Wednesday, August 15, 2012

The best defense is a good offense

The Democrats were very smug about how the Romney pick of Paul Ryan would crater senior support of Republicans because Democrats could demonize Ryan as that guy throwing Granny over the cliff. They are so blinded by their own ideology that they didn't realize their own vulnerabilities on Medicare. They've provided that opportunity for Republicans to combine defense of their own reforms of Medicare with how Obamacare has already ended Medicare as we know it. The Republicans are now running an ad attacking Obama for how he has taken $716 billion out of Medicare for funding Obamacare. Instead of being on defense on Ryan's plan, the GOP is going on offense tying Obama's unpopular health care plan to how it has, as verified by the CBO, raided Medicare.

Watch this short video from Mercatus on how Obamacare took over $700 billion from Medicare for Obamacare and then tried to count that money twice as both funding Medicare and also funding Obamacare.


As Yuval Levin wrote yesterday, "Obamacare changed everything."
This becomes evident in part when you consider that the arguments the Democrats naturally fall back upon regarding Medicare are just false now. So for instance David Axelrod on CNN’s State of the Union referred to “Congressman Ryan’s idea that we should turn Medicare into a voucher program, shifting thousands of dollars ultimately onto the backs of seniors.” But that’s simply a lie — Ryan’s actual Medicare proposal (which Romney has backed) simply doesn’t shift costs to seniors.

But it’s even more evident when liberals try to confront what they themselves — the supporters of Obamacare — propose to do to Medicare. Thus we find Rachel Maddow like a deer in headlights when Rich Lowry asked her a simple question on Meet the Press yesterday: “Do you support $700 billion in cuts in Medicare over the next ten years?” Obamacare takes that amount out of the program and spends it on other things, especially its new exchange subsidies. Maddow literally refused to answer the question. At one point she even said she shouldn’t have to answer it because “I’m not running for anything,” even though her occupation, as I understand it, is to express her opinion. And in the end, her defense of the cuts (though she still never said she supported them) was that Paul Ryan’s budget actually keeps them in place, eliminating Obamacare’s spending but not its Medicare cuts.

It’s at least a bit odd for Democrats who say Ryan is the devil to defend President Obama’s raid on Medicare by saying Paul Ryan does the same thing — and what’s more, it’s not true. The Ryan budget puts those $700 billion into the Medicare trust fund, to shore up the program’s future and reduce the deficit, rather than spending the money on yet another new entitlement. And Mitt Romney proposes not to make those Obamacare cuts in the first place — keeping the money in Medicare’s operating budget and so leaving the program simply as it is for today’s seniors and starting his premium-support reform for younger Americans when they retire, beginning a decade from now. Both undo Obama’s raid on Medicare, and both support a plan to save Medicare from bankruptcy in the years ahead.
Just wait until the Republicans start running ads about Independent Payment Advisory Board (IPAB, the independent group established by Obamacare that will decide which treatments get funded through Medicare and which don't and whose decisions are supposedly impervious to recall by either Congress or the courts.

The Republicans can explain how Obamacare is already leading to a shortage of doctors that people, including seniors are already experiencing.

As Jay Cost points out, it is the chief actuary for Medicare who has exposed the fact that Obamacare endangers Medicare as we know it.
The Affordable Care Act requires permanent annual productivity adjustments to price updates for most providers (such as hospitals, skilled nursing facilities, and home health agencies), using a 10-year moving average of economy-wide private, non-farm productivity gains. While such payment update reductions will create a strong incentive for providers to maximize efficiency, it is doubtful that many will be able to improve their own productivity to the degree achieved by the economy at large...

Thus, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries). Simulations by the Office of the Actuary suggest that roughly 15 percent of Part A providers would become unprofitable within the 10-year projection period as a result of the productivity adjustments.
So it's not Paul Ryan who is destroying Medicare. Obama has already done so. And by so doing, he has made the Democrats vulnerable themselves on the issue.

The Democrats might have thought that Romney wouldn't be able to make the attack because of his own plan in Massachusetts. But he is innocent of doing anything to Medicare in his own state because that is a federal plan.

Remember the best defense is a good offense. And now the Republicans are on the offense on what they themselves triumphantly have done to Medicare in order to fund Obamacare. And they didn't seem to realize how this made them vulnerable themselves. They will soon have to stop licking their chops over what they were going to do to the Romney-Ryan ticket in Florida and start worrying about seniors finding out exactly how they themselves have robbed Medicare. And then the Republicans can finish the one-two punch by explaining how the Wyden-Ryan plan is the only hope to save Medicare for those now in the program and those hoping to have funds there when they retire.

It's Medicare jujitsu and Obamacare made it all possible.

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