Campaign’s fierce rhetoric on Medicare dims hope for a solution, experts say

Many spending hawks in Washington had hoped that Mitt Romney’s selection of leading deficit warrior Paul Ryan as his running mate would open a more candid and sober debate about cutting federal spending.

But the tone of the campaign rhetoric on Medicare — with each party accusing the other of working to destroy the program — has raised concern among longtime deficit-reduction advocates that neither party is preparing the public for what they see as the demographic imperative of curbing Medicare spending.

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On Wednesday, Romney accused President Obama of siphoning Medicare dollars to fund his 2010 health-care law, and he promised to restore that money if elected.

Obama countered that he has strengthened the Medicare program and that his Republican challenger would end it.

The back-and-forth worried Robert Bixby, executive director of the Concord Coalition, a nonpartisan group that seeks an end to deficit spending. He said both candidates are undermining efforts to convince the public of the long-term need for Medicare reductions.

“I don’t think it’s off to a very good start, if what we’re looking for is a good, substantive debate on deficit reduction,” he said of the Ryan phase of the campaign. “There are good, legitimate debates we could have about the best way to control Medicare spending. But it quickly descends into charges of robbery and murder.”

Budget experts expect Medicare spending to balloon in the coming decades, as 10,000 baby boomers will turn 65 and become eligible for benefits each day for the next 20 years. The program’s rapid growth is a leading driver behind the growth of the federal deficit.

A complex debate has been underway about how to provide seniors the care they need at a cost the government can afford.

But several deficit experts said they worry that the escalating campaign rhetoric about which side is seeking Medicare cuts will damage both parties’ ability to come up with a compromise to reduce costs.

“Everyone knows that Medicare in its current state is unsustainable. There’s not a serious person out there who argues otherwise,” said Steve Bell, economic policy director at the Bipartisan Policy Center. “And we are now starting to have an emotional, distorted, propagandistic debate about it.”

Cost-cutting measures

The Democrats’ health-care law aims to curb Medicare spending by reducing payments to hospitals and other providers — not beneficiaries — in part as a trade for reducing hospitals’ costs by cutting millions from the ranks of the uninsured.

In the spending plan he authored as chairman of the House Budget Committee, Ryan proposed to end the health-care law. But he assumed the same cost reductions in Medicare spending as a way to reduce the deficit.

On Wednesday, Romney promised that if elected, he would restore the money to the program as a way to bolster it for current retirees.

“My commitment is, if I become president, I’m going to restore that $716 billion to the Medicare trust fund so that current seniors can know that trust fund is not being raided,” Romney said on CBS News’s “This Morning.”

“And we’re going to make sure and get Medicare on track to be solvent long-term, on a permanent basis.”

Those comments came after Republican National Committee Chairman Reince Priebus said Sunday on NBC’s “Meet the Press” that if anyone has “blood on their hands” in the Medicare debate, it is Obama. “He’s the one that’s destroying Medicare,” he said.

Bixby said Ryan’s budget position is “defensible,” plowing cuts from Medicare into deficit reduction.

But speaking on conservative radio host Sean Hannity’s show on Wednesday, the Wisconsin congressman joined the chorus in pledging to fight the cuts.

“We’re going to have this debate, and we’re going to win this debate,” Ryan said. “It’s the president who took $716 billion . . . from the Medicare program to spend on Obamacare. That’s cuts to current seniors that will lead to less services for current seniors. We don’t do that. We actually say end the raid and restore that, so that those seniors get the benefits today that they organize their lives around.”

Bixby said Romney has muddied efforts to curb red ink with his promise to restore the money. “I’m trying to figure out how you reduce Medicare spending without reducing Medicare spending,” he said.

Many Republicans think cutting payments to providers will succeed only in making it unaffordable for doctors to treat Medicare patients, resulting in fewer medical outlets willing to accept the federal health insurance.

In a statement, Romney campaign spokesman Andrea Saul said that “twisting the screws on providers won’t hold down costs, it just jeopardizes seniors’ access to care and threatens their benefits.”

Instead of relying on “on administrative price controls,” she said, Romney will “introduce choice and competition in the system.”

Attack, counterattack

Douglas Holtz-Eakin, a former director of the Congressional Budget Office and adviser to 2008 Republican presidential nominee John McCain, said Romney and Ryan must make a compelling case for the need to reduce Medicare spending for future seniors. But first, he said, they must neutralize the Democratic attacks on Ryan’s plan as one that will throw seniors off Medicare rolls.

Obama pressed that assault Wednesday in a speech in Dubuque, Iowa. His own reforms, he said, will strengthen Medicare by reducing “wasteful spending”; benefits for seniors are not cut “by a dime.” However, he said, a proposal in Ryan’s budget plan — which would offer future retirees a capped payment to purchase private insurance — “ends Medicare as we know it.”

The Bipartisan Policy Center’s Bell, a former staff director for the Senate Budget Committee under Sen. Pete V. Domenici (R-N.M.), said he fears that Obama will win by demonizing efforts to curb Medicare growth, making it harder to find common ground on the issue in a second term.

“My sense is that this is going to be a referendum, all right. But for people like me, who are really concerned about debt trends, the outcome will be a step backwards,” he said.

Adam Fletcher, a spokesman for the Obama campaign, said that the health-care law added eight years to the solvency of Medicare and that further cuts proposed by Obama in this year’s budget would add two more.

“The president has done a lot more than just talk about making Medicare more sustainable,” he said.

Rep. Jim Cooper (D-Tenn.), who has been warning of the dangers of a rising tide of debt for years, said the modern political process makes it nearly impossible for politicians to have a rational policy debate in the heated final weeks of a national campaign.

“We’re trying to solve some of the most complex policy dilemmas in history with an increasingly ADD nation,” he said. “It’s an in­cred­ibly tough challenge.”

But he said both parties should strive for a do-no-harm approach, in which they don’t allow their rhetoric to be so strident that they cannot make tough choices after the election.

Cooper said the current campaign is “not just worrying” him on the do-no-harm measure.

“It’s terrifying me,” he said.

 
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