Ethics & Public Policy Center

On Medicare, Go on Offense

Published in National Review Online on June 14, 2011



President Obama's leftist ideology is killing the economy, rationing health care, and trashing the Constitution. That is the winning answer to the “Leftist or failure?” question recently posed by Charles Krauthammer. Should Republicans in 2012 hit Obama for being far to the left of the country, or should they point to his dismal economic record instead? Krauthammer himself replies, “Both,” advising Republicans to show that Obama's “abysmal stewardship” is rooted in his “out-of-touch social-democratic ideology.” That is correct insofar as it goes. Yet Krauthammer dances around the Medicare issue. I fear Republicans may do the same.

The Weiner scandal has brought a respite from the Medicare debate. It isn't going to last. First chance they get, Democrats are going to go back to crying, “Republicans want to kill Medicare!” Up to now, the GOP has responded defensively, complaining about the unfairness of push-granny-off-a-cliff attack ads. What the GOP hasn't yet done is go on offense against IPAB (the Independent Payment Advisory Board), the clique of Obamacare bureaucrats who are going to ration Medicare into the ground. IPAB is what's really going to push granny off a cliff, giving her far less control of her fate than the Ryan plan. Up to now, though, the GOP has been too spooked by its loss in NY-26 to go after IPAB. That is a mistake.

The temptation to run from the Medicare issue is strong. Republicans fear that no matter how many times they demonstrate that Medicare is unsustainable and that the Ryan plan is the only workable way to save it, they will be undone by their anti-entitlement reputation. Voters are primed to believe that Republicans want to kill Medicare. So when Democrats scream it, the public buys it. Why not just drop the subject, then, and talk about unemployment?

Ceding the Medicare issue won't do. If Republicans don't fight back on Medicare, the Democrats win by default. What's worse, the attack on Obamacare is effectively neutralized as a result. After all, IPAB rationing is the politically toxic foundation of Obamacare itself. Even many Obamacare-supporting Democrats run from IPAB. If Republicans can't attack IPAB, they can't defeat Obamacare. That bets everything on the bad economy, meaning that a slight upturn in employment just before the election could be enough to let Obama squeak by.

Running from the Medicare battle is a mistake. If voters are disposed to believe that Republicans don't like entitlements, they are equally primed to credit attacks on Obamacare rationing and Democratic plans to force us into a single-payer system. The GOP has already won the public battle on Obamacare. It would be madness to throw that victory away. So let's have some graphic ads subjecting poor granny to IPAB rationing. They'd be more than justified.

No matter how many charts and graphs you lay out proving Medicare's unsustainability, the public won't really get it until they see each side accusing the other of transforming Medicare out of all recognition. Only then will voters accept the fact that something fundamental about Medicare has got to change, at which point the Ryan plan will look a whole lot better than IPAB.

Even if Republicans succeed only in fighting Democrats to a draw on Medicare—and I think they can do a lot better than that—the bad economy decides the election in the GOP's favor. But if Republicans cede the Medicare issue (and, implicitly, Obamacare itself), they are skating on thin ice.

It's also a mistake to chastise the president for refusing to float his own plan to save Medicare. That is a concession to Obama's strategy of pretending that IPAB won't have to ration care if a bunch of (imaginary) Medicare efficiencies work out. Obama and the Democrats already do have a plan for Medicare. It's called IPAB. Spell out the rationing IPAB will inevitably undertake, puncture Obama's attempts to disguise his plan, and illuminate the path from IPAB to single payer. The Tea Party won the Obamacare debate by telling the public the truth about plans the Democrats refused to avow. The GOP needs to keep to that strategy now.

The constitutional issues also need to be brought to the forefront in any attack on IPAB. So far, the GOP has been all but silent on this issue, although it has tremendous political potential. Just laying out the extraconstitutional character of IPAB is enough to scare most Americans. George Will's latest column calls IPAB “a travesty of constitutional lawmaking.” Maybe we need an ad showing grandma clutching a copy of the Constitution as IPAB's bureaucrats collectively wheel her off a cliff. The Goldwater Institute's constitutional challenge to IPAB also needs to be highlighted.

I'm emphasizing IPAB because Republicans are shying away from that battle, but Krauthammer's broader point still holds. We need to show that Obama's economic failures are rooted in his overreaching leftist plans. Irwin Stelzer has an excellent piece showing in some detail how Obama's tax and regulatory policies are at the root of the economy's current troubles. For example, the National Labor Relations Board's attempt to block Boeing from opening a plant in South Carolina is one of the most radical attacks on economic freedom we've seen in some time. And as Stelzer points out, the NLRB's move also sends out a business-killing signal sure to help smother the recovery. That's one of many examples of how Obama's leftism is at the root of his economic failure.

So there's no need to choose between highlighting Obama's leftist ideology and emphasizing his failing stewardship of the economy. It's the president's leftism that's killing off our jobs. Nor is there a need to run from the Medicare battle. On the contrary, Republicans need to demonstrate that Obama's socialist Medicare rationing plans are going to kill off our constitutional liberties, not to mention granny herself. In short, Obama's “out-of-touch social-democratic ideology” is at the root of our present and future troubles, and the American people are perfectly capable of grasping that point. A great many of them already get it. It's time to stop hand-wringing and go on offense.

Stanley Kurtz is a senior fellow at the Ethics and Public Policy Center, and the author ofRadical-in-Chief.

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