The Return of Mediscare

Tom Cotton is your basic republican red-state fantasy candidate. He is 36 years old, a former Army captain who served in both Iraq and Afghanistan, and a graduate of Harvard University and Harvard Law. He is a member of the House running for the U.S. Senate from Arkansas. His opponent is an unflashy Democratic moderate, Mark Pryor, who spent the first months of the campaign barraged by an estimated $2 million in Obamascare ads provided by Americans for Prosperity, the Koch brothers’ super PAC. Not surprisingly, Cotton has been leading–and is one of the reasons the Republicans may retake the Senate in 2014. Or maybe not: the polls suddenly turned around in March, and Pryor is now narrowly ahead. What happened?

Meet Linda … who joins Harry and Louise, and dozens of other average Americans–some real, some conjured–in the long, sordid history of political ads designed to scare the bejeezus out of other average Americans over health care. Linda appears to be real. She’s from Little Rock. She’s been married to the same lucky fellow for 37 years, and they have two “great” kids. We know this because a black-and-white family photo is shown prominently at the beginning of the ad. Then we see Linda, who seems to be in her 50s, with tightly curled gray hair and glasses, sitting in her breakfast nook gazing at her Apple computer. Retirement is just around the corner, she says. “That’s why I was so concerned when I read”–and here she seems to be reading off her computer–“that Tom Cotton voted to turn Medicare into a voucher system” that would allow insurance companies to “increase rates, cut benefits and cost seniors thousands more each year.”

It’s a brilliant ad, classic Mediscare. The fact that Linda seems to be reading the horrific news about Cotton off her computer lends a subtle authority to the information. Is it accurate? Well, yes and no. Cotton and 218 of his colleagues in the House did indeed vote for the Paul Ryan budget, which would slash costs by moving to a privatized “premium support”–or voucher–system of health care delivery for senior citizens. Is that a bad idea? Probably not. In fact, a more generous version already exists in the form of Medicare Advantage, the private-sector Medicare alternative that seems to be going great guns in the Obamacare era: an estimated 30% of seniors have signed up, an increase of 38% in recent years. The brute force of competition (plus some federal subsidies that both parties want to diminish) has allowed increased benefits like gym memberships and free medication. The fact that many of these plans are based within systems where doctors are paid salaries makes it potentially more cost-effective than classic fee-for-service Medicare. It would be very valuable to have a serious conversation about this. Pryor is a fiscal conservative. He’s said that all programs (including Medicare, presumably) should be on the table. He could be part of the solution, rather than hiding behind traditional Democratic battlements.

Democrats will say, Oh, come on. It’s about time we started playing hardball again. The Republicans strolled into a tornado by voting–symbolically, since it never had a chance of passage–for the Ryan budget. The Koch brothers have spent gazillions putting sketchy Obamascare ads on the air, including one starring Jerry, an Arkansas truck driver who “lost” his health coverage because of Obamacare, although maybe he didn’t, because the Arkansas insurance commissioner put a two-year delay on that ruling and now Jerry is “confused” by all these newfangled government machinations. This was one of the less toxic Koch ads–and “Jerry” has been smoked by “Linda” in the court of public opinion.

Of course, next month there could be a killer Obamascare ad starring “Arnie,” an Arkansas druggist whose health care premiums have skyrocketed. And later we may get to know “Marge,” who survived breast cancer because Obamacare saved her health insurance. We could go back and forth, Obamascare vs. Mediscare, all the way until November. It’s happened before. It’s worked before. But is it what you really want this election to be about? Isn’t it precisely the sort of campaign that turns people off politics? Don’t we have more important things to talk about? “I think the Republicans will still win the House and Senate,” says Steve Schmidt, a GOP consultant. “But when you have no real governing agenda, it becomes very easy to get caught up in entitlement issues.”

That is true for Democrats as well. They are proud of their demographics, especially the favor bestowed on them by younger voters. But younger voters may decide they don’t like paying for an unreformed Medicare system as we baby boomers live on and on and on. Those who live by the anecdote can die by the anecdote.