Once a upon a time, conservatives cautioned against the creation of a government-run health insurance program for people over 65, calling Medicare “socialized medicine.” But now — in campaign ads and speeches — Republicans across the country are positioning themselves as the real defenders of Medicare.
The new posturing helps conservatives claim they’re the ones preserving the status quo. Nevermind Republican lawmakers’ long quest to privatize Medicare. They’re the ones saving Medicare from Medicare for All, which is really the first step to “open borders socialism.”
“They want to raid Medicare to pay for socialism,” Trump said during a rally in Indiana last month. “The only way to control costs would be to ration care,” said House Speaker Paul Ryan (R-WI) during a National Press Club speech this week.
There’s a reason Republicans are suddenly talking about Medicare. Voters want to talk about health care, and conservatives don’t want to talk about their repeated failed efforts to repeal the Affordable Care Act last summer.
While attacking Democrats for embracing an idea that 70 percent of the country supports, Republicans are reusing the same smears from previous health care reform efforts — from the creation of Medicare to Obamacare.
“From [Medicare], it’s a short step to all the rest of socialism — to determining his pay and pretty soon your son won’t decide when he’s in school where he will go or what he will do for a living. He will wait for the government to tell him where he will go to work and what he will do,” Ronald Reagan said in 1961, at the time an actor hired by the American Medical Association (a fierce and influential opponent of Medicare for All today).
Mirroring Reagan yet again, Trump evoked fears in his USA Today op-ed Wednesday riddled with hyperbolic language and fallacies. The president begins by aiming to scare seniors — saying they “would no longer be able to depend on the benefits they were promised” — and ends by calling Democrats “radical socialists who want to model America’s economy after Venezuela.”
He also re-purposed a false criticism of the ACA in his op-ed: progressives’ latest aspiration is a “government takeover of American health care.”
But Medicare and the ACA (and all the reforms in between) didn’t ended freedom. They gave more people health care. Two years before Medicare’s enactment, only 54 percent of people over 65 had insurance that covered hospital stays. Three years after, 96 percent did. And the ACA reduced the overall uninsured rate among non-elderly adults.
When Republicans are warning about Medicare for All, they are referring more to single-payer health care advocated by Sen. Bernie Sanders (I-VT). Not all Democrats support this system, though the number is growing.
Unlike past health care reforms, a single-payer health plan would convert the country’s patchwork of private and public plans into one government-run health plan. But it’s not exactly an full government takeover, as hospitals and doctors don’t become federal employees. The objective is to address the country’s under-insurance problem, by abolishing out-of-pocket costs for medical care, and to cut overall health care spending.
“I don’t know if it’s genius or madness,” Center for Medicare Advocacy’s David Lipschutz said of Republicans’ new position, given their record on health care. “It’s essentially saying ‘I am for everything I opposed in the past and my opponents are against everything they supported in the past’ — it’s rather audacious.”
It’s unclear how Republican’s desire to make November a referendum on Medicare for All, by using misleading statements or straight-up lies, will ultimately land with voters.
“I don’t know if people will believe it,” Lipschutz told ThinkProgress, explaining that people are more fired up about defending coverage gains.
“I think people lose sight of the proverbial pie,” he added. “I think one of the ways opponents of health coverage expansion are raising opposition is they are operating under the assumption or want people to think that there is a fixed pie for Medicare… but depending on how coverage expansion will be set up, that pie by necessity will grow larger.”
It’s important to note that as conservatives blast socialism, Democrats are turning in a more socialist direction. Indeed, Democrats — particularly young people — have a more positive image of socialism than capitalism.
Republicans are targeting seniors with fear-producing campaigns because older Americans are actually concerned that redistribution can lead to Medicare cuts. Medicare for All doesn’t actually cut Medicare — it really improves benefits — but there is a reasonable concern about current beneficiaries’ access to providers — a point Vox’s Matthew Yglesias highlights.
“The Democratic proposals don’t contain any mechanism that would conjure up additional physicians or hospital beds, but would increase the utilization of health care services by non-elderly patients,” he writes. “Thus it’s at least plausible that elderly people currently covered by Medicare would find it harder to secure appointments.”
Still, Medicare for All won’t mean the United States will spontaneously combust and turn into Venezuela. (And it’s worth pointing out Venezuela’s woes are indicative of its authoritarian leadership.) If Democrats go all in with Medicare for All, the nation’s health care system will likely look more like Canada’s. There are also other Medicare-focused proposals that inch toward universal coverage in the Democratic pipeline — and none of them involve “open borders.”