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I’m aware of at least two Democratic Senators, Claire McCaskill (D-MO) and Dick Durbin (D-IL), who have appeared on television to promote the idea of means-testing Medicare. Such means-testing can be accomplished with 1) higher office visit and emergency room co-payments, 2) higher co-insurance payments for medical tests and procedures, and/or 3) higher Medicare premiums. Of course, the first two approaches are, by definition, benefit cuts—cuts that the progressive community, among others, is fighting hard to prevent. The third approach, I would argue, is a back-door benefit cut in part because it only impacts Medicare beneficiaries with no change to how Medicare is taxed. Nevertheless, when appearing in public, Democratic officials are vague about which approach or combination of approaches that they’re proposing. It’s up to us to let them know that no such approach is acceptable.

In the meantime, however, I continue to be disappointed that some of our Democratic representatives can’t keep their mouths shut about benefit cuts until Republicans say, publicly, what they mean by entitlement “reform.” We all know that they seek benefit cuts, but to my knowledge, Republican leaders have been smart enough, since the election anyway, not to say this either in writing or on television. Democrats have no business helping the Republican cause by proposing, on television, ideas that are further to the right than what leading Republicans have publicly specified. If Durbin and McCaskill expect Republicans and their super-PACS to honor some kind of an “ad moratorium” about Medicare in 2014 after Democrats were the first to publicly propose billions in benefit cuts, then I’m afraid that they’re in for an unhappy surprise.

The bigger question is, after winning an election, and with the polls (and the issues) on our side, why are Democrats on defense at all with this issue? Why are we trying to stop benefit cuts when we have the White House, the Senate, and received more votes for the House (despite its red tilt due to gerrymandering)? I suggest that the reason is that Democratic officials (and perhaps the rest of us) haven’t gone on offense on this issue. Republicans want Medicare reform, but they want us to define it for them. We should. And we should beat them over the proverbial head with it.

Democratic officials should show the public that they support Medicare reform by formally and immediately proposing and seeking a vote on allowing Medicare to negotiate prescription drug prices. Of course this isn’t a new idea, but Democrats, it seems, have taken it off the table…ostensibly because they would never get a House vote on it.

Who cares? Go on offense. Take negotiating lower drug prices to the public and compare the savings to Medicare (approximately $400 billion) with savings the Republican idea of increasing the Medicare eligibility age to 67 (about $125 billion). Who are the deficit hawks in this scenario? Who is fighting for Medicare beneficiaries and who is fighting for corporate interests? What is the more likely short-term compromise? Limited benefit cuts through means-testing or no benefit cuts? And in the 2014 mid-term elections, which idea for Medicare reform is more likely to carry the day and be enacted down the road?

God dammit Dems, get the Medicare reform defense off the field (e.g., Durbin and McCaskill) and put the offense out there.

Update: Excerpt from Durbin's appearance on yesterday's episode of Meet the Press:

DAVID GREGORY (HOST): I want to pin you down on one point about Medicare. You say you want to basically put off this discussion until later. But bottom line, should the Medicare eligibility age go up? Should there be means testing to really get at the benefits side, if you’re going to shore this program up, because as you say, 12 years before it runs out of money?

DURBIN: Here’s what it comes down to David. I do believe there should be means testing. And those of us with higher income in retirement should pay more. That could be part of the solution...

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