Last week, Inoted the strange factthat President Obama—and his top advisers—decry the Romney-Ryan plan for Medicare reform, because it incorporates the concept of “premium support,” while applying the same principles to 25 million low-income Americans under Obamacare. Thus far, the Obama campaign has been unable to account for this inconsistency. Well, on Monday, we learned that a top Obama health-care adviser in 2010 actually proposed going around Congress to voucherize Medicare, in his words. It’s time for President Obama to own up. Either the Romney-Ryan plan is sound, or Obama’s campaign is being dishonest.(DISCLOSURE: I am an outside adviser to the Romney campaign on health-care issues. The opinions contained herein are mine alone, and do not necessarily correspond to those of the campaign.)Meghan McCarthy of National Journal obtained internal White House emails documenting that two key Obama health-care advisers—David Cutler of Harvard and Jonathan Gruber of MIT—proposed that Obama privatize the Medicare program as part of the negotiations surrounding the Bowles-Simpson deficit commission in 2010, in ways that were well to the right of what Mitt Romney has proposed.“How about this…removing the special status of [traditional] Medicare,” Cutler wrote, according to McCarthy. Obama’s fiscal commission should support “moving the Medicare population into the [Obamacare] exchanges…that would be the same as the voucher” proposed by Rep. Paul Ryan and former Clinton budget Chief Alice Rivlin, in what became known as the Rivlin-Ryan plan.Cutler proposed going around Congress to impose Medicare privatizationWhat’s even more remarkable about Cutler’s suggestion, according to McCarthy, is that Cutler proposed enacting this reform by going around Congress. Cutler proposed using Obamacare’s new Medicare rationing board, the Independent Payment Advisory Board, to impose such a reform upon seniors without Congressional amendment.
Mixed Message From Obama Advisers on Medicare
E-mails show outside advisers were previously open to private plans.
President Obama has seized on Republican proposals to overhaul Medicare as a top campaign issue, saying that the GOP plan to add a private insurance option would end seniors’ guarantee of government health care. But behind the election-season politics, influential experts who have advised Obama on health care are open to a future for Medicare that includes competition among private insurance plans.The drumbeat against privatizing Medicare was loud and clear at last week’s Democratic National Convention and over the weekend as Obama campaigned inFloridaand made Medicare a top issue. Obama has warned that the plan from GOP nominees Mitt Romney andPaul Ryanwould cost seniors $6,400 more a year for their health care.It may not be what voters hear on the campaign trail from Obama and his surrogates, but converting Medicare from a government program that covers all of seniors’ health needs into subsidies that seniors use to buy private health insurance is the future—not the apocalyptic event Democrats would have voters believe.One private e-mail exchange illuminates this point well. In e-mail exchanges with the staff of the White House-appointed fiscal commission that were obtained byNational Journal, David Cutler and Jonathan Gruber, who have both advised Obama, gave qualified support to a Medicare voucher plan offered by Ryan and former Clinton budget director Alice Rivlin in talks to reduce the deficit.Cutler and Gruber are both hot shots of the health economics world. Cutler is a professor at Harvard, Gruber at MIT. Both advised Obama on health care in the 2008 campaign, and both had major roles in helping develop Democrats’ 2010 health care law. When they offer counsel, the White House is listening.Staff from the National Commission on Fiscal Responsibility and Reform — which was led by former White House chief of staff Erskine Bowles and former Sen. Alan Simpson — asked Cutler and Gruber in November 2010 for their thoughts on the Ryan-Rivlin plan,which did not keep traditional Medicare as an option for seniors. Both experts offered suggestions to make it more palatable to commission Democrats. Neither balked at the plan, which is arguably more conservative than the Medicare plan offered by GOP presidential nominee Mitt Romney.“How about this … removing the special status of [traditional] Medicare,” Cutler wrote. He then suggested giving an executive board created by the Democrats’ health care law the option of “moving the Medicare population into the exchanges.”“That would be the same as the voucher,” Cutler concluded.In other words, Cutler wasn’t just recommending that the Democrats incorporate vouchers into Medicare, something the Obama campaign is squarely against now. He was also proposing that the federal government move seniors into insurance exchanges through a much-criticized executive-branch Medicare board. That is a proposition you won’t hear in talking points from either Cutler or the Obama campaign.