Last week Republican leaders in the House of Representatives unveiled their plan to cut projected Medicare spending by $270 billion, or 14 percent, over the next seven years. The breakdown of the savings was not revealed.
But how will the proposed legislation actually be presented to the elderly? Don't think the Republicans haven't pondered that question long and hard.
Since early summer, memos have gone out to Republican
lawmakers suggesting how they should talk to elderly constituents about the proposed Medicare changes.
One such memo came from the Republican pollster Frank Luntz, who honed his sales technique during a series of town meetings and focus groups with the elderly. Here are excerpts:
* Keep in mind that seniors are very "pack-oriented" and are very susceptible to following one very dominant person's lead. . . . Keep individual anecdotes or isolated incidents from dominating and driving) the process.
* Personalize YOUR interest in Medicare. . . . Reassure your seniors that this issue affects you personally, and not just in theory (otherwise you may come across as an accountant rather than a human being). Talk about your parents, relatives or life-long friends currently on Medicare.
* Your No. 1 Priority is to save Medicare. "Saving, preserving and strengthening" Medicare needs to be repeated as the central theme at the beginning, during the session and at the close. Let your seniors know that you personally will not allow a program for 37 million people to go bankrupt by ignoring its current problems.
* You MUST appear bipartisan. . . . Be careful not to come across too harshly against the Dems, but it is acceptable to ask rhetorically for President Clinton's help.
* Don't talk about "improving" Medicare -- you are strengthening it. . . . When seniors hear the words IMPROVE and MEDICARE in the same sentence, they immediately think of lower deductibles, free prescription drugs, subsidized hearing aids and eyeglasses, cheaper in-home care and reductions in everything else they now have to pay for. THE QUICKEST PATH TO DEFEAT IS TO OVERPROMISE SENIORS.
* The newspaper is still very important to seniors. Seniors diligently read the newspaper, and they often clip articles about fraud and abuse involving Medicare. This is one issue where print media are as important as television or radio -- if not more so. Consequently, clip several local newspaper articles about Medicare waste and/or fraud and bring them to your town hall meetings to distribute to attendees. The word will spread rapidly.
* Seniors read their mail and scrutinize their hospital and doctor bills. Everyone has a story to tell, though none as poignant as this one: "I went in for eye surgery and they charged me for an autopsy. I complained and they came back and said 'I'm sorry, Mrs. Colby, but that should have been for an EKG.' I told them I didn't have one of those either."
* Ask your constituents to write your office with their accounts of abuse and also devote the first 15 minutes of your meeting to "fraudtoids." Beginning this way helps pave the way for the following argument about the need for change, while also letting you know at the outset who's with you and who's against you.
* Seniors are distrustful of Washington, know their own strength as a political constituency, and simply do not believe their elected officials will turn their back on such a strong voting bloc.
* No one believes Medicare will actually go bankrupt. . . . Seniors will not even consider changes in Medicare until they're convinced the system's going broke.
* The difference between Medicare and Medicaid is still not widely known. . . . Make sure you explain the difference early in your presentation. Seniors particularly hate the idea that legal and illegal aliens are receiving government benefits in general, and Medicare or Medicaid in particular. Cost/Financing Seniors realize that they're getting a great deal. Understandably, they're reluctant to give it up. It is therefore necessary to explain that while they may like what they have NOW, it won't be there IN THE FUTURE unless real changes are made. . . . This is why so much effort must be devoted to the simple task of explaining that Medicare is going broke.
* Seniors use specific figures to make their points. So should we. When discussing waste and overbilling, a surprising number of seniors point to $10 aspirins, $150 eye exams, and can remember the cost of their hospital bill to the penny. They have the ability to remember the cost of a single drug and a particular procedure because they PERSONALIZE rather than GLOBALIZE their medical care. We must do the same. Informing Medicare recipients that the average couple will take out over $100,000 more from Medicare than they have contributed to the system personalizes Medicare's impending bankruptcy (use exact numbers) in the same manner as a $10 aspirin personalizes its abuses.
* The potential need for increasing premiums by 300 percent is the "Killer Stat." . . . The possibility that Medicare premiums will increase by 300 percent is simply not acceptable to seniors -- and they will do anything to prevent this from happening. (Note: The other options, such as increasing taxes on working class families, produced virtually no reaction.)
* Remind your audience that Republicans want to "INCREASE spending but at a slower rate." This language works. Remind your constituents that only in Washington is an increase from $4,800 to $6,400 (a 33 percent increase) per recipient defined as a cut.
* Republicans must be seen as the party of hope: the party that took on the problems of Medicare head-on. It is the Democrats who are using "scare tactics" by allowing a program to go broke, to be riddled with waste and fraud, to become overly bureaucratized without offering a solution or even acknowledging a problem -- all just to score political points. Republicans WILL find a solution. For our efforts to be lTC successful, WE HAVE TO MAKE THE STATUS QUO A WORSE OPTION THAN CHANGE.
* You must solicit citizen input.
* You must have the last word in this debate.