Regardless of how one analyzes last November’s election results, it’s clear that voters over age 65 played a decisive role. According to Project Vote, turnout of senior citizens surged and approximately 60 percent voted Republican; that is 10 percent more than 2006.
Since seniors —13 percent of the population—cast more than one out of five votes, winning their votes is vital if Democrats want to regain control of the House of Representatives and keep control of the Senate and White House in 2012.
Both sides have reason to worry.
The annual trustee reports for Social Security and Medicare that were released last week found that Medicare's hospital insurance (HI) trust fund will run out of money in 2024 – five years sooner than last year's projection.
These findings put even more pressure on the effort to reform entitlements.
But so far, neither side has come up with a workable plan.
The Republicans have reason to worry about U.S. Congressman Paul Ryan’s (R-Wis.) proposed overhaul of Medicare and Medicaid -- turning Medicare into a voucher system through which government would give seniors a subsidy they could use to buy private insurance, and Medicaid into a block grant program – which many believe puts seniors at risk.
Rep. Ryan defended his budget plan in a speech to the Economic Club of Chicago Monday afternoon, one day after former House Speaker and presidential contender, Newt Gingrich, became the most high-profile Republican yet to publicly acknowledge that the plan is a loser on “Meet the Press.”
In March, the government projected a slight cost-of-living adjustment for Americans receiving Social Security benefits, but rising Medicare premiums threaten to leave millions without a raise for the third year in a row. Recent town hall meetings, from House Budget Chairman Paul Ryan’s district in Wisconsin to the race to fill former Rep. Chris Lee’s seat in New York, have brought back unpleasant memories of August 2009 when health reform tensions were at a boiling point.
This has been used in the New York 26th Congressional District special election race – which has effectively become a referendum on GOP plans to cut spending and reform Medicare and other entitlements. Indeed, the Ryan Plan is believed to be responsible for Democrat Kathy Hochul’s rise in the polls against Republican Jane Corwin in the traditionally GOP district.
The Democratic Party’s vulnerability is that they are basically eschewing any responsibility to put forth a sustainable and fiscally-responsible solution to pare back Medicare costs.
Rather, they are turning responsibility over to the Medicare “Independent Payment Advisory Board,” pr IPAB which came into existence with the enactment of the Affordable Care Act.
Put simply, the Democrats have no plan of their own, and the only idea that they have offered turns responsibility over to an unelected, arguably unrepresentative body to make decisions that could well impact on patient care.
With both parties’ deficit reduction plans having run their initial course, it’s time to convene a sober but practical and bipartisan conversation on the need to trim entitlement spending.
Democrats and Republicans need to carefully consider how they approach the broader issue of entitlements. The answer is not to have outsiders do it, nor is it to eviscerate programs.
Stated simply, both parties must come up with a set of plans and programs to experiment with different ideas, plans and platforms to fix Medicare responsibility and recognize that 1) seniors are scared and 2) they will undoubtedly assess perceived support for (and opposition of) ensuring continued high-quality services via Medicare in casting votes in the next election.
A good place to begin is rethinking IPAB.
The Board, which has been the subject of extensive debate, is required to propose a yearly set of cuts to Medicare that Congressional leaders can override only with super-majority votes. Seniors have every reason to be afraid of this: left alone to make unspecified cuts, the Board could result in cost-shifting that only increases spending and makes it harder to bring the deficit under control (something that, if left in the hands of Congress, would be just the opposite given that voters will make a point to hold Members accountable in future elections).
Politically-speaking, it’s also a tough sell to win over Medicare beneficiaries: although the Board isn’t a mythical “death panel,” it could end up limiting or denying the sort of medical care that almost anyone over 65, even those in good health, worries about needing.
A much smarter approach would be to focus on bi-partisan and fiscally-responsible reform policies like the adoption of health information technology that will drive greater efficiency and reduce patient errors. Medical innovation – inclusive of the development of new drugs and technologies for treating diseases like cancer, diabetes and HIV/AIDS – is also a pro-growth platform that seniors will rally around. Given the vast economic implications, Democrats and Republicans should press to make it a national priority in the same way that green tech is championed.
Additionally, better integration and coordination of care—the Government’s own Department of Veterans Affairs Hospital system and private entities like Utah’s Intermountain Health can serve as models in this regard--can offer a clear path for fiscally-sensible reform. The adoption of modern care delivery models is an unavoidable reality for Democrats and Republicans, and both sides would be well-advised to get serious about entitlement reform that prioritizes quality and incentive-based care over volume.
Whatever they do, Democrats, in particular, should know that the existence of provisions like the Independent Payment Advisory Board (and the cost-shifting implications that come with it) will alienate seniors and cast doubt upon the party's ability to deal with the deficit in a sensible manner.
Similarly, voters won't subscribe to Republican plans if they threaten the viability of Medicare. Rather than defend (or debate) unpopular policies, both sides should acknowledge specific flaws, improve where necessary and, above all, take steps to demonstrate to seniors that they’re for sustainable and fiscally-responsible solutions.
The alternative is putting a critical voting bloc up for grabs, and giving both sides the opportunity to demagogue – rather than really address serious problems.
Douglas E. Schoen is a Democratic pollster and strategist. He is a Fox News contributor and the author of several books. His latest book is “The Political Fix: Changing the Game of American Democracy, From the Grass Roots to the White House.”