There will be plenty of spin about how the huge upset in Buffalo last night was caused by a bad Republican candidate or the Tea Party candidate siphoning off votes from the favorite, but cast all that aside. This special election was all about rejection of the Paul Ryan Medicare plan. And it was about a big of a signal as was Scott Brown taking Ted Kennedy's Senate seat in January 2010. After all, this was the 165th most Republican seat in the country and some projections are that even without the 3rd candidate, the Democrat would have won by 3 points.
2012 is now set up to be the second election in a row driven by health care in general and health care for the elderly, more specifically. Yes, there was a lot of backlash in 2010 about other aspects of Obamacare, concerns about government overreach that drove formation of the Tea Party, and economic malaise. But a big part of what drove the 2010 results was the senior vote. House Republicans gained a 21% margin among those over 65 years old compared to a 10% margin for McCain in 2008. With seniors making up a bigger part of the electorate in the midterm -- you get a tsumani election.
In 2010, Republicans used death panels and cuts to some aspects of Medicare to frame the debate. There is no shred of doubt after last night what Democrats will do to frame the debate next year. Any penny spent on campaign commercials on other topics would probably be a waste of money. My guess is that Democrats ride this issue to gains in the House, perhaps big enough to take control, perhaps not.
So, where does that leave us?
Option 1: Medicare politics ensures that the program remains pretty much untouched, in which case spending on Medicare will crowd out almost all other government functions in the next 25 years and require middle class tax increases on young people to pay for their grandparents health care; or, Option 2: Medicare politics requires that Medicare reform will take place on a bipartisan basis -- essentially taking it out of politics. The first option is untenable, but I think it will take another election to get us to a place where Option 2 is possible.
So, strange as it may seem, the cold breeze for the GOP that flowed off of Lake Erie last night might ultimately be the first step in a creating a political dynamic to finally begin to address this problem in a serious way.