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Mark Shields
Mark Shields
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Republicans' Medicare Crisis


Remember the names of these four Republican house members: Rep. Walter Jones, N.C.; Rep. Dave McKinley, W.V.; Rep. Ron Paul, Texas; and Rep. Denny Rehberg, Mont.

Out of 240 House Republicans, these four intrepid individuals cast the only votes on the House floor against the bold blueprint of House Budget Committee Chairman Paul Ryan, R-Wis., to dramatically shrink the responsibility of the federal government in providing for the general welfare and to convert Medicare into a voucher program.

Out of 47 Republicans in the U.S. Senate, just five — Susan Collins and Olympia Snowe of Maine, Scott Brown of Massachusetts, Lisa Murkowski of Alaska and Rand Paul of Kentucky — defied Republican orthodoxy and voted against the Ryan budget plan.

These congressional votes put Republicans squarely on the record in support of completely overhauling Medicare. This is a serious problem for Republicans, because Medicare, in its current form, is enormously popular with three sizeable groups of Americans: A) those who are old themselves, B) those who personally care about someone who is old and C) those who think they, themselves, might one day be old.

It is true that most Americans probably do not have an encyclopedic understanding about the specific dollar costs of Medicare, but they know for certain how strongly they do care about Medicare.

By 2022, when Ryan's Medicare plan would become law, the average 65-year-old, according to the authoritative Congressional Budget Office, would have to pay between $6,400 and $7,000 more per year than she would pay under the traditional Medicare program.

Not surprisingly, information like the preceding has taken a major toll on pubic support for the GOP plan. When the CNN/Opinion Research poll asked in a national survey "from everything you have heard or read about the Republicans' plan to change Medicare so far, do you favor or oppose it," just 35 percent of all respondents favored the Republican plan, while 58 percent expressed their opposition to it.

Disapproval was consistent across the board: Americans under the age of 50 (36 percent favor/57 percent oppose), those over the age of 50 (33 percent favor/60 percent oppose) and political independents (34 percent favor/57 percent oppose).

The lonely island of support for the Republican Medicare plan was, surprise, among Republican voters who backed the party position by 68 percent to 26 percent.

Similarly, when the ABC News-Washington Post poll this spring asked, "In order to reduce the national debt (the Republicans' 2011 unifying mission), would you support or oppose cutting spending on Medicare, which is the government health insurance program for the elderly?" a mere 21 percent of those surveyed favored cutting Medicare spending, while a landslide 78 percent opposed any Medicare spending cuts.

In fact, any public criticism by a Republican of the Ryan plan puts the dissenter at risk of condemnation by party theologians as a heretic. Former House Speaker and current presidential candidate, as well as onetime keeper of the conservative flame, Newt Gingrich, was all but officially excommunicated from the GOP for his gratuitously disparaging knocking of the Ryan plan.

Here is where the Republicans' Medicare voucher policy becomes a painfully risky political dilemma for Republican candidates in 2012. By uncritically backing the Ryan plan — which is overwhelmingly supported by Republican primary voters — the Republican candidate improves his chances of winning a contested Republican primary. But the route to victory in a November general election against a competitive Democrat may well require that the Republican candidate divorce and distance himself from the Ryan-Medicare voucher plan, which, as we have seen, is emphatically unpopular with the large majority of voters who are not Republicans.

Already, Republicans' all-out support for the Ryan Medicare plan has cost them the loss, in a special congressional election in upstate New York, of a previously safe Republican House seat.

It is agreed that the winning Democrat, Kathy Hochul, was the decidedly superior candidate. But still there was a good chance that without Republican Jane Corwin's having stated that if she had been in the House she would have voted for the Ryan plan, Hochul — a committed opponent of the Ryan plan — would not have won. At least, that's how many Republican and Democratic observers of that upset victory read the outcome. And in politics, as we know, perception is reality.

This is why the Republicans have themselves to blame heading into 2012 for their party's Medicare crisis.

To find out more about Mark Shields and read his past columns, visit the Creators Syndicate web page at




5 Comments | Post Comment
Sir; ... I hope you are not expecting tears from me... The problem the Republicans face is one of their own making, where they have radicalized politics to the point where they are beginning to marginalize themselves... No one forced the parties to fix the number of representatives to the point where one person is supposed to represent over 600K.... That is not how we began this country, and the reason the government once worked better is because it was once more representative and democratic... No Constitutional Amendment was required to fix the number of members of the House of Representatives, and no amendment would be required to change it to a larger number, or let it float freely as the constitution intended... The house will not change what it has done, what the parties have done because that would mean giving up personal power to have a powerful institution, and one responsive to the people and democratic in nature... No one told the house they had to gerrymand their districts so the same party wins time after time... Yes; This would seem to be good to the parties, but what they must do to have national power, and to translate their regional power into international power through the presidency means they must always push a radical agenda, and sane politics, the politics of compromise and civility has no defense against radicalism.... If you tell a voter he has to push hard just to maintain his situation, and that would be electing the party of his choice, then you must assume he has the sense to push as hard as it takes or will take to effect real change... The reactionary republicans may be wrong, but they are right enough to realize that we are all going down the tubes... The want to win all, or die trying, and if that means getting more radical than radical, they will try it... The gerrymandered districts leave candidates vulnerable to their own radicals... Too damned bad, because the fix is an obvious one for both parties... Make districs representative, not of huge numbers, but to small districts and few voters... Make government responsive.... It is all in their hands, and in the hands of the parties.... Here is a hint... They will do nothing because they love the power as much as they love to see the people powerless in their own affairs... But, maybe the people have ideas of their own, and what ever it is hung up on, they will clear out of the way... Thanks... Sweeney
Comment: #1
Posted by: James A, Sweeney
Sat Jul 9, 2011 9:11 AM
"And in politics, as we know, perception is reality."
In all cases, perception equals reality of any individual. And you continue to push to hold people's perception of the medicare issue as a "Republican" issue when in fact it is an American issue. I, personaly, would fall into the group that gets the skewer just before I hit retirement age. Having the rug pulled out isn't nice and it doesn't make me happy. I do not expect to have much in the way of income when I hit retirement age. In fact, I don't expect I will be able to retire. But at least the republicans offer a plan, a solution, imperfect as it may be. The dems just want to pretend it'll work itself out while the issue just gets worse day by day. As far as I'm concerned, you have no room to criticize as long as you fail to attempt solution.
The problem isn't the old, the relatives, and those expecting to get old, it's selfish politicians and the selfish populace.
Comment: #2
Posted by: LF
Sat Jul 9, 2011 8:14 PM
By placing Medicare, Medicaid, and Social Security "on the table" in deficit-reduction talks, the President has completed the gutting of his support that was initiated by extending the Bush tax cuts for the wealthy, failing to end the wars, and refusing to prosecute the war criminals of the previous administration. It is beginning to is clearly the case that 2012 will be a choice between the Republican nominee and the other Republican with the Democratic Party's standard in hand. A victory for the "real" Republican might kindle a rebirth of the Democratic Party and principles, or possible better yet, help create a new party that supports the American people's values instead of those of corporate America. The President had us thinking out of the box in 2008. Unfortunately, he has proven to be that box.
Comment: #3
Posted by: Mike Ohr
Sun Jul 10, 2011 10:04 AM
What both Repes and Dems don't seem to get about costs out of control in government is that it's not just about the money available for entitlements. It's about the culture of government work and its utter lack of productivity.

If the civil service system didn't get in the way, we could probably fire about a third of all fed employees and not know the difference in terms of service delivery. But we can't do that.

Civil service rules virtually guarantee that when layoffs occur, the newest and most productive hires go first, and the flotsam and jetsam with the most seniority get protected. (Years and years and years of experience--does that count for anything if there is no indication of whether they were really doing anything of value during those years and years and years of service?)

Civil service rules also make it exceedingly difficult to fire someone or even discipline them. But it's not just the rules, it's the culture itself, not to mention the work ethic.

In the market, we have an imperfect, rough-justice way to measure productivity. Either your company turns a profit or it dies. As brutal and imprecise as the market is in meting out such justice, it at least imposes a significant measure of real accountability.

There is virtually no equivalent of that in government. It just grows and everyone assumes that those government workers are doing their jobs. That is, until you try to deal with them directly and try to get them to respond with something resembling a customer service or let's-get-the-problem-solved attitude.

The irony is, the liberal elite with their entrenched labor backing will be the first to criticize government when it doesn't regulate properly, as in Deepwater Horizon, for example. But guess who's civil service rules make it just about impossible to instill any accountability for the folks who are supposed to not be asleep at the switch?

Every time one of these things happens we find ourselves shocked to find out there's gambling going on in the house. But it is going on constantly. It's going on right now in just about every area of the government. They are collecting their paychecks and their big fat retirement benefits and nobody has a clue what they are really doing.

We need government. We need it badly.

It's not that government should necessarily be smaller. It should be a thousand times more efficient. If it were, it wouldn't have to be so big, it would be a lot less expensive, it would actually regulate, and it would get things done.
Entitlements like medicare (which means we the people) are taking the hit, and that is a tragedy.

The democrats will not get anywhere until they acknowledge these fundamental defects in the government structure brought about by their constituents' advocacy. The Repes will not get anywhere until they embrace the concept of good and responsible government, not “less” government. And that means we are dead in the water as a country until we break through this impasse.

And by the way, it's not just government that needs fixing. How about credit card companies, banks, and communications companies? When is the last time you felt there was anything being said in your interest (or even understandable enough to figure that out) in all that fine print that comes with your bill? They're in the queue too.

Remember the old saying, “We don't care, we don't have to. We're the phone company.” It's about delivering the service after the money has been paid, and how that doesn't happen when monopolization locks in the payment and blocks accountability.
Comment: #4
Posted by: Masako
Sun Jul 10, 2011 6:35 PM
All all of these statistics prove is the Ryan did a terrible job of explaining his Medicare proposals. No one has explained to seniors, people who know seniors and people who think they'll be seniors some day that "Medicare as we know it" is (1.) terrible insurance with high deductibles and co-pays and lifetime limits and (2.) even that bad insurance ended in March 2010 with the passage of the Patient Protection and Affordable Care Act (PPACA) by the Democrats.

The correct comparison is the Ryan plan vs. "PPACA Medicare."

"PPACA Medicare" is (1.) today's Medicare minus Medicare Part C-Medicare Advantage (which has been selected by 25% of seniors after only five years--see note) and (2.) today's Medicare with provider reimbursements lower than Medicaid (meaning seniors will not be able to get a doctor). That will force seniors who can afford them into private supplement plans -- just as many Part A and B Original Medicare subscribers are on today, particularly very expensive AARP insurance -- that will be much higher than the costs they will face with Ryancare as quoted by the author. (And the author is using CBO estimates that make the absurd assumption that some insurance company would design a policy as bad as Original Medicare with its high deductibles and co-pays and lifetime limits and try to sell it.)

Ryancare is like Part C Medicare and much better than PPACA Medicare. And it is cost-effective: 25% of seniors use Part C but Part C only accounts for 22% of the money drawn out of the Medicare trust funds. Many prefer to compare Ryancare to Part D. There is some logic flaws in that comparison but if you prefer it, Part D came in at 40% less than estimated by the CBO. What was the last Federal program that did that?

Note: Medicare Part C has been around for 25 years but has become very popular since the changes made by the Bush/Republican administration in 2005 at the same time as the equally popular Medicare Part D was added.
Comment: #5
Posted by: Dennis Byron
Mon Jul 11, 2011 3:43 AM
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