nate Ogden
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Nate Ogden

The election had nothing to do with a phony tea party canidate who got 8% of the vote? Nothing to do with the sex scandal?

Tim
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Tim

All of these articles are hilarious; they each project some rational schema onto “the voters”. The voters rejected the Republicans because this, the voters rejected the Democrats because that. And the particular schema that we are supposed to use to understand the voters always correlates, amazingly, with the writers’ own personal vision. Alright, I’ll try: the voters want higher benefits and lower spending (taxes). In other words, most people want their own money and their neighbors’ money. Each party gets elected by talking about the disaster the other is fomenting. In this environment, that party is most “in trouble” that… Read more »

pcp
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pcp

Could you please post the rest of Reich’s article. It’s interesting that a site devoted to HIT has so much trouble posting complete articles.