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The GOP's about-face on Medicare

Even as GOP Chairman Michael Steele vows to protect the program, he denounces it as 'a very good example of what we should not have happen with all our healthcare.'

August 30, 2009|Doyle McManus

The summer healthcare debate has revived an old American tradition: bare-knuckled demagoguery. The airwaves have resounded with spurious charges of socialism, "death panels" and free healthcare for illegal immigrants.

Now, just when we thought we'd heard everything, comes the chairman of the Republican Party with an audacious act of political cross-dressing. Michael Steele announced last week that his party would henceforth embrace the mission of defending Medicare, the federal health insurance program for senior citizens, against anyone who wants to limit its rapidly growing spending.

"We need to protect Medicare and not cut it in the name of health reform," Steele said at the head of a list of principles he issued for this fall's debate on healthcare.

In 1961, before the program's enactment, Ronald Reagan -- along with other Republicans -- denounced its creation as the leading edge of socialism; with Medicare in place, Reagan said, "you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free." Reagan eventually dropped his opposition to Medicare's existence, but as president he looked for ways to rein in its spending -- as have most other Republican leaders and, in recent years, responsible Democrats as well.

But this time, the most prominent leader calling for fiscal restraint in Medicare is Barack Obama, and that has driven Steele, as if by chemical reaction, to take the opposite position.

The about-face has left the GOP chairman struggling to articulate a lucid policy. He acknowledges that without any change, "Medicare will go deep into the red in less than a decade." But he nevertheless insists that limits shouldn't be imposed. And he certainly isn't advocating tax increases to plug the gap.

Weirdest of all, even as he vowed to "protect Medicare," Steele denounced it as a "single-payer program" and "a very good example of what we should not have happen with all our healthcare."

This isn't merely demagoguery; it's incoherent demagoguery. After several days of bad reviews, Steele backpedaled a step and said that he might not oppose all cuts in Medicare spending -- only the ones Democrats have proposed. But he refused to say what changes he would support to stop costs from spiraling out of control.

What has happened here, of course, is that Steele and other GOP tacticians believe they have found a new "third rail" in American politics: Medicare. The one great untouchable up to now has been Social Security: Whenever fiscally responsible Republicans have called for controlling costs, partisan Democrats accused them of plotting to rob the elderly of their pensions. Now, having seen the advantage of pandering to America's most powerful voting bloc, Republicans have adopted a ploy they once railed against.

Steele hasn't let facts stand in the way of promoting his "Seniors' Healthcare Bill of Rights." He claimed that Democrats want to ration heart surgery based on age -- granting operations to the young but denying them to the old. (An aide said he was referring to Obama advisor Ezekiel Emanuel, who has recommended using age as one of several criteria for allocating "very scarce medical interventions such as organs" -- not heart surgery, which is anything but scarce.) And he accused the Department of Veterans Affairs of "encouraging [veterans] to commit suicide" in a manual on living wills. (I've read the manual; it doesn't even come close.)

At the moment, these fulminations may look like a winning tactic. Polls show growing opposition to President Obama's still-fuzzy healthcare proposals among the elderly as they worry about what proposed trims in Medicare spending might mean. If senior citizens turn solidly against healthcare reform, the president's signature project could collapse.

If Obama and the Democrats hope to win this battle, they'll need to convince senior citizens that their medical care won't be harmed by curbing future growth in Medicare spending and subjecting the program to tougher scrutiny on cost-effectiveness. They haven't successfully made that argument yet.

In the debate about costs, many Democrats don't have clean hands. When then-President George W. Bush proposed modest Medicare spending trims in 2006, Senate Majority Leader Harry Reid accused him of "asking our seniors ... to clean up his fiscal mess with painful cuts in healthcare."

Still, Steele's argument is bad politics over the long run. The GOP chairman has declared that fiscal restraint, one of his party's most basic tenets, is no longer a virtue -- at least not this year. Many Republicans believe their party lost its way -- and its appeal to voters -- when it abandoned its fidelity to fiscal responsibility. Steele's defense of unfettered Medicare spending won't help the party recover.

More important, it's bad policy. Telling seniors that growth in Medicare spending is an unshakable entitlement is a commitment that the next Republican president will regret.

Other Republicans have warned that the rate of growth in Medicare spending can't be sustained. Sens. Tom Coburn (R-Okla.) and Richard Burr (R-N.C.) have proposed a healthcare plan that doesn't agree with Obama on much, but does look for ways to control Medicare costs. Sen. John McCain proposed trimming future Medicare spending when he ran for president, and says he still thinks cuts are needed. (Of course, the Obama campaign blasted him at the time for threatening senior healthcare.)

But Steele skipped those steps and went straight for the crowd-pleaser, promising that the Republican Party won't cut Medicare. He was seeking a tactical advantage for his side in the debate. Instead, he has put the GOP in danger of being not only the Party of No, but also a party of no sense.

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doyle.mcmanus@latimes.com

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