Touching the Third Rail

Medicare, the government program that provides health insurance to the elderly, is enormously popular. It is also headed for insolvency. This presents a delicate challenge for politicians: how to make necessary changes to Medicare without angering the electorate. The issue of Medicare is so politically dangerous that it has been nicknamed a “third rail” after the electrified rail in some mass transit systems that can kill anyone who touches it.

Congressman Paul Ryan (R-WI), the chairman of the House Budget Committee, has put forward a budget blueprint entitled “The Path to Prosperity” that dramatically cuts federal spending. One aspect of his proposal steps on the third rail of Medicare, replacing the current system under which the government pays for healthcare directly with a voucher that would provide a subsidy for seniors to purchase their own health insurance.

Unsurprisingly, the proposal has proved decidedly unpopular among the general electorate. In the recent special election held in New York’s 26th congressional district, located between Rochester and Buffalo, Democrat Kathy Hochul rode the issue to a surprise victory over her Republican opponent. In the Republican presidential primary, with its more conservative electorate, Ryan’s plan is much more popular.

Most Republican candidates have triangulated their positions by claiming to support Ryan’s plan with the caveat that they will offer a different plan at some point in the future. The one candidate to depart from this path has been Newt Gingrich, who called Ryan’s plan “right-wing social engineering” on NBC’s Meet the Press. Gingrich was swiftly condemned by a broad range of conservative voices and forced to change his position, with some commentators suggesting that the episode may have done serious damage to his nascent presidential campaign.

While the Ryan plan will likely be overshadowed by other events in the coming months, these events serve as reminders that politicians from both parties must tread lightly near the political third rail of Medicare.