It's a Shame

It would be a damned shame if we finally lost a constituency as prized as seniors because of the current Democratic president. And yet that appear to be exactly what’s happening. In the summer of 2009, there were reports of a Democratic “problem” with seniors. Victoria McGrane and Chris Frates, writing in POLITICO, described how the town hall rage was being fueled by senior citizens. Seniors, angered by proposed cuts to Medicare floating around Congress, controversial talk of “death panels,” and the like, promised to be a concern for Democrats in the upcoming midterm elections. In 2008 they backed John McCain over Barack Obama by 8 points.

More than a year later, the news hasn’t gotten any better according to The Washington Post. A full 66% of older voters are enthusiastic about voting in November and most of them ready to cashier the Democrats. And they should be. Since they are free of the responsibilities of governing, the vocal conservative opposition has often been right.

In addition to the ones that exist with private insurance, governmental rationing regimes are not beyond the realm of possibility. People often confuse them with the completely innocuous concept of end-of-life counseling, which had been supported by Republicans in years past. The death panels, however, are notions of governmental bureaucrats—full of fulsome praise for the British system of rationing—with the power to deny care for the sake of cost-cutting. Responding to the criticism his work has engendered, bioethicist and administration official Ezekiel Emanuel assured us he was “writing really for political philosophers. [T]he average person, it's not what they're used to reading.”

As far back as 2009, there were new reports contradicting the president’s public statements that there were no cuts to Medicare in any of the proposed legislation. These days you find conservative activists warning us in the pages of The Wall Street Journal that the new reform law will: “Cut $818 billion from Medicare Part A (hospital insurance) from 2014-2023, the first 10 years of its full implementation; [Cuts] for Medicare Part B (physicians fees and other services) brings the total cut to $1.05 trillion over the first 10 years.”

Trouble abounds with the president’s Deficit Commission, or the “Catfood Commission,” as it’s known in good quarters. The uninspired notion of a blue ribbon commission to grab the third rail, among other things, was championed by both Obama and Hillary Rodham Clinton during the 2008 primaries. It was weak sauce though forgivable. What is unforgivable is the reported thirst for cuts in Social Security that have animated the Catfood business so far. Despite the hype, even hysterical news reports are forced to admit that Social Security will be solvent until 2037. Praise Jesus, or whoever, for House speaker Nancy Pelosi. For all of her faults, she has stood in the gap on this issue.

Of course there’s always the greater problem of America’s Scylla and Charybdis political system. In opposition to the Obama administration, we have the Republicans. In the closing phase of the 2004 election, John Kerry tried to make an issue of President Bush’s designs for Social Security. Bush’s campaign dismissed the charges as desperate “scare tactics.” Once safely re-elected, the Republican president commenced with an effort to privatize Social Security. America’s largest senior advocacy group, AARP, and the Democratic Party, which was denounced as the party of no,” were right to stand firmly against Bush’s schemes. Republicans of today aren’t much better.

Amid the mess, there is opportunity. Speaker Pelosi’s intervention in the Catfood Commission, along with other desperate attempts to seek distance from this administration, reveals the Obama way is not the only way. Things have so deteriorated that people are willing to engage in the fantasy that Mrs. Clinton would have been superior to Mr. Obama. We are asked to believe, despite their sameness in terms of policy, what separates them is a sorely-lacking toughness and competence. Color this erstwhile PUMA unconvinced.

The erosion of support for Democrats among older voters is alarming and unremitting. This critical bloc went for McCain in 2008 and favors Republicans this year. By 2012, President Obama will have no other recourse than to implement the strategy used by many Democrats this cycle: “Look over there! They’re extreme!” Whatever proposed cuts exist in Rep. Paul Ryan’s roadmap, President Obama will answer for the ones mandated in his law.

Tags: Barack Obama, Democratic Party, Republican Party, Older Voters, Medicare, Social Security, Deficit Commission, Catfood Commission (all tags)

Comments

8 Comments

the Republican messaging on Medicare is interesting
All over the country they're bashing Democrats for cutting Medicare, after having that issue thrown in their faces for many election cycles. The Chamber of Commerce ad against Leonard Boswell in IA-03 says he voted for big government health care, and in the next breath says he voted for Medicare cuts (like that's a bad thing). Brad Zaun complained two months ago that the health care bill is a budget-buster because Medicare's actuary says those cuts will never materialize. But he's up with a tv ad now saying Boswell voted to gut Medicare with $500 million in cuts.
by desmoinesdem 2010-10-14 11:17PM | 0 recs
Keep thinking...

... I'm reading Redstate these days on MyDD. How far this site (and it's pageviews) have fallen..

by Philly Ed 2010-10-15 12:07AM | 1 recs
RE: Keep thinking...

BINGO.

You called it.  

There is a group of people who I thought were Democrats who seem to crave seeing this President fail.    I don't know why.   I guess they like Bush / Cheney beating on them instead.   Maybe some people are not happy unless they feel they are the victim.  

by RichardFlatts 2010-10-15 10:51AM | 0 recs
RE: Keep thinking...

Ugh, seriously.  I haven't been here for a while, but my google reader ran out before I'm going out for the evening so I thought I would check out the ol' MyDD, and I have to say I'm not altogether surprised at what I found on the front page.

I guess you could lay some blame at Obama's feet for not fighting the Republican lies harder about the health care bill, but this author seems to be arguing that the Democratic health care bill and policies are inferior to those of the conservatives (which are...?).  Listen, HCR was FAR from perfect from a progressive point of view, but I never heard any kind of alternative from conservatives.

Anyway, Jack should go write for Redstate if he feels this way.  It's odd and more than a little sad for a progressive blog to have a front page author be a sore loser (from 2008 primaries, I'm assuming?) who believes conservative policies are better than the progressive counterparts.

by minnesotaryan 2010-10-15 11:12PM | 0 recs
Again,race is a part of it.

I hate to say it, while never inquire as to how they vote, I don't think my grandparents would vote for Obama.   We are talking about two white, blue state retirees.  

I think a lot of older white voters, while not hateful, or overtly racist, just can't make that leap to vote for a black man.  

by RichardFlatts 2010-10-15 10:54AM | 0 recs
RE: It's a Shame
Despite the hype, even hysterical news reports are forced to admit that Social Security will be solvent until 2037. Praise Jesus, or whoever, for House speaker Nancy Pelosi. For all of her faults, she has stood in the gap on this issue.

...America’s largest senior advocacy group, AARP, and the Democratic Party, which was denounced as the party of no,” were right to stand firmly against Bush’s schemes. Republicans of today aren’t much better.

That's some RedState rhetoric, I'm sure. Seriously, I don't read RedState so I can't speak to it specifically, but I do know it's a conservative blog. Probably not a bastion of--even qualified--praise for Mrs. Pelosi or criticism of reactionary plans to loot and privatize Medicare and Social Security.

Denouncing Democrats doesn't make a person a conservative. This is a ridiculous, but favorite, line of attack. It is hyper-partisan dickery.

by Jack Landsman 2010-10-16 07:42AM | 0 recs
Denouncing Dems is not the problem; Conservative talking points are

"Denouncing democrats" isn't the issue with this post; it's repeating a variety of rehashed sentiments, a number of which repeat conservative tropes, none more indicative of the problem than muddled repeat of charges about "rationing" and end of life care. This goes to a problem I've long suspected is the real trouble with what was attmepted in "healthcare reform" - the blanket assumption that people on the left are well informed about healthcare issues, when many aren't... and generally, lack of understanding about the issues involved in healthcare makes substantive reforms all but impossible.

When it comes to "rationing" the obvious point is - we ration care now. Health care is rationed, in economic terms because it is a scarce resource: there are a limited number of providers, and a finite amount of goods (drugs, devices) available. Our resources on healthcare are not limitless (a fact that still seems to confound the "healthcare is a right" crowd as much or more than conservatives who believe that "the greatest healthcare system on Earth" can do nearly anything for anybody with a health plan), and that means limiting how care is distributed. The point of thoughtful reform is to make care more widely available in a way that makes sense - more basic care, more preventive care, that limits the possibility of extreme or catastrophic events, allowing better options for more resources in extreme circumstances.

This approach is complicated by the challenges posed with end of life care; there is a point, a reasonable one, in fact, when it becomes necessary to ask whether a proposed treatment or intervention makes long term sense. Not because of cost (or at least, cost should be only a small piece of the puzzle), but because of ideas like Quality of Life and Need to Treat. Wrapped up in this is a lot of cultural assumptions about healthcare, ideas like the pervasive notion that any and every treatment must be attempted, and that Doctors and other professionals (though mainly Medical Doctors) are all knowing experts who cannot be questioned or challenged. Progressives have not helped the case for reform by falling back on a lot of these tropes ("you will be able to have the doctor you want and your doctor will not be blocked from doing what's needed" play into those assumptions), and a lot of cultural issues are in play when the discussion turns to end of life care.

The point is that Zeke Emanuel is right, if perhaps a bit remote about the squeamishness of taking on end of life issues: this is a discussion many want to avoid, and it brings up uncomfortable issues about when care should be declined and machines stopped and death becomes a greater reality. None of this has to be cold or impersonal or cruel; but it does have to be discussed And I don't think it's a failure on the part of liberals to say that, in a reasonable way, these discussions should happen more, and sooner, and with more realistic consideration of the issues involved. It's a reminder of the overall unseriousness of conservatives on healthcare - who, even in a campaign season working in their favor, cannot begin to provide a coherent notion of the kind of reforms to healthcare that could replace what has been done with the bill they despise so much.

Landsman's casual lumping of reasonable reforms to Medicare (which needs substantial reform, by nearly every assessment) and the scare tactics of conservatives about "government beaurocrats" denying necessary care aren't some "denouncement" of Democrats; they're wholesale repeats of right wing talking points meant, as he points out, to do the work they've done in scaring seniors. I don't think the alternative is for Democrats to not have attempted reform, or to cave in to people's fears. More to the point, I don't think a lot can be accomplished until complex issues are discussed with at least  some minimal examination of the complexities they have, and dealt with in their complexities. And I think Democrats have missed an enormous opportunity to begin a more realistic, more honest dialogue about Medicare reforms that are desperately needed, and to deal more thoughtfully with rationing and end of life care, precisely because of playing to the kind of fears stoked by Landsman's repetition of mindless conservative boilerplate. And I'd denounce a Dem for that, too.

by nycweboy1 2010-10-17 12:39PM | 0 recs
RE: Denouncing Dems is not the problem; Conservative talking points are

"Denouncing democrats" isn't the issue with this post; it's repeating a variety of rehashed sentiments, a number of which repeat conservative tropes, none more indicative of the problem than muddled repeat of charges about "rationing" and end of life care. This goes to a problem I've long suspected is the real trouble with what was attmepted in "healthcare reform" - the blanket assumption that people on the left are well informed about healthcare issues, when many aren't... and generally, lack of understanding about the issues involved in healthcare makes substantive reforms all but impossible.

When it comes to “rationing” the obvious point is – we ration care now. Health care is rationed, in economic terms because it is a scarce resource: there are a limited number of providers, and a finite amount of goods (drugs, devices) available. Our resources on healthcare are not limitless (a fact that still seems to confound the “healthcare is a right” crowd as much or more than conservatives who believe that “the greatest healthcare system on Earth” can do nearly anything for anybody with a health plan), and that means limiting how care is distributed. The point of thoughtful reform is to make care more widely available in a way that makes sense – more basic care, more preventive care, that limits the possibility of extreme or catastrophic events, allowing better options for more resources in extreme circumstances.

This approach is complicated by the challenges posed with end of life care; there is a point, a reasonable one, in fact, when it becomes necessary to ask whether a proposed treatment or intervention makes long term sense. Not because of cost (or at least, cost should be only a small piece of the puzzle), but because of ideas like Quality of Life and Need to Treat. Wrapped up in this is a lot of cultural assumptions about healthcare, ideas like the pervasive notion that any and every treatment must be attempted, and that Doctors and other professionals (though mainly Medical Doctors) are all knowing experts who cannot be questioned or challenged. Progressives have not helped the case for reform by falling back on a lot of these tropes ("you will be able to have the doctor you want and your doctor will not be blocked from doing what's needed" play into those assumptions), and a lot of cultural issues are in play when the discussion turns to end of life care.

The point is that Zeke Emanuel is right, if perhaps a bit remote about the squeamishness of taking on end of life issues: this is a discussion many want to avoid, and it brings up uncomfortable issues about when care should be declined and machines stopped and death becomes a greater reality. None of this has to be cold or impersonal or cruel; but it does have to be discussed And I don't think it's a failure on the part of liberals to say that, in a reasonable way, these discussions should happen more, and sooner, and with more realistic consideration of the issues involved. It's a reminder of the overall unseriousness of conservatives on healthcare - who, even in a campaign season working in their favor, cannot begin to provide a coherent notion of the kind of reforms to healthcare that could replace what has been done with the bill they despise so much.

Landsman's casual lumping of reasonable reforms to Medicare (which needs substantial reform, by nearly every assessment) and the scare tactics of conservatives about "government beaurocrats" denying necessary care aren't some "denouncement" of Democrats; they're wholesale repeats of right wing talking points meant, as he points out, to do the work they've done in scaring seniors.

I don't think the alternative is for Democrats to not have attempted reform, or to cave in to people's fears. More to the point, I don't think a lot can be accomplished until complex issues are discussed with at least  some minimal examination of the complexities they have, and dealt with in their complexities. And I think Democrats have missed an enormous opportunity to begin a more realistic, more honest dialogue about Medicare reforms that are desperately needed, and to deal more thoughtfully with rationing and end of life care, precisely because of playing to the kind of fears stoked by Landsman's repetition of mindless conservative boilerplate. And I'd denounce a Dem for that, too.

You’re right “we ration care now,” and it’s obvious because I said so in the diary. We know resources aren’t limitless because of rationing done by insurance companies. (I wouldn’t consider health care a “right,” in the Constitutional sense.) But as far as the need for thoughtful reform, ObamaCare doesn’t meet the standard. I’m not convinced it was better to make Democrats walk the plank for an incompetent scheme that does more than “scare” seniors. Everyone alarmed by the reports of proposed cuts in the legislation wasn’t “mindless,” or a conservative. I think end-of-life decisions are the province of private legal proceedings. Encouraging end-of-life counseling seems harmless, though. It’s not as if doctors would be given legal authority in the actual decision.

by Jack Landsman 2010-10-17 07:35PM | 0 recs

Diaries

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