Republican Mitt Romney gave himself a tremendous boost in last weeks debate. He achieved his main goal presenting himself as a reasonable alternative to the incumbent. Now he must convince a majority of voters its time to fire President Barack Obama.
Romney is still some distance from the latter objective. But many on the left recognized that Wednesday night was a quantum leap for the challenger.
One of the most important exchanges during the debate dealt with Medicare, where Obama was on thin ice from the beginning.
He said the $716 billion hes yanking from Medicare and shifting to Obamacare represents savings from no longer overpaying insurance companies and making sure we werent overpaying providers.
Romney fired back, saying accurately that its not so: Those arent just claw-backs in overpayments, they are across-the-board reductions. They will reduce benefits for many current recipients, while the Romney plan wont touch people 55 and above.
In a report made public during the summer, the Congressional Budget Office said the billions shifted from Medicare includes cuts for hospitals, nursing services, hospice facilities, home health and a $156 billion reduction in Medicare Advantage, which uses private plans to deliver benefits to 27 percent of Medicare recipients.
Robert Moffit of the Heritage Foundation, a former deputy assistant secretary of Health and Human Services, said that during the Senate debate over Obamacare, members worried that the proposed Medicare cuts would decrease benefits for current Medicare Advantage recipients. Administration officials, queried on that point, agreed that they would, Moffit recalled.
In addition, he noted that soon after the bill was enacted, Medicares chief actuary declared that the Medicare reductions would also jeopardize access to care for other Medicare patients; lower fee payments would drive some hospitals and doctors out of the program.
Some Obamacare defenders argue that the Medicare spending reductions are directed at providers, not beneficiaries and thus wouldnt affect services. But Medicare is a fee-for-service program. If you cut the fees, youre going to affect services.
Obama also erred by repeating an inaccurate Democratic talking point, namely that Romneys Medicare plan would subject seniors to the tender mercies of the private market armed only with an inadequate voucher. The voucher, Obama said, wouldnt necessarily keep up with health care inflation. He cited estimates that it would cost the average senior about $6,000 a year.
Wrong. As The New York Times reported last month, The outdated charge that future Medicare beneficiaries could face $6,400 in higher costs comes from an analysis of an old proposal that has since been revised. The story even says Obama himself has acknowledged that, leaving one to wonder why he used the inaccurate version Wednesday.
As Romney explained in the debate, premium support under his plan would be set at the level of the second-cheapest plan, so seniors would have at least two to choose from without having to pay more out of pocket. Nor would the plans on offer be strictly private; theyd be government-vetted. They would have to provide the full range of Medicare services. Traditional Medicare would be one of the options.
The credibility boost Romney gave himself Wednesday will help him sell his Medicare plan, a critical part of his platform. But he has a long way to go. Another Times story reported that Romney has been losing ground among baby boomers worried about his plan even though most, because of age, wouldnt be affected.
Romney has to convince voters that hes proposing a reasonable modernization of a program that otherwise will crash of its own weight.
People love Medicare but they dont understand how it works or how its financed, Moffit said. We are looking at $37 trillion in promised benefits that are not paid for. Its a real crisis, and it will intensify as the boomers start to retire.