Don't Rule Out Ryan's 'Premium Support' Idea

This note on Medicare by Bill Galston makes an important point. It makes me wonder about something I just said in a column for Bloomberg, "Ryan Starts a Great Debate on the Wrong Subject." In that piece, I said the debate we'll be having isn't the debate we most urgently need: We'll be arguing about big and small government, justice and freedom, individual initiative and collective endeavor, and all that stuff, when the discussion we most need is about when and how to balance the government's books. But I allowed an exception for the quarrel about Medicare. That serves a purpose, I said, because Ryan's "premium support" idea could be part of the answer, regardless of what you think about those bigger issues.

Galston describes a different scenario, and on reflection it's all too plausible.

Here's what I fear will happen instead. The Obama campaign will not take the other side in a high-minded debate. Instead, it will relentlessly attack Romney-Ryan for plotting to "end Medicare as we know it," and for leaving the poor to go hungry without food stamps and suffer, even die, without health insurance. In the process, the Obama campaign will rule out not only the Romney-Ryan plans, but also less draconian reforms that might be part of a long-term solution.

We've seen this movie before. In 2008, John McCain wanted to treat employer-provided health insurance as taxable income, a policy that many economists in both parties favor as helping to slow the pell-mell increase in health care costs. The Obama campaign went on the attack, to great effect. But in the process, they made it impossible to include any robust version of that policy in the architecture of the Affordable Care Act.

There are many Americans who believe two things about where things stand right now: The Romney-Ryan approach is unacceptable, and the status quo is unsustainable. Obama may be able to win the election by persuading a majority of the few voters still open to persuasion that in the short-term, the status quo is preferable to Romney-Ryan. But if he closes the deal by shutting the door to the reforms that we may well need in the long-term, it will be a Pyrrhic victory.

You know what I find most depressing about this? I think Obama would be delighted with a Pyrrhic victory. And so would Romney. Actually, is there any such thing as a Pyrrhic victory in politics? You've won: end of story. I recall Obama once saying that he wasn't interested in winning a second term if it meant he wouldn't be able to do what was right in his first, or words to that effect. This was back when he was a uniter not a divider. I wondered if I believed it at the time. Now it's hard to believe he even had the nerve to say it.

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