So I was watching the Fox News 6:00 PM show and the panel was discussing whether Ryan could defend his Medicare cuts or if Ryan’s Medicare cut plan will hurt the Republicans among seniors. This is nuts as a matter of both fact and politics. As between the most recent Ryan budget and the most recent Obama budget, there isn’t any disagreement about whether to cut Medicare. There isn’t even any disagreement about how much to cut Medicare. They both agree to fund Medicare at GDP+.5%. They disagree on how to cut Medicare. Obama wants a central government board (called IPAB) that can cut how much is paid to providers of health care services to Medicare recipients. If IPAB cuts health insurance provider payments too much, the providers will stop seeing Medicare patients and the Medicare recipients won’t get the services. And since Obama-style Medicare cutting only includes one option (what IPAB says or pay out of your own pocket), middle-class and working-class Medicare recipients will simply be out of luck. The Ryan Plan (which is really very close to the Ryan-Wyden Plan) allows future seniors to choose between multiple plans that compete to offer the same services as Medicare at the lowest price. One of the choices will be the current Medicare Fee For Service program that we already know. The Republicans need to make this into an argument between Obama’s IPAB without-appeal vs. choice and competition. One of the problems we face is that, even in among parts of the right-leaning media, the issue isn’t being framed according to the actual policy disputes. This is one of consequences of the right-of-center’s relative lack of interest in positive health care policy prior to about the middle of the last decade. Ryan has done more than any other political figure to move the debate, but his own side isn’t quite ready to hold up its end yet. So what is the Romney campaign to do? Let Ryan go on offense in the paid media. Here is one way to go about it:
1. Buy two minute blocks of commercial time. It costs more than a 30 second spot, but one ad that leaves an impression is worth more than ten that just go over the heads of the audience. Medicare policy is pretty complicated and most viewers don’t know about the proposals in dispute. Also, Ryan is at his best when he has a little time to work with.
2. Let Ryan spend the first minute explaining how Obama’s budget cuts Medicare spending. Have him explain how IPAB works and why those kinds of centralized cuts are both a bad idea in principle and why working-class and middle-class Medicare recipients would be in the most danger if providers stopped seeing Medicare recipients. A lot of the audience will be surprised to learn that Obama has proposed such large Medicare cuts, much less how Obama plans to implement them.
3. Let Ryan spend the second minute explaining how Ryan-Wyden-style premium support works. Have him explain that all bidders would have to offer the standard Medicare benefit and that the current Fee For Service Medicare system will be one of the choices. Have him explain that sicker Medicare recipients will have larger premium support payments. Have him explain why he thinks this will allow the government to buy more health care services for seniors per dollar spent while giving seniors more choice.
4. Take your time. Get the most out of every word and use some graphics. Ryan is pretty good at this. Make the most of his skills.
5. Fund the ad buy. Spend lots of money. If you can win the Mediscare war, you are a long way to winning. Right now, defining this battlefield is the most important thing. There will be plenty of Republican-affiliated Super PAC money to run ads about how Obama has presided over high unemployment, high gas prices, and epic deficits. The Romney team has to carry the weight of neutralizing Obama’s Mediscare campaign, and Ryan is the best person on the Romney team to make this case.
6. Spending the money doesn’t just get you those eyeballs for those two minutes that Ryan explains the Medicare issue. It is an investment. Romney’s allies and well wishers will see the ads and pick up the message. They will learn how to frame the issue. It will also make it easier for the Romney-Ryan ticket to make the Medicare case if tens of millions of Americans have a basic understanding of how Obama has proposed to cut Medicare and how the Ryan-Wyden-style premium support plan works. All of this makes it much harder for Obama and his media allies to successfully demagogue the issue later in the campaign.
7. So let Ryan do his thing. Make the ad. Spend the money. Win this fight.
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