Medicare as an Issue in the 2010 Election Campaign
The theme of health care rationing for older Americans was especially prominent in the period leading up to the 2010 Congressional elections. From the outset of President Obama's health care reform effort, which ultimately became the Patient Protection and Affordable Care Act (PPACA) of 2010, an overarching message from the President was that the costs of reform would be substantially offset by savings from the Medicare program. He was primarily referring to a reduction in excess government subsidies to Medicare Advantage programs (see White House, 2009).
As the reform legislation moved along, an early version of it in the House of Representatives had in it a provision that expanded Medicare to cover the costs of a voluntary consultation with a physician, every 5 years, concerning end-of-life planning through living wills and health care durable-power-of-attorney documents (see Blumenauer, 2009). A number of prominent Republican politicians and conservative broadcasters distorted these two themes—end-of-life planning and savings from Medicare—by transforming them into the specters of "death panels" and efforts to "pull the plug on granny." When members of Congress held town hall meetings in their districts during their 2009 summer recess, they faced rowdy crowds in which older persons expressed concerns about rationing in the Medicare program (Blumenauer, 2009). Such concerns were culturally ratified by Newsweek (2009) when it published a cover headlined "The Case for Killing Granny," accompanied by a photograph of a "pulled" electric plug. Subsequently, AARP acknowledged that it faced a challenge in explaining to its members why it had endorsed health care reform (Calmes, 2009). According to the author of a recent scholarly book about AARP, at least 4,00,000 members quit the organization in response to news of this endorsement (Lynch, 2011).
Advertisements for Republican and Tea Party candidates throughout the nation in the 2010 election campaign consistently hammered on the theme that President Obama and Democratic members of Congress were intent on rationing Medicare (see Steinhauer, 2010). In effect, Republicans ran what came to be known as a "Mediscare" campaign. For instance, an ad run by the 60 Plus Association (which billed itself as the conservative alternative to AARP) attacked an incumbent Democratic congressman in the following way. "Boyd voted for Nancy Pelosi's health care bill which will cut $500 billion from Medicare. That will hurt the quality of our care" (Holan, 2010, p. B1). (Although journalists estimated that huge amounts of money were spent on these Republican Mediscare tactics, no data are available to document just how much.)
Meanwhile, the Democrats did not effectively counter this Republican blitz, either nationally or locally. Not surprisingly, efforts by the President and his staff to explain that the Medicare cuts in the PPACA were essentially eliminating a 14% excess subsidization of Medicare Advantage plans did not produce effective sound bytes for a war of words and ads about cuts in Medicare. In short, the stage seemed set for older voters, in particular, to vote against Democrats and for Republicans in the 2010 election.