At least for now, Medicare is the issue of 2012 election. In a period of sustained austerity, it’s a little jarring to see America’s major political parties wrestle over who will best preserve the sanctity of a major social welfare program. But that’s exactly what’s happening: Democrats are running against Paul Ryan’s plan, which would replace the single-payer model with a private voucher system, while Republicans are hammering President Obama for supposedly “robbing” $700 billion from the Medicare coffers.
One way to explain Medicare’s central role in the campaign is to say that it’s a proxy for the larger philosophical split between liberals and conservatives on the issue of social welfare. Democrats, this story goes, are defending Medicare because they believe that the government has a responsibility to take care of its neediest citizens when the free market can’t. And Republicans support the Ryan plan because they believe the free market does a better job of fairly allocating resources—including health care—than the federal government.
As edifying as that debate might be, it doesn’t match up with the rhetoric being employed by both parties. If Republicans believe a private voucher system is fairer and more efficient than single-payer, why are they so livid over the $700 billion going from Medicare to health care reform? The Affordable Care Act—which, remember, expands health care by requiring nearly everyone to acquire private insurance—is closer to what Ryan and other Republicans evidently think Medicare should be like.
For that matter, if Democrats believe in the social safety net so deeply, why is the Obama campaign trying to run to the right of Mitt Romney’s welfare position? As labor journalist Josh Eidelson has noted, an Obama “campaign statement charged that Romney ‘petitioned the federal government for waivers that would have let people stay on welfare for an indefinite period, ending welfare reform as we know it, and even created a program that handed out free cars to welfare recipients.’” Snarks Eidelson, “Only Obama can protect us from a Republican regime of hand-outs and Oprah-style free cars for the undeserving poor.”
Compare that to how both parties treat Medicare’s cousin, Medicaid. Ryan’s budget plan actually does even more damage there: evidently, Republicans don’t consider scooping out a full third of that program’s budget to be “robbery.” And while Obama has mentioned Ryan’s proposed gutting of Medicaid in passing, you might have barely heard it over the Democrats’ near-constant hammering of the Medicare issue.
The reason why is simple: Medicare users are the more powerful constituency. The elderly are more likely to vote than any other age group, and retiree advocacy group the AARP lays claim to nearly 38 million members. Organizations for low-income Americans, like the late ACORN, simply don’t command that level of influence. And because the voter ID laws currently sweeping the nation disproportionately disenfranchise the poor, their preferences are now even less relevant.
The truth is, Republican denunciations of Medicare “robbery” could not be more disingenuous. Neither, however, could the pious invocations of fairness from a Democratic Party that has long embraced President Clinton’s gutting of the welfare state. The fight over Medicare is not due to a deep, principled disagreement; Democrats and Republicans are simply trying to out-pander one another for the senior vote.