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Winning the Medicare Debate

Over the past two months, the Medicare reforms contained in Congressman Paul Ryan’s budget proposal have become an important part of the Democratic message and an issue of controversy.  Republicans will need to rebut Democratic mischaracterizations and refocus the debate in a winning way as we move toward 2012.

This memo summarizes some recent public opinion and messaging data and our thoughts on how Republican Elected Officials like you can redirect and win this messaging battle in the months and year to come.

Key Message Points

We need to counter-punch with the fact that the Democrats are the only ones who have voted to cut Medicare for current beneficiaries.

· In 2010, Republicans won 59% of the senior vote according to national exit polls, up from just 48% in 2006.  This was in no small part because of the $500 million in Medicare cuts in the Obama healthcare bill.

o By Election Day in 2010, a plurality (34%) of Americans believed the healthcare bill would hurt Medicare according to a Kaiser Family Foundation tracking poll.

o This has not changed substantially as a plurality (31%) of Americans still believes the healthcare plan hurts Medicare.

The focus of this debate needs to shift from the deficit to the future of Medicare itself.

· Unfortunately, a majority of Americans think that Medicare cuts are not necessary to balance the budget.

o A recent Associated Press/GfK poll (May 5-9) showed that a majority of Americans (54%) believe the budget can be balanced without changing Medicare.

o But, the facts are overwhelming—even government bureaucrats say that Medicare already pays out more than it takes in and it will be bankrupt in short order—this is not a budget argument so much as it a separate, program argument.

Because changes to the program are going to have to happen, we need to win the fight on our ideas to fix it versus the Democrats’ plans.

· Coupling Medicare reform with the budget debate was a losing idea, but the war of our plan versus the Democratic plan is a potential winner.

o Americans have long believed that Medicare is in a state of crisis.  As long ago as 2005, a super-majority of Americans (64%) thought the Medicare system faced either a crisis or major problems (Quinnipiac Poll, 1/15-31/05).

o The Democrats only solution is to put bureaucrats in charge of making healthcare choices under Medicare while our plan will preserve the doctor-patient relationship and keep the government out of these critical decisions.  We won this exact fight once before, in 1994, and can win it again if positioned this way.

Implications

We made a mistake in wrapping Medicare into the deficit fight because we allowed Democrats the opportunity to paint us as “sacrificing” Medicare, a necessity voters are unwilling to accept.  But, if we position the fight as one over the future of Medicare itself, the data suggests we have the opportunity to succeed by:

· Reminding voters that Democrats are the one who recently made major cuts in Medicare as part of their over-reaching healthcare bill;

· Reinforcing the belief that something must be done to fix a system in crisis; and

· Position our solution as the one that preserves the doctor-patient decision-making system while the Democrats will have to impose government bureaucrats on the decision-making in order to keep the system solvent.

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COMMENTS

  • YnotNOW

    I do not think it is a mistake to tie Entitlement reform (including Medicare) to the budget debate.

    I recommended because it is important to have a solid message to educate the public on the impending problem (which as you point out the majority just refuses to face as of yet), before they will be willing to make reforms. Your points on this are spot on.

    I think this debate can be tied to the budget debate because:
    1) The urgency of the budget debate highlights the need for entitlement reform, because entitlements comprise the majority of Federal spending, and therefore MUST be addressed in order to approach budget sanity.
    2) The urgency of the budget debate forces us to face this issue, rather than the usual preference to ignore it, put it off until later, and hope someone else will pay for it.

  • http://theheartlander.wordpress.com/ heartlander

    …that it is NOT a mistake to tie entitlement reform, including Medicare, to the budget debate — that is, it’s not a mistake SO LONG AS Republicans get out there and vigorously make their case. We need a whole army of people who are as informed and articulate as Paul Ryan is about this stuff. The people like Chris who say that talking about it now is a political mistake are people who just assume that Republicans will continue to be the Party of Stupid — or that they will follow George W. Bush’s example and never bother to explain anything.

    I also agree very strongly with your point #2, that we HAVE TO talk about Medicare now, like it or not, because at the rate we’re going, Medicare will be completely bankrupt IN NINE YEARS. When we consider how quickly a year passes, we can see how ridiculous it would be to think we have the luxury of procrastinating for another election cycle or two.

    This is why Paul Ryan is really my hero of heroes: He seems to be the only grown-up in the room. Rather than avoid the problem, he is taking it by the horns — because that’s what responsible adults DO. Now we just need for a whole bunch more Republicans to grow up — and fast.

  • http://theheartlander.wordpress.com/ heartlander

    I agree that it’s NOT a mistake to tie entitlement reform, including Medicare, to the budget debate — that is, it’s not a mistake SO LONG AS Republicans get out there and vigorously make their case. It’s only a political disaster if Republicans LET it be one!

    We need a whole army of people who are as informed and articulate as Paul Ryan is about this stuff. The people like Chris who say that talking about it now is a political mistake are people who just assume that Republicans will continue to be the Party of Stupid — or that they will follow George W. Bush’s example and never bother to explain anything.

    I also agree very strongly with your point #2, that we HAVE TO talk about Medicare now, like it or not, because at the rate we’re going, Medicare will be completely bankrupt IN NINE YEARS. When we consider how quickly a year passes, we can see how ridiculous it would be to think we have the luxury of procrastinating for another election cycle or two.

    This is why Paul Ryan is really my hero of heroes: He seems to be the only grown-up in the room. Rather than avoid the problem, he is taking it by the horns — because that’s what responsible adults DO. Now we just need for a whole bunch more Republicans to grow up — and fast.

  • YnotNOW

    Absolutely that tieing Medicare reform to debt ceiling pre-supposes that our representatives will make a cogent and forceful argument explaining the urgency of the problem and turn it from a political albatross to a winning election campaign.

    Because you are right that 9 years is way too short, and every year that we dawdle is just that much harder to address the problem (less money for transition to future system and cushion the impact on current/near retirees).

    Note: 9 years is for SS trust fund to run out – 2024 for Medicare. But that is assuming that the trust fund is not a mythical creature:
    http://www.redstate.com/ynotnow/2011/04/04/the-myth-of-the-social-security-trust-fund/

  • http://theheartlander.wordpress.com/ heartlander

    Did you see the results on that Pew “Political I.Q.” quiz posted here the other day? VERY sobering. Only 29% of Americans have a clue as to how HUGE government spending on Medicare really is. We have got a huge job in front of us, getting our fellow Americans educated about this.

  • YnotNOW

    so much that they run away screaming from any “skoolin”

    Education is key, and many do not want to learn. We have an uphill battle.