Sorry I've been away. Getting away from the horse race stuff, what does the Republican presidential debate look like on the key issues of Medicare, Social Security, and health care policy generally? Here are my impressions after watching the first six Republican debates and the Freedom Forum thing in South Carolina:
Medicare - Almost nothing after the first debate. Rick Santorum mentioned the benefits of a premium support model for Medicare in the first debate and I think several candidates mentioned that they supported the Ryan Medicare reform proposal. That is about all I've heard. Gingrich mentioned his snake oil about cutting fraud in one debate too. Reforming Medicare is an enormous fiscal issue and will probably be THE key battleground over whether we move to a higher tax, more statist, more centralized direction or a (comparatively) lower tax, more market-oriented direction. The early Republican debates have done nothing to advance public understanding this issue or any particular Medicare reform proposal.
I haven't heard Perry say anything about this issue.
As usual, Romney is the antimatter of political courage. His Medicare proposal in his economic plan is short and to no point. Romney writes
put forward by Congressman Paul Ryan makes important strides in the
right direction by keeping the system solvent and introducing market-based
president, Romney's own plan will differ, but it will share those objectives.
" Or as Reason
described Romney's plan "Does Romney support Ryan's plan, or its basic framework? Not...exactly. "As president, Romney's own plan"--wasn't this supposed to be Romney's plan?--"will differ, but it will share those objectives." The same. But different." What a waste.
The best that we can hope for are that Perry and Romney are hoping to get elected and then throw America a Medicare reform surprise party. Worst case, we are headed for the rocks.
Social Security - So far it has been mostly attitudinizing from the two frontrunners. Perry and Romney aren't actually that apart on substance - in the sense that neither has much just yet. They both want Social Security to remain unchanged for current recipients. They both want the system to be reformed so that it will be there for younger workers. And neither has committed to any actual reform proposals. So that leaves posturing. Perry has done a lot of big talking and writing that Social Security is an unconstitutional Ponzi scheme monstrous lie that maybe should be run by the states. Running on such a platform would probably be political suicide so Perry isn't advocating moving Social Security into a state-run program. But he can neither fully embrace nor fully reject his previous statements. So he ends up defending his past statements while denying that they will form the basis for forward-looking policy. And when that fails, he just starts talking about Romneycare regardless of whether it makes sense in the context of the discussion.
Meanwhile, Romney is busy pretending that Perry would try to destroy Social Security. Reality check: If we repealed the 22nd Amendment and Rick Perry served three terms as President, Perry would leave office with Social Security being a federal-level program of intergenerational transfer and/or forced savings.
The only candidate who has had anything real to say on Social Security has been Herman Cain with his proposal of moving to Chilean-style private accounts. The problem is that Social Security is suffering a medium-term funding shortfall. The amount coming in from payroll taxes isn't going to keep up with benefits. Diverting the payroll tax contributions of younger workers into private investment accounts only makes that shortfall worse over the next several decades. That means the shortfall has to be made up with either greater government borrowing, higher taxes, lower benefits for retirees or some combination of the above. What am I missing? This isn't even getting into the political problem of selling private accounts after the stock market gyrations of the last eleven years.
Health care policy - All the Republican presidential candidates hate Obamacare. I heard some stuff from Perry about tort reform. Romney mentioned something about interstate purchase of health insurance. If you were just the average voter, you had little idea what either of them were talking about or how you might benefit by the weird-sounding policies they passingly mentioned. Not one of them can produce a coherent and concise critique of Romneycare Romney is (amazingly) getting away with hiding the policy similarities between Romneycare and Obamacare. Perry's explanation of Texas' high rate of uninsured residents is that
Washington ate his Medicaid waiver. Not one of the candidates has mentioned (for instance) how moving more of the working age population to system of HSAs/catastrophic coverage might maintain health care security while increasing worker take home pay,
At the presidential debate level, the quality of the Republican message hasn't improved even a little bit over 2008. All we have done is seen "stop socialized medicine" replaced with "repeal Obamacare." This issue (along with Medicare) is where Mitch Daniels and Paul Ryan are missed the most.