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For the past ten days, GOP strategists have worried anonymously that Representative Paul Ryan's presence on the national ticket will hurt Mitt Romney's campaign, especially in the must-win state of Florida. One of the top Democratic talking points of the last year and a half has been Ryan's plan to "end Medicare as we know it" by forcing future retirees to purchase government-subsidized private health insurance.
Romney's strategists seem to have decided that the best defense on Medicare is a good offense. A television commercial launched last week attacked President Barack Obama's record on Medicare, and a brand-new spot echoes that charge. Both videos are after the jump, along with transcripts and one of the Obama campaign's response ads.
On August 15, the Romney campaign started running a spot called "Paid In," which seeks to link Medicare's fiscal problems to the 2010 health insurance reform law.
Annotated transcript:
Male voice-over: You paid in to Medicare for years. Every paycheck. [Visual of sad-looking older man looking into camera. Words on screen YOU PAID]
Now, when you need it, Obama has cut $716 billion dollars from Medicare. [Visual of large empty wheelchair, which shrinks to make room for words on screen: OBAMA CUT $716 BILLION FROM MEDICARE Congressional Budget Office 07.24.12]
Why? To pay for Obamacare. [Visual of medicine capsule linking words TO PAY FOR above with OBAMACARE below]
So now the money you paid for your guaranteed healthcare [visual of stethoscope lying on blank white screen, words THE MONEY YOU PAID FOR YOUR GUARANTEED HEALTH CARE]
Is going to a massive new government program that's not for you. [visual of an empty hospital bed with a breakfast tray, words on screen MASSIVE NEW GOVERNMENT PROGRAM THAT'S NOT FOR YOU]
The Romney-Ryan plan protects Medicare benefits for today's seniors and strengthens the plan for the next generation. [Photo of Romney and Ryan waving to crowd of supporters, then photo of Romney greeting veteran, then photo of Ryan talking with older woman, words on screen PROTECTS MEDICARE BENEFITS]
Romney's voice: I'm Mitt Romney, and I approved this message. [Photo of Romney and Ryan waving to supporters, campaign logo and website on screen]
The commercial makes it sound as if the Medicare cuts have already happened, although those are planned spending reductions over the next decade, and the savings are supposed to come from eliminating waste in the program.
Nevertheless, Ryan has been hammering the Romney campaign's talking point in his stump speeches:
"Nearly one out of six hospitals and nursing homes are going to go out of business, or just stop taking Medicare patients, because you know why? President Obama treated Medicare like a piggy bank to fund ObamaCare, and his campaign calls that an 'achievement,' " Ryan said Tuesday on the campaign trail in Carnegie, Pa.
The 2010 health care law cut Medicare reimbursements to hospitals and insurers, not benefits for older Americans, by that amount over the coming decade. But repealing the savings, policy analysts say, would hasten the insolvency of Medicare by eight years - to 2016, the final year of the next presidential term, from 2024.
While Republicans have raised legitimate questions about the long-term feasibility of the reimbursement cuts, analysts say, to restore them in the short term would immediately add hundreds of dollars a year to out-of-pocket Medicare expenses for beneficiaries. That would violate Mr. Romney's vow that neither current beneficiaries nor Americans within 10 years of eligibility would be affected by his proposal to shift Medicare to a voucherlike system in which recipients are given a lump sum to buy coverage from competing insurers.
For those reasons, Henry J. Aaron, an economist and a longtime health policy analyst at the Brookings Institution and the Institute of Medicine, called Mr. Romney's vow to repeal the savings "both puzzling and bogus at the same time."
Our elected officials have starved Medicare. They add costly benefits, such as prescription coverage, without increasing the revenue to pay for such changes. People like Romney insist the program is structurally and fundamentally flawed. It's not. But in choosing Rep. Paul Ryan as his running mate, it's clear how Romney wants to "fix" Medicare.
It doesn't get much worse than the congressman's plan.
In a nutshell, Ryan proposes providing subsidies so seniors can sign up for commercial insurance. Instead of Medicare directly paying your doctor, the government would send a check to the private insurer who is supposed to be managing your care. Such an arrangement has been a proven fiscal failure in "Medicare+Choice" plans in the 1990s and in Medicare Advantage plans today. It costs taxpayer more than basic Medicare, and it creates confusion for seniors. Some health providers would not accept these plans.
But some politicians just keep pushing the idea. They keep saying that the private sector is better than the government at delivering health care. They keep hoping Americans will believe it's true. Fortunately, Americans didn't just fall off the turnip truck.
The president may not be so confident that Americans will see through the Medicare attacks. The Obama campaign responded to last week's Romney commercial with a new 30-second spot launched on August 17. "Facts" defended the president and attacked Ryan's plan.
Annotated transcript:
Obama's voice: I'm Barack Obama and I approve this message. [footage of Obama walking outside, next to the White House]
Female voice-over: Now Mitt Romney's attacking the President on Medicare? [Screen shows part of Washington Post article from 8/14/12, headline Romney turns Medicare attack against Obama in new ad, view zooms in to direct attention to word "Medicare"]
The nonpartisan AARP says Obamacare "cracks down on Medicare fraud, waste and abuse, and strengthens guaranteed benefits." [word AARP on screen, then photo of Obama with American flag in background, words AARP 6/28/12 3/19/10 "cracks down on Medicare fraud, waste and abuse" "strengthens guaranteed benefits in Medicare"]
Voice-over continues: The Ryan plan? [Photo of Romney and Ryan with American flag in background, words on screen THE RYAN PLAN?]
AARP says it would undermine Medicare and could lead to higher costs for seniors. [Photos of Ryan and Romney next to each other, words on screen THE RYAN PLAN "would undermine the market power of Medicare and could lead to higher costs for seniors" AARP 3/21/12]
And experts say his voucher plan could raise future retirees' costs more than six thousand dollars. [photo of older woman sitting at a table, looking stressed as she holds what might be a bill in her hand; words on screen RAISE SENIORS' COSTS BY $6,400 A YEAR Center on Budget and Policy Priorities, 4/8/11]
Get the facts. [words on screen Get the Facts: MedicareFacts.com ]
The brand-new Romney spot, launched in Iowa and other swing states today, is called "Nothing's Free."
Annotated transcript:
Male voice-over: Some think Obamacare is the same as free health care. [Graphic shows two medicine capsules in center of screen, connecting words OBAMA CARE on left with FREE HEALTH CARE on right]
Voice-over continues: But nothing is free. Obama is raiding $716 billion from Medicare, changing the program forever. [Photo of Obama smiling and waving, words on screen OBAMA IS RAIDING $716 BILLION FROM MEDICARE Congressional Budget Office 7/24/12]
Taxing wheelchairs and pacemakers. [image of empty wheelchair on screen next to words TAXING WHEELCHAIRS AND PACEMAKERS]
Raising taxes on families making less than $120,000. [aerial footage of middle-class neighborhood, words on screen HIGHER TAXES $120,000 OR LESS Congressional Budget Office 12/2010]
Free health care comes at a very high price. [Words on screen in red against plain white backdrop: FREE HEALTH CARE COMES AT A VERY HIGH PRICE]
The Romney-Ryan plan will restore Medicare funding and protect and strengthen the program for the next generation. [triumphant music plays in background, color footage of Romney and Ryan greeting supporters at a rally, words on screen ROMNEY-RYAN PLAN PROTECT MEDICARE]
Romney's voice: I'm Mitt Romney, and I approved this message. [Romney campaign logo and website on screen]
As with most of the other political ads I've seen this year, I suspect these commercials are not changing anyone's minds, only reinforcing preferences already formed for each candidate.
Any comments about Medicare or the presidential campaign in general are welcome in this thread.
Romney is holding an event in Bettendorf today. I'll update this post later with news clips. Obama is planning two more short Iowa visits next week, when the Republican National Convention will be dominating the political news.
Today, employees of the business Romney visited stood behind him on stage, wearing t-shirts which read "Government Didn't Build My Business, I Did." At one point Romney turned to speak to the group.
"To the team back here that did build this business, congratulations on the work you've done," Romney said. [...]
Rob Zimmerman - the co-president of LeClaire Manufacturing which was the site of Romney's event - also criticized Obama during his remarks to the crowd.
"Over 30 years of working in LeClaire Manufacturing, I haven't had one person come up to me and say, 'Hey Rob, it's a good thing the government helped you make this company grow.' Not once," Zimmerman said, to cheers from his employees and the Romney supporters invited into his business for the campaign event.
Romney began his remarks by praising Zimmerman's speech and suggesting the eastern Iowa businessman should run for office. Romney concluded his remarks with a new challenge to his Iowa supporters.
"I want you to each find one person who voted for Barack Obama last time and convince them that we should take a different course. Remind them how disappointing it's been over the last three-and-a-half years," Romney said this afternoon in Bettendorf. "Find 'em. Talk to them. Get them to the polls."
SECOND UPDATE: The Obama campaign's latest tv ad in Iowa says the Ryan budget would increase school class sizes by cutting government spending on education.
THIRD UPDATE: The Obama campaign launched another television commercial about Medicare on August 25. "Promises" will run in Iowa, Colorado, Nevada, Ohio and Virginia, and later in Florida, North Carolina and New Hampshire as well.
Annotated transcript:
Obama's voice: I'm Barack Obama, and I approve this message [photo of Obama speaking to an elderly woman]
Male voice-over: It's a promise that was made long ago. [Black and white photo of President Lyndon Johnson signing the Medicare bill in 1965; words on screen A PROMISE]
You work hard, pay in, your Medicare benefits are guaranteed. [footage of man stocking grocery store shelves, words on screen YOU WORK HARD; shifts to footage of woman working with papers at a desk, words on screen YOU PAY IN; shifts to footage of medical personnel speaking with a patient, words on screen YOUR MEDICARE BENEFITS ARE GUARANTEED]
But Mitt Romney would break that promise, [photo of Romney standing next to Paul Ryan, both waving at crowd of supporters, words on screen MITT ROMNEY WILL BREAK THAT PROMISE]
replace your benefits with a voucher. [Man looks into camera, words on screen REPLACES BENEFITS WITH A VOUCHER Associated Press, 11/4/11]
Insurance companies could just keep raising rates. [Senior citizen handling bills at kitchen table, words about replacing benefits remain on screen, plus these words are added: INSURANCE COMPANIES COULD RAISE RATES, Boston Globe 8/18/12]
Instead of a guarantee, seniors could pay sixty-four hundred dollars more a year. [footage of woman putting various prescription medications in a pillbox; words about replacing benefits and raising rates remain on screen, plus these words are added: SENIORS PAY $6400 MORE A YEAR, Center on Budget and Policy Priorities]
AARP says the plan Mitt Romney supports undermines Medicare. [footage of older woman sitting in doctor's office, words on screen "WOULD UNDERMINE...MEDICARE" AARP 3/21/12]
Mitt Romney. An end to the Medicare Promise. [Photo of Romney, words on screen MITT ROMNEY AN END TO THE MEDICARE PROMISE; in small print at bottom of screen, Approved by Barack Obama. Paid for by Obama for America.]
"The Obama campaign's Medicare ad is false," Romney's Iowa spokesman Shawn McCoy said this morning. "Governor Mitt Romney will protect and strengthen Medicare, while President Obama has no plan to save the program from going bankrupt."
"Worse yet," McCoy said, "the president robbed $716 billion from Medicare to pay for Obamacare, resulting in millions of retirees being punished with changes to their current plans and thousands of hospitals seeing massive funding cuts. As president, Mitt Romney will reverse these disastrous cuts, ensuring Medicare is protected for today's seniors and strengthened for future generations."
An Obama spokeswoman says that "benefits would go down" under the Medicare plan put forth by Ryan, and largely embraced by Romney. Ryan says cuts in Obama's health care law to the growth of spending "will lead to fewer services for seniors." But actually, neither plan has much of a direct impact on current beneficiaries.
A Romney campaign ad wrongly claims that "money you paid" for Medicare is being used to pay for Obama's health care law. But the law doesn't take money out of the existing hospital insurance trust fund. It cuts the future growth of spending. And in the future, seniors will still receive more in benefits than they paid in.
Obama says Ryan's "original plan would force seniors to pay an extra $6,400 a year." But that's based on an outdated analysis; Ryan's current plan is more generous than his first. In fact, over the long run, both men propose capping the growth of Medicare spending at the same rate.
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