With a presidential election looming, you know what else is coming thick and fast upon us: Scare Senior Citizens Season.

It’s a big shock to Democrats this time around that Republicans have had the temerity to seize the Medicare issue because, in the past, the Democrats have pretty much been able to rely on threats to reform Medicare to scare the living daylights out of older voters. They’re still trying, but it is a little harder. This is because GOP vice presidential candidate Paul Ryan is determined to have a candid conversation about Medicare. The Democrats? Not so much.  

James Capretta, a fellow at the Ethics and Public Policy Center, and an associate director of the Office of Management and Budget from 2001 to 2004, has a good piece on National Review Online about distortions the Democrats are employing to save, if not Medicare, certainly President Obama’s skin.

Ironically, it is Obamacare, the president’s signature achievement, that has made Medicare an iffy subject for Democrats. In order to finance Obamacare, it was necessary to carve $716 billion out of Medicare, which really should frighten anybody who is 65 or older, and who might get sick sometime in the future.

The Democratic position on these cuts: Yes, but…. They've been pushed into admitting that they're makaing them, but now they insist that $716 billion in cuts won't affect anything. 

Defenders of the cuts say, for example, that the cuts won’t matter because they only affect the insurance companies. This conveniently forgets about Medicare Advantage plan, which provides better care and is currently a choice. Trustees of Medicare Advantage have estimated that four million senior citizens will lose the program because of the cuts. Capretta sees a parallel:

This is a direct violation of the president’s tattered promise that, under Obamacare, Americans who like their current insurance plans would get to keep them.

There will also be large cuts to reimbursements for hospitals and physicians. Maybe the Democrats think seniors aren’t smart enough to realize that these cuts will reduce their access to hospitals, nursing homes, and doctors. It’s great to have an insurance card, but unless there is a provider there to take it, you’re up the creek without a defibrillator.

The Democrats have claimed that Ryan embraces these cuts. It is true, Capretta notes, that his plan did not assume the undoing of the cuts “largely because the committee was unable to find enough offsetting cuts elsewhere in the budget.”

The Ryan budget allowed for substituting sensible savings in Medicare for the blunt and irrational cuts contained in Obamacare.

Ryan’s plan to provide premium support has been derided as VoucherCare” or “CouponCare.” In reality, these private plans hold out the possibility of better medical care for older citizens, while costing less because of market forces. The Democrats would prefer to have costs cut by bureaucrats who simply decide if Gramps is worth the cost. I don’t know about you, but I know which of these systems I find the more frightening.  

Capretta sums up:

In the end, the debate over Medicare is no different from the debate about health care more generally. Who is in control? Is it the federal government? Or is it American consumers and their families, working with their physicians?

President Obama’s plan would lead inevitably to diminished quality in American health care, and eventually to rationing and waiting lists for services. That is always the byproduct of a centrally managed system.

The Romney-Ryan vision is very different. They want a patient-centered system that fosters life-saving innovation and disciplines costs without sacrificing quality. When the debate is seen this way, there is little doubt which approach the American electorate would choose.

Just a few words on Mitt Romney’s remarks on a Sunday talk show that he would preserve some features of Obamacare. Some Obamacare foes immediately decided that Romney’s words mean he is not true blue. Grace Marie Turner says: Calm Down.

She writes:

Romney was responding to a question from host David Gregory who asked him what he would do about two of the most popular provisions of Obamacare. Romney said up front he would repeal Obamacare, then he immediately acknowledged there are indeed problems which demand solutions.

Romney is right. There are problems in the health sector that need to be fixed, and we can’t stick our heads in the sand and pretend otherwise. If we fail to act, the health-reform battles will return with a vengeance.

Romney, as is often the case, could have said this better.

Still, this election will be our last chance to get health care reform right for decades to come.