Conservatism, Medicare, and the Votes of Older Americans

I am old enough to remember a time, before 1994, when Americans over 65 reliably voted Democratic in national elections. Everybody said they did so because they depended on programs that Democrats had enacted over Republican opposition, especially Social Security, Medicare, and Medicaid.

These days Americans over 65 reliably vote Republican. Republicans have achieved this feat by playing a double game of posing as cultural and fiscal "conservatives" while attacking Democrats for trying to reform Medicare.

I have to think that eventually people will catch on to this two-faced ploy. Americans do depend on government-funded health care, especially older Americans. But while grandstanding about their opposition to "Death Panels," Republicans have been developing budgets that savagely cut Federal health spending. Paul Ryan's budget will cut Medicaid spending by more than half over ten years (remember that the biggest part of Medicaid spending goes for nursing home care), and his long term plan for Medicare forces all seniors into ever shrinking private insurance plans. This shrinking is necessary because Republicans want to cut taxes on the rich and keep defense spending high, and there is literally not enough money in the rest of the budget to achieve balance without health spending cuts.

This will create an interesting experiment in what really motivates voters. Will older Americans continue to vote their identification as "conservatives," even if that means cutting their own health benefits? Or will self-interest, or a belief that providing health care for everyone is only just, win out over a desire to protest social change and big government? Will people continue to think of themselves as conservatives when they figure out that this means they won't get the prescription drugs they think they need? Will the sight of rich people getting great health care while ordinary old folks get turned away have a big political impact?

No doubt many Americans mean what they say, and they want to shrink the government and affirm "traditional" values no matter what it costs them. But I bet the Republican hold on the senior vote will be broken when the bill for health care cuts comes due, and millions of votes will be shifted back to the Democrats.