By Charlie Cook
NationalJournal.com
Tuesday, July 1, 2003

Here's a prediction for 2004: If the prescription drug benefit is a factor in next year's election, it will be as an albatross around the necks of Republicans and the Bush administration. While the White House and GOP strategists have long said passing a drug benefit for Medicare recipients was a key element in the president's re-election strategy, the implication was that they needed to pass something called a drug benefit, with the contents and details less important than having done it. That may well turn out to be true, but maybe not.

The Bush campaign sees a prescription drug benefit as its Democratic issue of choice to run on next year.

Not too long ago I served on a panel discussion at Washington & Lee University with Dick Morris, the politically androgynous strategist who has worked for a variety of leading figures in each party in a career that has spanned more than three decades. While Morris is not necessarily one of my favorite people (and I disagree with perhaps 80 percent of what he has to say), there is clearly a mad genius in the man that generates some very provocative ideas amid a clutter of goofball thoughts and theories.

While many talk about Morris' triangulation strategy that he developed for former President Bill Clinton back in 1995, which contributed to the first elected Democratic president to be re-elected since Franklin Roosevelt, it was his broader view of strategy I found most interesting.

According to Morris, certain issues "belong" to Democrats while others "belong" to Republicans. Historically each party has certain issues on which it is perceived as very strong, while on others there is little credibility. Morris points out that these lists remain fairly static; one rarely sees issues on one party's list transfer to the other. Morris argues that the goal of a candidate is to maximize his party's strength on the issues that his party is strong, then embrace one or two issues that "belong" to the other party, allowing virtually no distance between themselves and the other party on that issue. The point is to demonstrate to swing voters that you are not a lock-step party type, but rather demonstrably moderate and pragmatic.

In 1995 and 1996, by emphasizing his efforts to balance the federal budget and his signing a welfare reform bill into law, Clinton managed to avoid the liberal tag and, though incurring the wrath of many in his own party, went on to win re-election by a fairly comfortable eight-point margin.

In 2000, Gov. George W. Bush picked the education issue and was pictured almost daily visiting a school, reading with some cute little kid and more closely identifying himself with education than any Democratic presidential candidate in history. Very clearly, the Bush campaign sees a prescription drug benefit as its Democratic issue of choice for next year.

But it may not be that simple. I have noticed two things about senior citizens. First, they tend to have a great deal of time on their hands. Second, they don't mind telling anyone what they think about things. Even the most cursory look at polling data and reports from focus groups indicates that senior citizens have very specific ideas of what they expect in a prescription drug benefit. What they have in mind is something resembling what a Fortune 500 company provides (or used to provide) employees: A modest premium, minimal co-pay, no gaps, no restrictions on what drugs physicians can prescribe and unlimited coverage. Typical is a July 2001 report on eight focus groups conducted by the Democratic firm of Peter D. Hart Research Associates and the Republican firm of Public Opinion Strategies for the Henry J. Kaiser Family Foundation. Reading this and similar reports, looking at polling data and conducting interviews show that seniors are quite adamant about their wants, and Medicare is the vehicle of choice. In short, the proposals passed last week by the House and Senate bear very little, if any, resemblance to the benefit they have in mind.

The idea of a plan being passed that doesn't begin to meet their expectations and won't kick in until after the next presidential election could well trigger the same kind of reaction that resulted in seniors picketing members of Congress in the late 1980s after passage of the catastrophic coverage plan. That example of political disconnect came the famous scene of old-timers climbing on the hood of House Ways and Means Chairman Dan Rostenkowski's car, hurling obscenities at the Illinois Democrat.

The problem, of course, is that seniors are looking for a prescription drug benefit that would probably cost at least $800 billion (twice the cost of the plans that the House and Senate just passed), and very likely much more than that. Many would at this juncture say, "we simply can't afford an $800 billion to $1.2 trillion Medicare drug benefit, given the size of the deficit, the tax cut and the war with Iraq." While that's absolutely true, try to convince seniors that the tax cut is more justified than the drug benefit. Go ahead, I'll watch.

Republicans decided that they wanted to pass a drug benefit and they had about $400 billion to spend. Between the two plans, they seem to have done a reasonable job of coming up with the best benefit they could, but it just isn't in the ballpark of what seniors are expecting.

So for all this talk about prescription drugs being a breakthrough issue for the GOP, I think it just as easily could become a liability that they really don't need given everything else that is going on. Had they trimmed the tax cut a bit to leave room for the kind of benefit these seniors are demanding, they might have gotten the political pop that they were seeking.

Charlie Cook, a NationalJournal.com contributing editor, is the founder and publisher of the Cook Political Report. This column, which also runs in CongressDailyAM when Congress is in session, appears each Tuesday morning. In addition, Cook writes a weekly column for National Journal magazine. His e-mail address cookreport@nationaljournal.com.

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