This week marks the 50th anniversary of Medicare. Democrats celebrated by dusting off their traditional "Mediscare" tactic for the presidential-campaign season.
The first GOP debate hasn't even taken place, but one of the Republican candidates is already under attack on Medicare. In New Hampshire on July 22, Jeb Bush said he wanted to "phase out" traditional Medicare to build a more efficient, market-based system, focused on patients. It didn't take long for Democrats to pounce. MSNBC and the liberal blogs sensationalized the comment. The Democratic National Committee's press secretary, Holly Shulman, claimed that under a Bush presidency working Americans "won't have the same health benefits that seniors rely on."
That Democrats are once again deploying the Mediscare tactic shouldn't come as a surprise to Mr. Bush or any of the other 2016 GOP hopefuls. These campaigns of accusation and obfuscation have a long political history, going back at least as far as President Jimmy Carter's losing run for re-election against Ronald Reagan in 1980.
Mr. Carter repeatedly accused Reagan of opposing the creation of Medicare, including a strident salvo used in his only debate against Reagan. In response to Mr. Carter's Medicare accusation, Reagan issued his famous "there you go again" retort, which helped sink the Carter campaign.
Yet most people forget that Reagan went on to explain that he was not opposed to "the principle of providing care" for seniors. "When I opposed Medicare," he said, "there was another piece of legislation meeting the same problem before the Congress. I happened to favor the other piece of legislation and thought that it would be better for the senior citizens and provide better care than the one that was finally passed."
Since then the attacks on Republicans over Medicare have grown in intensity as the program has expanded. Between 1975 and 1990, Medicare spending increased at 2.4 times the inflation rate. The program that was first slated to cost $12 billion in 1990 actually grew to $110 billion. By 2014, the program cost $511 billion. With increased spending and dependence, the attacks grew fiercer.
In 1995, when President Bill Clinton and his underlings were savaging the GOP Congress for its Medicare-reform ideas, New York Times columnist William Safire defined Mr. Clinton's "Mediscare" game plan as a "shamelessly demagogic campaign to frighten older Americans into thinking that deficit reduction might soon leave them destitute in the snow, and to bamboozle them with pie in the medical sky."
Mr. Clinton claimed that Republicans wanted to let Medicare "wither on the vine," distorting a statement from then-House Speaker Newt Gingrich. Mr. Gingrich wanted to let seniors choose their own private health coverage, with the goal that well-served seniors in a dynamic market would eventually lead the cumbersome and costly Medicare bureaucracy to "wither on the vine." Exactly the opposite of the "draconian cuts" the president accused him of wanting.
Clinton Press Secretary Mike McCurry went even further, saying that "the reason [Republicans are] trying to slow the rate of increase in the program, I suppose, is because eventually they'd like to see the program just die and go away. You know, that's probably what they'd like to see happen to seniors, too, if you think about it." This last comment elicited an "Ooooooooh!" from the White House press corps, as recorded on the official transcript from the briefing at the Clinton Library.
In more recent years, Democrats have continued to press the attack on supposed GOP opposition to Medicare. When asked about her top priorities for 2012, Rep. Nancy Pelosi told the Washington Post that they were: "Medicare, Medicare, Medicare."
Even when thoughtful GOP leaders attempt bipartisan reforms, Mediscare is just too tempting. In 2011 House Budget Committee Chairman Paul Ryan included a Medicare-premium support plan—a plan to make Medicare spending more manageable and predictable by having the government subsidize seniors' insurance premiums—in his proposed budget. This was an idea that had been developed by Democratic Sen. John Breaux in 1999, and also backed by former Clinton Office of Management and Budget Director Alice Rivlin. Mr. Ryan was repaid with an ad showing a Ryan-lookalike pushing a wheelchair-bound senior off a cliff.
Yet Republicans have reason for optimism. History shows that the Democrats' scare tactics can be met and repulsed. Reagan turned back the Carter attack with a combination of exasperation and geniality, and then went on to serve two terms and revive the flagging U.S. economy.
And while Mediscare helped re-elect Mr. Clinton in 1996, Republicans held the House, in the next election and for the next decade. Over time, more and more Americans, even Democrats—as Mr. Breaux and Ms. Rivlin have shown—have come to realize that Medicare needs to change if it is to continue assisting seniors live longer, healthier lives. The recently released 2015 Medicare Trustees Report shows that Medicare's 75-year unfunded liability is $28 trillion, and that the Medicare Hospital Insurance Trust Fund faces insolvency by 2030.
Even President Obama has acknowledged in the past that "If you look at the numbers, then Medicare in particular will run out of money, and we will not be able to sustain that program no matter how much taxes go up." Mr. Obama also has taken some of the sting out of claims that Republicans are anti-Medicare by cutting Medicare spending to help pay for his Affordable Care Act.
The lesson, then, for Jeb Bush and all the GOP presidential hopefuls, is not to run in fear when Democrats level Mediscare charges. Gov. Bush did the right thing after the New Hampshire incident: He stood his ground, and followed up by issuing a statement that highlighted some of the Medicare Trustee Report's most dire warnings. Refusing to acknowledge the real threats to Medicare, he said, "is a politically expedient choice that jeopardizes the program itself for future generations."
It's too soon to say if his response will be effective, but history—and Medicare's problems—both suggest that the Democrats' Mediscare tactics may be losing their potency. Like the Medicare trust fund, Mediscare itself is running out of time.