All Politics is Local: What Healthcare Reformers Forgot

All Politics is Local: What Healthcare Reformers Forgot
by Donna Smith
Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.
September 3, 2009


Tell a senior citizen you are going to raise property taxes for new schools and it won't matter for even a moment that the money is for their grandkids' education - those seniors will vote no. Ask any number of local or state candidates for office. Seniors, more than any other voting block, vote their pocketbooks and vote their own immediate well-being.

Don't get me wrong, I love older folks. In fact I am getting to be one. But many in the 65 years old -plus generation only hear that you are going to cut Medicare spending - sounds like you are going to cut their health benefits and what you spend on old people. Then they hear the scary, if tainted cries of the crazies saying lots of other unfriendly-to-the-older-set dribble and there you go ... a political revolution has begun. It's hard enough for many to survive on the retirement they have, so why wouldn't potential cuts be scary?

We'd be in healthcare reform heaven right now if some brainchild in Congress or the administration had sold it this way:

We're going to close the Medicare Part D, drug-benefit donut-hole;
We're going to end the Medicare Advantage subsidies paid to insurance companies;
We're going to preserve and protect Medicare benefits with no increase in premiums for seniors.

Nirvana. Political gold. No matter what you put forward in the rest of the healthcare reform story would have been safer and far less worrisome to the entire nation. But you all scared the seniors, and now you are paying the price of inelegant and shifting messaging.

Political miscalculation isn't pretty to watch. And it is unfortunately going to reinforce what seniors were worried about in the first place - being lied to about health reform and being maneuvered to their detriment. Perhaps because we all watched a fairly brilliant campaign strategy pile on top of a fairly arrogant Republican collapse in 2008, we expected some political savvy to endure.

You forgot politics 101, boys and girls. All politics are local, Tip O'Neill once said. Seniors wanted to know seniors would be helped. Oops.

Please read the complete article at:

http://www.commondreams.org/view/2009/09/03-0

silly. Some approaches might well be better than others but there are no magic bullets. The opposition is deeply entrenched and remnants of a pervasive red scare leave the population very susceptible to propaganda.

The way I see that we could have made seniors more comfortable is if Medicare was made the public option. Everyone would continue to pay in as normal but younger and healthier people would also be allowed to buy in giving the risk pool better balance which would go a long way towards bending that cost curve and making Medicare more solvent and secure.

Especially, if we're left to reconciliation then this would seem the best way forward. After all, private insurance would already be completely failed if the government did not take on the heavy lifting with seniors and those with debilitating chronic illness and handicaps. Government is already taking care of those that are the most expensive to cover anyway so adding 50-100 million younger people would slowly but surely make Medicare stronger.

I'm not sure this would make ENOUGH difference among seniors because they are, on the whole, being stupid, greedy, and illogical, but it would be tough for the rational to make a case that Medicare was in any way in danger.