If there is one thing that Democrats, Republicans, and the media all agree on, it's that Republicans are running a grave risk by trying to reform Medicare. Remember, they will point out, that Republicans tried to reform Medicare in 1996 under Newt Gingrich and suffered terribly at the polls as a result. And furthermore, they'll remind you, voters punished Republicans when George W. Bush tried to reform another entitlement program, Social Security. This message is reinforced by polls finding that Republican proposals are unpopular, and by the angry and raucous reaction to the plan at congressional town halls.
It's a compelling story. But it is fiction.
In 1996, Democrats did in fact seize on Republican Medicare proposals, and on Gingrich's clumsily worded observation that the program (or at least its bureaucracy) would "wither on the vine." Despite their best demagogic efforts, and despite the backlash over the government shutdown, Democrats not only failed to recapture the House in the next election, they gained only eight seats. Considering the size of the Republican victory two years before and the fact that Republicans had to defend a large number of marginal seats, that was a pretty mediocre Democratic rebound. Moreover, Republicans gained two seats in the Senate.
Sure, Bill Clinton defeated Bob Dole in 1996. But we are talking Bob Dole here. That was not exactly heavy lifting. And does anyone recall Dole's spirited defense of entitlement reform? Me neither.
Similarly, Republicans took big losses in 2006 and 2008, but Bush's failed Social Security plan doesn't appear to have been much of a factor. Senior citizens, in fact, split about evenly between Democrats and Republicans in 2006. The most outspoken congressional supporters of Bush's plan were nearly all reelected. In fact, it could be argued that the expansion of Medicare (through the prescription-drug benefit), representative of a general failure of fiscal discipline, contributed to Republican losses — exactly the opposite of the conclusion drawn by most pundits.
During the 2010 midterms, Democrats again attacked Republicans for wanting to "privatize Social Security" and "destroy Medicare." They repeatedly tried to link Republican candidates with Paul Ryan's "Roadmap for America's Future." How far did that get them? Some of the most outspoken supporters of entitlement reform, including Marco Rubio, Ron Johnson, Rand Paul, and Pat Toomey, now sit in the U.S. Senate.
Even those discouraging polls are not quite what we have been led to believe. According to a Kaiser Foundation poll, half of Americans want Medicare to "continue as it is today." But 46 percent believe "Medicare should be changed to a system in which people choose their insurance from a list of private health plans that may offer different benefits at different premium amounts and the government pays a fixed amount (sometimes called a voucher) towards that cost." An NBC/Wall Street Journal poll also found the public evenly split. When asked about "a proposal to change how Medicare would work so seniors being enrolled in the program ten years from now would be given a guaranteed payment called a voucher from the federal government to purchase a Medicare approved coverage plan from a private health insurance company," 21 percent of Americans thought it was a good idea; 22 percent thought it a bad idea. More than half didn't have enough information to form an opinion. And a Gallup poll found that seniors are actually more supportive of the Ryan plan than of President Obama's proposals for Medicare reform, by a 48–42 percent margin.
How the question is phrased makes a difference, and not every poll is so favorable. Still, Ryan's plan hardly seems the career-killer it is portrayed as being.
Given America's looming fiscal disaster, reforming Medicare is the right thing to do — no matter what the polls say. But sometimes good policy is also good politics. If Congress acts to stem the tide of red ink, reformers may actually find that voters are on their side.