This morning’s op-ed in the Washington Post suggests that the Republican party has abandoned any intention of negotiating a health care reform bill in good faith. The GOP chairman, as it turns out, has outsourced the party’s health care thinking to professional provocateur Betsy McCaughey and Republicans are now arguing that “that government shouldn’t get between seniors and their Medicare:”
But he and congressional Democrats are planning to raid, not aid, Medicare by cutting $500 billion from the program to fund his health-care experiment….. Second, we need to prohibit government from getting between seniors and their doctors. The government-run health-care experiment that Obama and the Democrats propose will give seniors less power to control their own medical decisions and create government boards that would decide what treatments would or would not be funded… Simply put, we believe that health-care reform must be centered on patients, not government.
The anti-government rhetoric is a throwback to the fear mongering of the 1960s, when party icons Ronald Reagan and Barry Goldwater warned that the Medicare program would lead to socialism and undermine the doctor patient relationship. Despite Medicare’s success and the unrealized fears of its detractors, the party is doubling down on its critique, seemingly condemning both the government-run Medicare program and the new public option. Or is it defending it? Along with the op-ed — Protecting Seniors — the Republican party has also released The Seniors’ Health Care Bill of Rights to “protect Medicare” and “ensure seniors can keep their current coverage” while prohibiting “doctors from getting in between seniors and their doctors.”
Does the party support the government-run program or is it against government-sponsored care? Steele is on a tight rope. He wants to “prohibit government from getting between seniors and doctors” — i.e. limit the government’s role in the Medicare program — but “protect [government sponsored] Medicare” — including the $500 billion in waste that’s already in the system.
Steele characterizes the proposed cuts as a “raid” on the system, but they’re really designed to eliminate inefficiencies, reduce insurance company subsidies, unnecessary hospital readmissions, and lower payments that encourage overtreatment. None of the $500 billion is coming out of benefits. In fact, some of the cuts have been endorsed by the health industry, and supported by Republicans. All of the latest Republican health care plans call for eliminating Medicare “waste, fraud and abuse”, for instance, and a good number of Republicans voted for Medicare payment cuts as part of the Balanced Budget Act of 1997. In other words, they supported decreasing Medicare spending by 12.7% in 1997, but they’re now opposing cutting some 10% out of the program over 10 years.
To be clear, there is a difference between cutting around the edges of the Medicare system and cutting into the system. And, despite Steel’s commitment to “protect Medicare,” Republicans have proposed numerous schemes to slash benefits or privatize the program. Most notably, in 1995, under the leadership of then House Speaker Newt Gingrich (R-GA), Republicans proposed cutting 14% from projected Medicare spending over seven years and forcing millions of elderly recipients into managed health care programs or HMOs. The cuts were to ensure that Medicare is “going to wither on the vine,” Gingrich explained. Similarly, during the 2008 Presidential campaign, Sen. John McCain (R-AZ) proposed cutting $1.3 trillion from Medicare and Medicaid.
The party that opposed the creation of Medicare (and has worked to undermine it) is now disingenuously coming to its rescue by opposing the kinds of changes that would help sustain the program over the long term. It’s recycling the inflammatory charges of Betsy McCaughey and Sally Pipes — Steele writes that government will “ration health care based on age” and dictate “the terms of end-of-life care” — and then feigning surprise at the Democrats’ inability to pass a so-called “bipartisan health care bill.”
Despite the GOP’s political posturing, however, Democratic health care reform still attracts popular support. “More than three out of every four Americans feel it is important to have a “choice” between a government-run health care insurance option and private coverage,” and the majority support the other tenets of Obama’s reforms. As Tom Daschle has pointed out, “the degree to which Republicans make themselves less and less relevant is the degree to which a public option is more and more likely, because we are negotiating with the Democrats rather than the Republicans who oppose it. So I would say that a reconciliation vehicle would probably have a pure public option just because most likely it will only involve Democrats deciding what that reconciliation package will be.”