Column: The Republican Plan to Destroy Medicare
The rhetoric was, at best, silly. But at least in that era conservatives professed their convictions with some semblance of probity: that is, through a filter of clinical paranoia untreated by slick mass-marketing consultants. From every hilltop GOPers unabashedly rang the alarm of domestic Bolsheviks plotting to enslave the populace with social compassion. People politely listened, then promptly dismissed Republicanism in droves.
The good old days. Republican pols were honest - hence a minority.
Things are of course different now, though Medicare remains every bit the bugaboo. The right has always belittled government's ability to get anything right or do anything right, promoting free-market options as better and cheaper. Unlike the Pentagon, which has a habit of misplacing a few billion here and a few billion there with impunity, Medicare forever has been under an intensive conservative microscope and equally intensive criticism.
Yet time has shown these selective fiscal watchdogs that, left to its own devices, for-profit health care simply cannot deliver as efficiently as government. Just compare Medicare's administrative costs to any HMO, or consider studies that show seniors with private health plans are less satisfied with their care than their Medicare counterparts. That factual history lesson is more than a thorn in conservatives' side; it's a dagger in their ideological heart.
Their response? A curious, dishonest and misnamed tour de force of cognitive dissonance: the Medicare "drug" bill. In brief, to eviscerate a social program that has worked well for nearly 40 years, laissez-faire conservatives have set out, in effect, to socialize - or to put it euphemistically, welfare-capitalize - the dickens out of private health care alternatives. It seems our American Tories believe only socialist ripostes can slay the demon of social equity.
So much for living up to the courage of one's convictions.
Indeed, the Medicare bill is a study in ideological contradictions, public policy time-bombs and negative consequences that are anything but unintended. It allots a whopping 30 percent more of your money on privately covered seniors than otherwise would be spent through Medicare. To pay for massive HMO subsidies, the bill robs many of the elderly poor of Medicaid's "wrap-around" protection. While it covers less than one-fourth of the elderly's prescription costs (according to the Center on Budget and Policy Priorities), the bill lavishes mountains of cash on already profit-gorged and politically sheltered drug companies by barring Medicare from the free-market practice of negotiating volume buys. And in permitting private health-plan "cherry picking," the bill leaves Medicare with the sickest population and its recipients with skyrocketing premiums.
You can almost hear the kaboom.
The deathblow will come when Medicare is in shambles and the federal deficit too bloated to do anything about it. (Say, what a coincidence that will be.) It'll be closed-for-business time, as well as time for crocodile conservative tears over "socialized medicine" having always been doomed to fail.
Meanwhile, there's that one inconvenient fact that must stick in the craw of every conservative who sired the drug-bill stalking-horse. Medicare is among the most efficacious social programs ever. The contemporary right won't stand for that, so it's out for blood - out-Medicaring Medicare with perverse welfare-capitalist tricks that would make bygone conservatives heave.
© Copyright 2003 P. M. Carpenter
Mr. Carpenter's column is published weekly by History News Network and buzzflash.com.