Tuesday, March 13, 2012

Rovian Romney

Karl Rove, the political mind behind George W. Bush's campaigns, was a master of dealing with his candidate's weaknesses and attacking his opponents' biggest strengths. The best example of his approach is attacking John Kerry on his military service record, when Kerry was a decorated veteran and Bush got a coveted spot in the National Guard, far away from Vietnam.

Mitt Romney's campaign took a page from Rove's handbook yesterday by releasing a memo that accuses Obama of trying to "end Medicare as we know it". One of the strongest lines of attack Democrats will have against Republicans is the GOP plan to change Medicare into a voucher system. Romney seeks to blunt this by clouding the issue and creating a false equivalence between Obama's reforms to Medicare under ObamaCare and the Paul Ryan plan to actually end Medicare as we know it.

There's a great discussion of Romney's memo by Brian Beutler at Talking Points Memo. Allow me to summarize (and occasionally expand upon) the main points:

Romney asks "Why is President Obama ending Medicare as we know it by allowing it to go bankrupt in less than 15 years?" The plan Romney advocates holds Medicare funding to the same levels as Obama's plan. So if Obama's plan will allow it to go bankrupt in 15 years, so will Romney's. And there's reason to think the cost-cutting measures in ObamaCare will help the program be more fiscally sound.

Romney also accuses the President of trying to "end Medicare as we know it by funding Obamacare through $500 billion in medicare cuts for today’s seniors". This is because ObamaCare results in cost savings for hospitals, which are the largest providers of services to Medicare beneficiaries. If you show up in a hospital needing care but without insurance, most hospitals will provide care free of charge, or at a reduced rate, and make up the difference by overcharging people with insurance, such as Medicare. ObamaCare will result in millions more people having health insurance, so hospitals won't have to overcharge Medicare as much. Medicare can therefore become cheaper without any benefit cuts for seniors. That Republicans were able to ride this line of attack to majorities in Congress is a failure of our political system.

Romney next attacks the Independent Payment Advisory Board as an "unaccoubtable board to ration care for today's seniors." The IPAB is explicitly set up to find cost savings without affecting coverage or quality. Its goal is to find areas of waste, of which I have seen many examples during my training. Medicare and other insurances pay for treatments which are more expensive than other possible treatments without any known advantage to the more expensive treatment. The IPAB seeks to identify these areas of waste, without harming the care provided to seniors. It will in no sense ration care.

Next up, Romney goes after Obama for going after Medicare Advantage, which is a program in which Medicare gives money to private insurers to provide insurance for seniors instead of getting their coverage straight from the government. The government's average cost of Medicare for an average beneficiary is given to the private company, but the company is allowed to cherry-pick which seniors they want to cover. They pick younger, healthier seniors who are cheaper to insure than the average beneficiary and therefore can pocket the difference. Getting rid of this corporate welfare is a good thing and in no sense ends Medicare as we know it, as it results in no cuts in benefits for seniors.

Romney concludes by dinging Obama over not having a permanent solution to the "doc fix", which is needed due to a mistake previously passed by Congress which results in dramatic underpayments for doctors who care for seniors. While it's true that Obama hasn't proposed a better solution than just spending more money and paying doctors what they should be paid, Romney hasn't proposed a better solution, either.

Nothing Obama proposes results in benefit changes for seniors, while Romney advocates a plan that devastates the ability of future seniors to find care. We can't let him get away with trying to portray himself as a defender of a program he intends to destroy.

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