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BONITA SPRINGS, Florida (Reuters) - Bill James, a retired state trooper and resolute Republican, knows what he wants from a presidential candidate: "Fix the economy, straighten out the budget, do something about the national debt."
But when it comes to curbing Medicare costs, a prime driver of the nation's deficit, James doesn't favor any cutback.
Should the ballooning federal insurance program be revamped? "Only if I got approximately the same benefits and paid approximately the same amount of money," said the 77-year-old, who is battling bone cancer.
Medicare and Social Security, the massive programs that pay benefits to tens of millions of older Americans, are contentious issues in the 2012 presidential campaign. Seniors want the nation's sputtering economy to be fixed, but not at their expense.
In the midterm elections two years ago, one in five voters were over 65. If older Americans turn out in force this year, they could swing the presidential race. President Barack Obama and his GOP opponent, Mitt Romney, are neck and neck in current surveys.
In a nationwide Reuters/Ipsos poll, 42 percent of seniors said they would vote for Romney and 39 percent for Obama if the election were held today. Among other voters, the two candidates were even.
However, when asked which party better serves the needs of Americans over 65, Democrats edged out Republicans among seniors by 34 percent to 31 percent.
CONFLICTING MESSAGES
As was the case in 2010, strident rhetoric, partisan distortions and ugly ad campaigns are sowing confusion over programs that serve the elderly.
"There's only one president in history who has cut Medicare by $500 billion - and that's Barack Obama," Mitt Romney tells voters. (In fact, Medicare spending would continue to grow under Obama's plan.)
A conservative group, AmericanDoctors4Truth, launched an ad campaign in March that showed Obama pushing an old lady in a wheelchair off a cliff. The spot, which ran in Florida and Texas, mimicked a 2011 video by a liberal group that showed Republican Representative Paul Ryan of Wisconsin, author of a Medicare privatization plan, rolling a disabled senior down a steep hill.
Romney has endorsed Ryan's legislation to steer future retirees to private health insurance, which was adopted by the GOP-controlled House earlier this year, along with a cap on Medicare spending.
Obama contends that the Romney-backed plan would "end Medicare as we know it," telling an Ohio rally last month, "We're not going to go back to the days when our citizens spent their golden years at the mercy of private insurance companies."
In Limetree Park, a Gulf Coast mobile home community where James and his wife, Rosalie, spend the winter, the ideology of residents ranges from far left to far right. But all agree on one thing: the importance of an adequate federal safety net.
"We couldn't survive without Medicare," said Rosalie James. At 78, the former switchboard operator has had two knee replacements and is being treated for diabetes and heart disease.
Two doors away, Andrea Davis, 63, a former secretary, said she hadn't worked long enough at one place to build up a 401(k). "If it weren't for Social Security, I would probably be on the street," she added.
BINGO, BILLIARDS AND BIBLE STUDY
On a sunny afternoon in Limetree, men in shorts play shuffleboard; women in floral bathing suits lounge around the pool. Activities are posted on a board at the barbecue pavilion. Monday: poker and dominoes. Tuesday: bingo and billiards. Wednesday: koffee klatch and Bible study.
An entrance sign at the 240-unit park greets visitors with the motto "Finding friendship in paradise." To preserve harmony, Limetree retirees say they rarely talk politics with their neighbors.
In the Reuters/Ipsos poll, 32 percent of seniors said Obama has better plans for Social Security and Medicare, while 30 percent said Romney does.
"Rich seniors are better served by the GOP, while the policies of the Democrat party are slanted toward the middle class," said Mark Findlay, 67, a retired Pennsylvania businessman who spends winters at Limetree. "But ... Tea Party members don't seem to realize it."
Bill Bontrager, who lives a few doors away on Golden Sand Avenue, sees it differently. A Tea Party sympathizer and Romney supporter, he wants fewer government regulations, lower taxes and spending cuts to fix the deficit.
Including cuts to Social Security and Medicare benefits? No, that's not what Bontrager, 68, has in mind. "It is very irritating when they say these are entitlements," he complained. "How can something be an entitlement when you've paid for it your whole life?"
DEFICITS AHEAD
In fact, American workers and retirees are not paying enough for either Social Security or Medicare to remain solvent.
Obama and Romney agree that the programs must be changed, but they differ sharply on how to do it.
With 78 million baby boomers entering retirement, Social Security is set to run short of money by 2037, according to government actuaries. The projected deficit: roughly $87 billion a year.
Romney favors a plan, popular in the business community, to partly privatize Social Security by directing the contributions of future retirees into 401(k)-type investment accounts. Obama opposes the idea, saying it would subject retirement savings “to the whims of the stock market.” In the Reuters/Ipsos poll, seniors disagreed with the idea by 46 percent to 25 percent.
Romney would also raise the retirement age for full Social Security benefits beyond 67 and would gradually boost the eligibility age for Medicare until it matches life expectancy. These "commonsense reforms," he says, would help "save Social Security and Medicare for future generations."
Obama has backed away from proposals to postpone benefits, which would be unpopular among blue-collar voters with arduous jobs.
"I blew out my knees, my feet and my shoulder with construction work," said Limetree resident Dewey Schilling, 62, who survives on Social Security disability benefits. "If you work till you're 70, you ain't got a whole lot of life left to enjoy."
Instead, Obama, along with many Democrats, would replenish Social Security by lifting the current cap on the payroll tax, so that income above $110,100 a year would no longer be exempt.
THE 'MEDISCARE' STAMPEDE
Lifting the cap is anathema to Republicans who vow not to raise taxes, but it taps into a growing public sentiment that the rich are not paying their fair share.
"They need to change the tax structure," said Jeanne Cross, 82, a former receptionist who votes Republican. "All these people making all this money, they're not paying as much taxes as you and I."
Bontrager, the Tea Party sympathizer, disagrees. He once owned an Indiana factory that made truck bodies and employed 135 people. The tax-the-rich rhetoric is foolhardy, he said. "Have you ever seen a poor man create a job?"
In the 2010 midterm elections, Republican assertions that the Patient Protection and Affordable Care Act, passed by Congress and dubbed Obamacare, would slash Medicare benefits and institute "death panels" to ration care set off a stampede to the polls by furious seniors.
In 2008, 16 percent of voters were over 65, but two years later that proportion had jumped by five points. The power of what pundits called Mediscare helped the GOP recapture control of the House and gain six seats in the Senate.
In the next decade, spending for the giant insurance program is set to nearly double, from $576 billion to $1.05 trillion a year, because of the rising cost of medical care and the aging of the population. By 2030 the number of Americans on Medicare will jump from 49 million to 79 million.
Obama's healthcare reform law doesn't cut senior benefits. In fact, it expands preventive care and prescription coverage for the elderly. It would slow Medicare spending by curbing payments to nursing homes and other health facilities, penalizing error-prone hospitals, speeding generic drugs to market, and boosting premiums for wealthier retirees.
Overall, it would cut the projected rise in per capita Medicare costs from 6.8 percent to 5.5 percent over 10 years, for a net savings of $428 billion by 2019.
WIDESPREAD CONFUSION
That estimate has given Romney an opening to accuse Obama of cutting healthcare for seniors. Obama, meanwhile, calls the GOP-supported budget and Medicare plan "a radical vision" and "thinly veiled social Darwinism."
A TV spot launched in Florida and other swing states last month shows a young Obama with his grandparents and touts his administration's recovery of $4 billion from healthcare scam artists who prey on seniors.
The Reuters/Ipsos poll revealed the whipsaw effect of conflicting messages: Sixty-one percent of seniors disapproved of the Obamacare law. But they were evenly split on whether Obama or Romney has a better plan for healthcare.
In Limetree Park, confusion is widespread. Stan Brummel, 69, a retired Michigan toolmaker, voted for Obama in 2008. Now he's on the fence. Obama is the one trying to cut Medicare, said Brummel, who suffers from polymyalgia.
Like many of his neighbors, Brummel was unfamiliar with the Ryan plan to restructure Medicare, which, as it happens, retains the very savings in Medicare spending that were enacted under Obamacare and that GOP candidates have attacked.
The House-passed premium support plan, endorsed by Romney, would give seniors vouchers to buy private insurance beginning in 2022, gradually replacing government-run Medicare. The goal: market competition to drive down costs.
Last year the nonpartisan Congressional Budget Office calculated that if Medicare fully transitioned to private insurance plans, as proposed in the 2011 House-passed budget, it would more than double seniors' out-of-pocket costs, to $12,500 a year. That measure died in the Senate.
This year's version retains traditional Medicare as an option. It is co-authored by Senator Ron Wyden of Oregon, a Democrat, but most Democratic lawmakers oppose it because it could allow premiums to rise.
COMFORT FACTOR
At Limetree, Ruth Hoeger, a retired nurse, knows the value of a safety net more than most. Her father was a coal miner who died of black lung disease when she was 11; Hoeger and her siblings survived on Social Security.
Now she and her husband live with a 45-year-old son who receives Social Security disability payments for chronic pulmonary disease. A former carpenter, he was exposed to asbestos.
Hoeger, 74, fears the Romney Medicare plan. "I've got arthritis and high blood pressure. What insurance company would cover me for the price of the voucher?" she asks. "If you privatize Medicare, the elderly will die earlier."
Her neighbor, Bontrager, thinks the privatization plan might be a good idea. "What happens to the money we pay into Medicare?" he asks. "It is mismanaged. The government should get out of the insurance industry."
As the campaign heats up, the intricacies of how to slash the deficit and reform entitlements seem unlikely to lend themselves to nuanced discussion.
Beyond the charges and countercharges, however, many older Americans are fully aware that how the safety net is designed can mean the difference between poverty and a comfortable life in a place such as Limetree Park.
They'll be paying keen attention before casting their votes in November.
(This is the third article to run as part of American Mosaic, a yearlong Reuters/Ipsos polling and reporting project that focuses on the diverse groups and competing views at play in the 2012 presidential race. The data is drawn primarily from online surveys using sampling methods developed in consultation with outside experts. By Election Day the survey will have reached 150,000 people, mixing respondents recruited from the Internet with individuals screened by Ipsos. Their responses are weighted based on demographic information and refined using a monthly telephone poll. With this method, accuracy is measured using a statistical calculation called a credibility interval. To see all the data from this survey and other polls in the series, go to www.reuters.com/politics/american-mosaic.)
(Editing by Lee Aitken, Prudence Crowther and Douglas Royalty)