US Politics Of Medicine

After presiding over an economy with a record disappointing performance, which usually gets incumbent presidents fired, Intrade puts Obama’s chance of re-election at 79%! I attribute an important part of this to the politics of medicine. Here’s recent US medical politics in a nutshell:

Seniors vote a lot more, and they love their free medicine, so US politicians have long written them a blank check, leading to rapid cost increases. Wonks have long said “something must be done” about costs, and the left has long wanted to expand the number with health insurance. So Obama pushed through a law requiring such an expansion, and declaring an intention to do something about costs. Later. But something, they swear.

This created a vague unease among seniors that their free medicine might get cut. Vague because seniors don’t really get how exactly costs might be cut. But still, cuts! Which created an opening for a Republican to get elected president by promising to never cut senior medicine. Except that the frontrunner Republican candidate was someone who had implemented a similar program when he was governor. And then he made a “bold” move to pick a running mate with a bold plan to turn Medicare into a voucher system. Which Romney thought would give him credit for taking problems “seriously.”

Bad move. Voters don’t really like “bold” politicians. Since seniors have a better idea of what “vouchers” mean, and how exactly they lead to cuts, that let Obama more effectively attack Romney as planning to cut seniors’ free medicine. Which is sticking, because although everyone says “something must be done”, seniors don’t actually believe that their free medicine needs to be cut. So seniors in key swing states move toward Obama, and he gets re-elected.

And after the election, there’s pretty much no chance Obama will let senior medicine get cut, at least in any way they could trace back to him. Nor will the next president after him. Maybe we’ll go into more debt, or raise taxes, or cut military spending. But no way will they stop writing medical blank checks to seniors, and letting costs rise as they will.

Here’s the recent data fleshing out this public opinion story:

Voters in three critical swing states broadly oppose the far-reaching changes to Medicare ­associated with the Republican presidential ticket. … For seniors in Florida, Ohio and Virginia, Medicare rivals the economy as a top voting issue. And by majorities topping 70 percent, seniors say they prefer to keep Medicare as a program with guaranteed benefits, . … [Romney’s] choice of Ryan — who wrote a proposal that would move Medicare toward vouchers as part of an overall attempt to curb the deficit — is considered a bold and politically risky move, given Medicare’s popularity. …

Although seniors nationwide dislike the idea of moving away from the current system, their opposition is even more pronounced in Florida, Ohio and Virginia, where both candidates have spent weeks saturating the airwaves with Medicare attack ads. Obama hammers the Ryan plan continually, telling supporters at a campaign event in Milwaukee last Saturday that Romney and Ryan would “turn Medicare into a voucher program in order to pay for tax cuts for the very wealthy.” …

Underlying support for not changing Medicare is the widespread belief that the system is functioning smoothly. In Florida, 70 percent of all voters say the system is working well — rising to 91 percent of the state’s seniors — and positive assessments of Medicare are nearly as high in the other states. … There is also a widely held public perception that changes are needed to keep Medicare sustainable for future generations. The problem for Republicans is that swelling budget deficits are not a sufficient motivator for voters. Across the three states, about three-quarters of voters say that Medicare cuts are not essential to deficit reduction. (more)