Medicare vs. Obamacare. That’s what this year’s Senate race between Sen. Mark Pryor and Rep. Tom Cotton is about.
Cotton’s campaign points to Pryor being the necessary vote to pass Obamacare, and Pryor’s points to Cotton’s Medicare votes that would raise the eligibility age for future beneficiaries and create a voucher-like system where seniors would buy insurance using government subsidies.
Last week, Pryor received the endorsement of the National Committee to Protect Social Security and Medicare. He stood before seniors who held hand-lettered signs, talked about how he voted to increase benefits, and said that House members who had voted to change Medicare were irresponsible.
Vouchers are a bad idea, but Medicare really does face serious, long-term challenges. It’s 14 percent of the federal budget, and Social Security is 24 percent. The costs of those two programs are part of the reason the Congressional Budget Office projects we’ll add another $541 billion this year to our $17.6 trillion national debt. The challenges will increase as the baby boomers age and as Americans live longer.
Call it a “cut” if you want, but somehow Medicare will have to spend less than it’s projected to spend – for its sake and for the rest of the budget’s. When I asked Sen. Pryor at his press conference what changes he would support, he said reform is needed and listed a few ideas such as allowing the program to negotiate drug prices and emphasizing preventive care. When I followed up by asserting those wouldn’t be enough, he didn’t disagree, saying, “The only way we’re going to get Medicare fixed is to do this in a bipartisan way.”
That’s true. But campaigns create the environment in which officials govern after the election. When candidates win by assuring voters that actual problems aren’t really problems, it weakens the ability of Congress to create those difficult bipartisan fixes later.
Republicans have used Obamacare – and President Obama himself – to gain a 5-1 majority in the Arkansas congressional delegation and majorities in the state Legislature. The message has been simple: Obamacare is bad.
But that message ignores the health care system’s serious problems. It hasn’t insured millions of people. Before Obamacare, it cold-heartedly denied insurance to those with pre-existing conditions and stopped covering them if they cost too much money. It’s 18 percent of our gross domestic product, far more than the rest of the industrialized world. A big reason Medicare has challenges is because it’s paying to treat seniors within this system.
Republicans, including Cotton, have focused far too much on what’s wrong with Obamacare and not enough on their own ideas. “Obamcare is bad” is not a health care policy.
Cotton’s Medicare votes are becoming a bigger political problem than Pryor’s support of Obamacare, as reflected by recent polls showing Pryor in the lead. By now, everyone who’s paying attention knows that Pryor voted for Obamacare, but they’re just now learning about Cotton and Medicare.
We’ve also reached the point where the news about Obamacare is not all bad. Yes, the employer mandates have been delayed, the website rollout was a disaster, and Obama never should have said that people who liked their plans could keep them. But the latest news, that eight million people have enrolled in insurance plans, gives Democrats the ammunition they’ve needed to return fire on the issue.
In an ideal democracy, the candidates would engage in an honest debate about Medicare’s long-term sustainability and about how to fix a health care system that was broken before Obamacare and still is. That debate, mirrored across the country, would continue in a statesmanlike fashion in Congress after the election, resulting in better policies.
Instead, the candidates will shout past each other – one saying “Medicare!” and the other “Obamacare!” – until November. It’s not an ideal democracy, but it’s the one we have.