Medicare Politics and Gullible Oysters

Tenniel, “The Walrus and the Carpenter”

On Monday I quoted Lewis Carroll’s “How Doth the Little Crocodile” while discussing Mitt Romney and Paul Ryan’s “just trust us” approach to the 2012 election. Along the same lines, I could also have quoted “The Walrus and the Carpenter,” whose two protagonists invite the oysters to trust them, with catastrophic results.

Indeed, I used the poem to talk about Medicare just over a year ago. The poem is recited by Tweedledee, and in my former post I made the point that one of the parties was Tweedledum and the other Tweedledee, each playing games with Medicare for electoral purposes. I no longer see the two parties as equally guilty, however.

The Democrats may not be fully facing up to the looming insolvency of Medicare and Medicaid as medical costs explode, but at least they made a good faith effort when they passed (with no Republican assistance) the Affordable Healthcare Act or Obamacare. Remember, the purpose of Obamacare was not only to insure all Americans—the fact that we have 30 million who are uninsured is a national disgrace—but also to bend the rapidly rising cost curve through a number of measures. Some of these measures were effectively demagogued as “death panels” and “health care gulags” in the 2010 election, and now it appears that the Romney campaign wants to repeat this campaign strategy.

Romney and Ryan are appealing to a generational divide by claiming that Obama wants to strip $716 billion from Medicare and give it to undeserving other people (most notably minorities). The fact that the same cost savings are to be found in Paul Ryan’s own budget plan and that they are not actually stripped from Medicare is conveniently ignored. So is the fact that a President Romney repealing these efficiency measures would speed up Medicare’s insolvency. Meanwhile, Romney has endorsed Paul Ryan’s voucher plan which, conveniently for Romney’s senior supporters, would only affect people under 55.

Experts believe that Romney and Ryan (like the walrus and the carpenter) are selling the public a bill of goods. Here is Michael Tomasky of The Daily Beast quoting Henry Aaron of the Brookings Institute on how Ryan’s vouchers would devastate Medicare for those under 55:

The reason is technical, but easy to understand. The premium for those who stay in traditional Medicare under the Ryan plan would be calculated as under current law, but the average cost of serving those who remain in traditional Medicare would go up as private insurance companies market selectively to those with relatively low anticipated costs. The average cost of those who remain in traditional Medicare would therefore increase. As a result of this gap, the financing for traditional Medicare would become progressively less adequate, throwing into doubt the very survival of the program.

So take a look at the poem again.  The oysters that are being fooled are the younger ones. The eldest oyster is comfortable with the status quo and so, though he knows the walrus and the carpenter are up to something, he doesn’t warn the next generation. Here’s the interchange:

“O Oysters, come and walk with us!’
 The Walrus did beseech.
A pleasant walk, a pleasant talk,
      Along the briny beach:
We cannot do with more than four,
      To give a hand to each.’

The eldest Oyster looked at him,
      But never a word he said:
The eldest Oyster winked his eye,
      And shook his heavy head —
Meaning to say he did not choose
      To leave the oyster-bed.

But four young Oysters hurried up,
      All eager for the treat:
Their coats were brushed, their faces washed,
      Their shoes were clean and neat —
And this was odd, because, you know,
      They hadn’t any feet.

Four other Oysters followed them,
      And yet another four;
And thick and fast they came at last,
      And more, and more, and more —
All hopping through the frothy waves,
      And scrambling to the shore.

The trust of the young oysters, of course, is repaid by their all being eaten. Unlike the poem, however, Mitt Romney’s promises of “a pleasant walk, a pleasant talk” have not get generated a stampede of support. It is not only the eldest oyster who is suspicious.

There’s another way in which the poem doesn’t capture our situation. According to Tomaskey and Aaron, the eldest oyster isn’t isn’t as safe as he thinks. Tomasky sums up Aaron’s findings on how those over 55 will also be negatively impacted by a repeal of Obamacare:

Health reform closes in the infamous ‘donut hole’ in Medicare drug coverage—the gap of thousands of dollars of drug costs that the original drug benefit left open. If health reform is repealed, that benefit vanishes.

Gone also would be health reform’s coverage of cost sharing for prevention services.

Gone would be the subsidies that will eventually cover 75 percent of the cost of generic drugs.

Gone would be Medicaid benefits for millions of older Americans, working and retired, who would be newly covered by Medicaid expansions under the Affordable Care Act.

Until enactment of the Affordable Care Act, a 60-year-old who did not work for an employer that offered group health coverage had to pay high or unaffordable premiums for individual coverage or go uninsured. If health reform is repealed, they will return to that intolerable predicament.

The savings that are to be achieved under health reform would vanish. As a result, the Hospital Insurance Trust Fund would be exhausted in 2016 rather than in 2024, as projected under current law.

Tomasky notes in another article that the future that awaits America’s oysters under the Romney-Ryan plan, young and old,  is so unpleasant that the candidates must do everything they can to muddy the waters, including lying:

In polls like one the Kaiser Family Foundation commissioned earlier this year, even majorities of Republicans don’t want Medicare restructured along Ryanesque lines. These guys may not be able to count, but they can read polls, and so they know very well that if they gave the county the honest debate we were told we were going to have about Medicare, and for that matter about taxation, they’d wake up Nov. 7 with about 120 electoral votes in their pockets and conservatism in tatters.

They know this. They know that the truth would crush them electorally. And so it follows that they know they must lie. They must lie about their Medicare plans. They must lie about the effects of their tax plans on average people and rich people. And they must tell a number of lies about Obama, all the better if they involve race, as the welfare lie does [that Obama wants to gut the “work for welfare” program].

So this will be the entire point of the Romney-Ryan campaign. Lie lie lie. Muddy the waters. Turn day to night, fire to water, champagne to piss. Peddle themselves as the precise opposite of what they actually are. That is clearly the m.o.

Turn day to night? That sounds like our poem again:

The sun was shining on the sea,
      Shining with all his might:
He did his very best to make
      The billows smooth and bright —
And this was odd, because it was
      The middle of the night.

I’ve stated multiple times that Carroll’s Alice books appear to be the best works for describing this election. (See all the previous posts below.) Tomaskey helps us understand why Romney is (here I switch to Dryden’s MacFlecknoe) “through all the realms of Non-sense absolute.” Why, like Hilaire Belloc’s Mathilda, he tells such “dreadful lies.” Here’s the explanation:

Following trickle down economic theories, George W. Bush presidency asserted that the economy would grow through tax cuts weighted towards the wealthy, a rollback of regulations on the financial industry, and  money borrowed to finance two wars and a Medicare prescription drug program. When the debt exploded, the finance sector and housing markets imploded, and we had the greatest financial crisis since the Great Depression, the GOP had two options: it could rethink its assumptions and remake itself or it could go “all in” with its prescriptions. It chose the second route, which meant that it had to deny reality, and the logic of the situation led to it choosing a candidate who would say anything. (No other serious candidate could have pulled it off.) Given what happened to the country, how could one keep a straight face while arguing for more tax cuts for the wealthy, more deregulation, more military spending. The secret was to avoid all policy specifics and run a “trust us” campaign. Romney had to become an expert in shining forcefully as he contended, over and over, that night is day.

Unfortunately, as I noted in my previous blog post on Medicare, while Tweedledum and Tweedledee are trading accusations about who spoiled their “nice new rattle,” a monstrous crow is looming. Call it the coming insolvency of our entitlement programs and, more generally, the hollowing out of the middle class.

If there were ever a time when we needed an electorate capable of critical thinking—the informed citizenry that Thomas Jefferson dreamed of—this is it.

Added note: In an article today, Jonathan Cohn of The New Republic has one of the best articles I’ve seen comparing and contrasting the Obama and Romney/Ryan approaches to Medicare. You can find it here.

Further note: Matt Yglesias of Slate, on the other hand, sees a Tweedeledum-Tweedledee situation but in a good way. He writes, “on Medicare, Obama and Romney actually agree about almost everything.” Of course, that’s just the Medicare part. Obama also believes that 30 million uninsured Americans should receive insurance.

Other posts on Lewis Carroll applied to American politics:

Romney and Ryan’s Gently Smiling Jaws

Mitt Romney and Looking Glass Politics

The Presidential Candidates in Wonderland

Rightwing Rewrites Reality

Tweedledum, Tweedledee, and Medi(s)care

Believing 6 Impossibilities before Breakfast

It’s Been a Mad Tea Party

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