Republicans: The Champions of Medicare?

This past week, I began reading the novel 1984. For those who have not read it, it is a futuristic novel describing a society that lives under the rule of a totalitarian government described as “the Party.”  The government controls and monitors every aspect of human life and even practices historical revisionism quite literally—burning books and re-writing history—to have everything reflect whatever it (the government) happens to be saying. The agencies within the government are all a blatant contradiction. The Ministers of Truth re-write history and instigate direct government propaganda through always-on “telescreens” found literally everywhere in society that don’t turn off; the Ministers of Peace advocate war; the Ministers of Plenty plan economic shortages, and the Ministers of Love carries out the government’s “corrective” punishment and torture of its rebellious citizens.

In one scene, there is a Hate rally (which occurs regularly to inspire hatred within the people for the enemies of the Party) and at the rally the Party shifts its diplomatic allegiance, so the nation it has been warring with is suddenly its ally, and the former ally is now the enemy. Despite the obvious contradiction when the speaker changes the nation he refers to as the enemy during his speech, the crowd simply accepts the change without question and even is embarrassed that they brought wrong signs to the event. Just in the same way people accept the ministries conducted by the Party aforementioned even though they blatantly contradict their titles in their action. What is with the collective intellectual schizophrenia? How can people look right passed the most obvious facts? This theme that runs throughout 1984 is about a troublesome little tendency to believe or argue for some truth that obviously and patently contradicts other truths.

In the ongoing health care debate, this same sort of schizophrenia has come about. I almost shouted “yes!” in a public library when finally I saw the political contradiction pointed out in the Washington Post:

After years of trying to cut Medicare spending, Republican lawmakers have emerged as champions of the program, accusing Democrats of trying to steal from the elderly to cover the cost of health reform.

The exact policy question aside because it is its own debate, I cannot for the life of me comprehend how with any sense of credibility many Republican lawmakers are lamenting about Medicare cuts, saying effectively that the Democrats are going to cut into the care available to seniors, which will inevitably lead to rationing in the form of euthanasia. This often has a “death panel” spin to it.

Despite the collective amnesia of the American people, to the obvious joy of Republican political strategists, historical record on the other hand points out a glaring contradiction that makes their arguments seem wholly and entirely politically pragmatic. For example, during a vote in the House on April 2, 2009 the majority of House Republicans sought to end Medicare as it currently exists in the vote on the Republican budget alternative submitted by Budget Committee Ranking Member Paul Ryan (R-WI). The amendment won support from nearly four-fifths of House Republicans and effectively would have converted Medicare into a voucher system providing future retirees with a fixed amount of money to buy private insurance plans.

A few weeks ago, the National Republican Congressional Campaign Committee launched radio ads against the Democratic health care proposals describing the impact it would have on Medicare:

“And how do they pay for the Pelosi health plan? By cutting Medicare. Cutting Medicare by $500 billion according to President Obama’s own projections. That’s right: the Democratic health care plan will be paid for on the backs of America’s senior citizens.”  (Listen to it here).

It is nothing but sheer political pragmatism that the GOP can rail against the Democrats for trying to cut Medicare while conveniently forgetting that this has been part of the Republican party’s agenda for more than a generation. Did the GOP suffer some sort of collective amnesia? Is it not true that once upon a time then-Senate Majority Leader Bob Dole bragged that he fought against Medicare in the 1960s because the GOP “knew it wouldn’t work”? Didn’t House Speaker Newt Gingrich take issue with President Clinton for refusing to sign a balanced budget bill that called for cuts to Medicare? Did everyone forget that just last year Senator McCain, the Republican presidential candidate signaled that his health care reform plan involved cutting $1.3 trillion from Medicare and Medicaid over 10 years?

Just recently, RNC Chairman Michael Steele rose to defend America’s single-payer program from any cuts insisting “we need to protect Medicare and not cut in the name of health-insurance reform.” One would suppose that the Republican Party experienced some sort of conversion of heart,  collectively are terribly confused, or will say anything that seems politically viable. This happens way too much in American politics.

This inconsistency unfortunately, in my view, occurs with pro-life groups that often work with Republicans (which is fine) to the point that the association translates into the organization working like a Republican PAC (like my own job for a pro-life legal advocacy group). Medicare cuts (which Republicans have obviously supported for so long) will inevitably lead to rationing care, it is argued, in the form of government-sanctioned panels authorizing euthanasia and denial of care (see here for slightly amusing comments on a forum at The Free Republic about the subject and an article “the Democrats’ Senior Problem” on Politico).

The National Right to Life says on the issue:

Medicare, the mandatory government program that since the1960′s has provided health insurance for older Americans, is in deep trouble.  It is paid for largely by payroll and income taxes, through which workers essentially pay for health care costs of retirees.  When the baby boom generation retires, the proportion of retirees to workers will rise dramatically, so that there will be less tax money available for each retiree, imperiling the ability of Medicare to continue to provide unrationed health care to senior citizens. The economic reality is that in order to provide Medicare coverage for the baby boom generation as it retires, without unrealistic massive future tax increases, government payments per beneficiary will not be able to keep up with medical inflation. If the funds available for health care for senior citizens from all sources are so limited, the only possible result will be rationing. Since senior citizens are required to participate in Medicare, this would amount to government-imposed involuntary euthanasia.

National Right to Life supports MSAs (Medical Savings Accounts) so that seniors can use their own funds and have the available choice of un-rationed and un-managed health insurance if they choose. This point needs no debating. But if the system is direly in danger of looming rationing, it would logically follow that NRTL would speak out against Medicare cuts which would decrease funds and from this line of reasoning, tighten the management of care, i.e. lead to rationing. Indeed, they have regarding the current Democratic proposals, but their complaints of previous Republican initiatives to limit funding to a system in ration-danger must have gotten lost in the wind.

In a previous post (see the very bottom headline), I argued how nonsensical much of the “death panel” rhetoric tied to this issue had gotten. I attempted to outline a more intelligible way of expressing concerns about respect for life. Regarding the alleged “death panel” provision in the Democratic health care proposal, as I said previously, it merely states that health insurance must pay for—not mandate—advanced care planning consultations between individuals and physicians every five years, during which a spectrum of end-of-life options can be explained and discussed so individuals can knowledgeably choose their own treatment preferences in advanced—living wills, medical power of attorney, and expressed desires of what course of treatment is to be preferred in many situations might actually avoid the incidence of euthanasia (unless you live under the Texas Advance Directives Act of 1999 signed by then-Governor George W. Bush; you’re good as dead here).

Now in professional medical practice, a doctor might include physician-assisted suicide as an option or a hospital ethics committee (like those found in Texas) might just override everything you opt for and euthanize you anyway. This is hardly some sort of cold, calculating government-sanctioning of euthanasia program rather it’s private sector “death panels.” Yet the Republican Party, following the “death panel” assertion of Sarah Palin for quite some time (and still now at times) runs with this notion. If it were not for the collective amnesia that has characterized much of the sensationalist, he-said, she-said, let’s-be-dramatic-and-not-talk-about-anything-substantive part of this debate, the GOP by all logic would have picked another provision of the Democratic health care bill (I’m sure they could have found one in the gazillion pages) to mischaracterize and rail against rather than attack something they once upon time voted for!

In the 2003 Medicare prescription drug bill that passed with 204 House Republican votes and 42 Republican Senators, there was a provision for end-of-life counseling and care. The bill reads:

“The covered services are: evaluating the beneficiary’s need for pain and symptom management, including the individual’s need for hospice care; counseling the beneficiary with respect to end-of-life issues and care options, and advising the beneficiary regarding advanced care planning.”

I can hardly see the difference between the 2003 provision and the infamous “death panel” provision given by the Democrats that supposedly threatens the sanctity of life except that the GOP’s clause was only applied to terminally ill patients, whereas the Democrats’ language made it so that anyone could voluntarily receive such counseling before they became terminally ill. I see no reason to have moral qualms with either. But it seems that either Republicans were in favor of “death panels” previously, all the while the National Right to Life was of course lollygagging and too busy railing against the Democrats to scream “death panels!” against the GOP, or there has not been any “death panel” language in anyone’s legislation. Either the Democratic language doesn’t legitimize “death panels” or the NRTL is awfully partisan. Though this still says a lot about the fact that the Republicans, in some fashion, appear to be political opportunists who will say anything, even condemn language similar to what has been previously proposed and passed by their own members, if it means defeating the Democrats.

Of course, this disconcerting reality is all the more troubling because I find little consistency in throwing around criticism in the Catholic circles I frequent. The issue is always the Democrats. Now, of course, the Democrats are frequently at fault and rightly so. I’d like to think I can hardly be accused of being partisan when my voting ballot is almost entirely for the party I don’t belong to and am very critical of. In fact, I thought this would surely be the year that I would become a Republican because of the Obama Administration and the two appalling figures leading the Democratic-controlled chambers of Congress. This has not been then case; the opposite is true and terribly true at that. I feel I have become even more strongly Democratic because the “party of no” has not been at all impressive even while I roll my eyes as our incompetent Democratic leaders think they have stumbled onto some solution that is, as it often has been in the last 11 months, another move toward failure.

My disappointment has peaked recently because I work for a right-to-life organization and yet there has been no mention or attention given to the fact that the RNC for roughly twenty years has covered elective abortions for its employee health insurance. Not a word. I have never given the RNC money, but I’m sure people who have would like to know if that coverage has ever been used (not that such information would be revealed). I would hope that people learn to support candidates and not the party establishment. Nevertheless, the attention given to something so scandalous was both unimpressive and very disconcerting. Just today, I read that Focus on the Family, a leader in petitioning against the health care reform bills, has made the same insurance error as the RNC. This, of course, is appalling news. I’m sure the policy will be changed particularly after its reality has been pointed out and circulated on pseudo-feminist blogs about “anti-choice hypocrisy.”

On a final note, the Democratic Party in particular needs to establish why it is suddenly legitimate to cut funds to Medicare after decades of fighting those allegedly bigoted Republicans who supposedly are ardent enemies of socio-economic justice. Moreover, President Obama needs to reestablish his credibility and present with coherency (though, I think he has, at least, partially in an interview) how he could have so vehemently attacked Senator McCain for wanting to cut funds to Medicare as he stands by while his fellow Democrats do so. Moreover, it needs to be clarified precisely what funds and to what aspects of Medicare are being cut. One can gather that funds are being “restructured,” i.e. funds that lead to waste are allegedly being cut and/or moved elsewhere. This may or may not be true. Either way it needs clarification.

Quite similarly, the GOP needs to have their feet held to the fire—simply saying “no” and having “party amnesia” in order to say whatever is necessary or pragmatic to oppose, and beat, the Democrats will not hold water; whatever majority they might win will not last long otherwise—solutions mean more than saying “no” and of course, being in the majority means society is not so susceptible to amnesia and will deliver the pink slip if failure calls for it.

10 Responses to Republicans: The Champions of Medicare?

  • Well, for what it’s worth, there are some on the right/libertarian side of things who have been pointing out the same thing: All this rhetoric about not cutting Medicare is going to make it a lot harder the next time the GOP tries to support some kind of privitization of senior care.

    I think there are basically two things going on here. One is a basic partisanship: Republicans tend to assume that their own proposals are well meant and will work out well, while assuming that Democratic proposals are nefarious. So they assume that if they cut Medicare and replaced it with something private, it would be to the benefit of seniors — while if Democrats try to do it, they’re ready to assume the worst. By the same token, Democrats have often insisted that Republicans want to starve the elderly and then leave them to die without medical care, but now everyone on that side of the aisle is _sure_ that the cuts are only waste. (Since when has the Democratic Party been sure there was half a billion or more of waste in Medicare?)

    Another element is that there are fixed constituencies for everything, and if one party isn’t willing to take one, the other generally will. The elderly are often eager to support Republicans on social issues or on tax issues, but they easily turn on Republicans when it comes to making any changes (other than expansions) to Social Security and Medicare. This is how Democrats have repeatedly staved off Republican reform efforts on those programs, but it’s probably hardly surprising that Republicans are willing to play the same game with the fears of the elderly now the shoe is on the other foot.

    My own thought would be that this whole thing is an extended exercise in Kubuki theatre. I find it almost impossible to believe that the spending cuts being queued up would actually take place. Similar cuts have been voted for in the past in order to make spending deficit neutral, and congress always comes through and does an emergency repeal of the cuts before they actually take place. So inreality, the program if passed will likely be a massive deficit expansion.

    Unfortunately, that’s an explanation that takes longer than thirty seconds to get across, so few in the public square seem interested in it.

  • John Henry says:

    Good post, Eric. Douthat wrote a column about the hypocrisy of Republicans on Medicare a few months back, saying Republicans will likely regret it in the future. But, as Darwin points out, the AARP and other groups are quite happy to back one party or the other depending on which way the winds are blowing.

    And I’d add that voters don’t pay that much attention to the individual talking points on such a complex topic anyway. The reason why politicians constantly change their positions and spout ideologically incoherent nonsense (take Obama’s classic lower taxes + higher spending = a lower deficit trope from last year’s campaign as an example) is that voters let them get away with it.

    I think it’s also important to identify where the cuts are coming from. Personally, I’d like to see means testing for Medicare and Social Security; it’s a fairly progressive and obvious solution, although of course some people reflexively oppose any cuts proposed by the opposite party. On the other hand, I think cutting ‘waste and inefficiency’ (remember Obama pledging to pay for his program above by going ‘line by line’ through the budget) is another way of saying that nothing will be cut. Politics is dysfunctional, which is one reason among many that 1984 is so widely cited. But it’s worthwhile to have posts like this that point out the contradictions; sunlight can be a helpful disinfectant.

  • American Knight says:

    In all truth it is impossible for an orthodox Catholic to belong to either of these parties, if it is even true that they are two parties. It is more likely that they are one party with different facades in order make the electorate feel as if we have a choice, that we have some control, that we influence government in some way. It is a show.

    Reading the Pope’s latest encyclical clearly indicates that the Church is well beyond the false left-right paradigm – when are we going to catch up?

    It had better be soon or we may not get much of a chance to do anything about it.

  • Gabriel Austin says:

    Much confusions arises from the notion that politically one must be “republican” or “democrat”. The reality was caught by Lewis Carroll when he described Tweedledum and Tweedledee.

    Ideally, each candidate would run as a candidate, independent of parties. [Read G. Washington on the subject]. We are told we need parties. We are told this by party people. It is not true.

  • Blackadder says:

    Political parties will arise naturally under any democratic form of government. Speculation as to whether we would be better off without them is therefore a moot point.

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