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Republican Hypocrisy In The Health Care Debate

Back during the initial debate over what became the Patient Protection And Affordable Care Act, one of the more bizarre messages that came from the people who would show up at Congressional Town Halls was summed up in the seemingly contradictory slogan “Keep Your Goddamn Government Hands Off My Medicare.” It wasn’t just ordinary citizens saying stuff like this, consider what Arthur Laffer said on CNN in August 2009:

 ”If you like the Post Office and the Department of Motor Vehicles and you think they’re run well, just wait till you see Medicare, Medicaid and health care done by the government.”

And, when some Republicans tried to explain to people that Medicare already was a government program, well, it didn’t go so well:

In other pockets of the state, the reaction to Democratic proposals has been strong, too. At a recent town-hall meeting in suburban Simpsonville, a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”

“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”

Inglis, of course, had more than a few run-ins with the Tea Party crowd during that year and was rewarded for his apostasy by being booted out of office in 2010. In any event, for some reason, the fundamental illogic of campaigning against the PPACA by pointing out that it would turn a government-run heath care program into, well, a governing run health care program doesn’t seem to have occurred to many people on the right. Indeed, conservatives at The Weekly Standard and National Review argued that there wasn’t anything inherently contradictory about the argument at all. During the 2010 campaign, after the PPACA had passed, the theme returned in many Republican Congressional and Senate campaigns, with the additional comment that the recently passed law had “taken” money from Medicare.

In the two years that have passed, of course, Republicans have talked about Medicare in many other contexts. Paul Ryan and other members of Congress have proposed plans that are meant to address the long-term solvency issues that the program faces and Democrats have responded by accusing them of wanting to fundamentally transform the program. Now, with the ObamaCare battle rejoined in the context of the 2012 elections, the GOP has returned to using Medicare as a weapon in its fight against “government run health care”:

WASHINGTON — For much of the past year, Republicans assailed President Obama for resisting the Medicare spending reductions they say are needed to both preserve health benefits for older Americans and avert a Greek-style debt crisis. Representative Paul D. Ryan, the House Republicans’ point man on the budget, has called the president “gutless.”

Yet since the Supreme Court upheld the Democrats’ 2010 health care law, Republicans, led by Mitt Romney, have reversed tactics and attacked the president and Democrats in Congress by saying that Medicare will be cut too much as part of that law. Republicans plan to hold another vote to repeal the law in the House next week, though any such measure would die in the Democratic-controlled Senate.

“Obamacare cuts Medicare — cuts Medicare — by approximately $500 billion,” Mr. Romney has told audiences.

That is a reprise of Republicans’ mantra of the 2010 midterm elections, which gave them big gains at both the state and federal levels and a majority in the House. Yet the message conflicts not only with their past complaint that Democrats opposed reining in Medicare spending, but also with the fact that House Republicans have voted twice since 2010 for the same 10-year, $500 billion savings in supporting Mr. Ryan’s annual budgets.

The result is a messaging mess, even by the standards of each party’s usual election-year attacks that the other is being insufficiently supportive of older people’s benefits.

And in this year’s contests, which both parties describe as a referendum on who can best correct the nation’s economic course, such talk underscores how far Republicans and Democrats are from truly squaring with the public about curbing the growth of the major entitlement programs: Medicare, Medicaid and, to a lesser extent, Social Security. That growth is driving the projections of a federal debt that is mounting unsustainably as the population ages and health care costs rise.

“A pox on both their houses,” said Ron Haskins, a former Congressional staff member who is now a scholar of social programs and budgeting at the Brookings Institution. Democrats and Republicans “know they have to do something about Medicare, and then they harass each other about cutting Medicare. It’s so discouraging to me, but I’m a Republican, so I’m much more distraught about Republicans.”

And, Mr. Haskins added, “$500 billion is modest compared to what Ryan would do.”

It’s understandable why politicians do these things, of course. Medicare is a popular program, as is Social Security, and there have been numerous times over the decades where a politician has been attacked for threatening those programs with one idea or another. Since these attacks tended to work — see, for example the uproar that occurred in the wake of President Bush’s relatively modest Social Security reform proposal in 2005 — they keep getting used again and again, even when its apparent that the attack itself doesn’t really amount to much of anything. Remember, for example, the over-the-top response to Paul Ryan’s plan that included a commercial where a Ryan look-a-like pushes an old woman in a wheelchair over a cliff? That’s not rational politics, that’s blatant fear mongering, and that’s exactly what the GOP is going here.

There’s a broader point here, though.

Haskins is right when he points out that the manner in which both sides demagogue the issues of Medicare (and Medicaid, and Social Security, and pretty much every other important item in the Federal Budget) makes it next to impossible for any real reform to take place because that just mean your political opponents are going to ram it down your throat. Where Social Security was once called the “third rail” of American politics, we now have fourth, fifth, and sixth rails, all of them equally dangerous to the politician who would dare to put forward a bold idea about how to deal with a problem we all know is coming at us at full speed. Add into that the hyperpartisan nature of American politics, and the odds of any kind of real bipartisan effort on issues like this become pretty low because nobody is willing to compromise in areas that would be politically disadvantageous for their party. It’s the reason why we’re never able to solve our long term problems until they’re right on top of us, and that’s a problem we’ve had for decades now.

In this particular case, though, the Republican position has always struck me as especially hypocritical. Arguing against what you contend is a big government health care plan by arguing that it poses a danger to another big government health care plan is really quite idiotic notwithstanding the justifications that I noted above. Using political rhetoric that makes it seem like Medicare and Medicaid aren’t already government run programs is dishonest. Putting forward plans to reform Medicare and then attacking the President for “endangering” the program with cuts that are smaller than the ones your own party is proposing is hypocritical. Quite honestly, they ought to be ashamed of themselves for doing stuff like this, but I really don’t think they have any shame.

 

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About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May, 2010 and also writes at Below The Beltway. Follow Doug on Twitter | Facebook

Comments

  1. al-Ameda says:

    ”If you like the Post Office and the Department of Motor Vehicles and you think they’re run well, just wait till you see Medicare, Medicaid and health care done by the government.”

    In other pockets of the state, the reaction to Democratic proposals has been strong, too. At a recent town-hall meeting in suburban Simpsonville, a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”
    “I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”

    The Administration completely ceded the debate to the conservative movement, and those 2 example tell you a lot about how the discussion went. The Administration failed to take the floor and explain ACA to the public, instead we got “the end of freedom’ “socialism” “death panels”

    Like or Dislike: Thumb up 12 Thumb down 0

  2. James says:

    Doug,

    Why oh why do you continue to keep the kid gloves on for conservative lawmakers? You write:

    Paul Ryan and other members of Congress have proposed plans that are meant to address the long-term solvency issues that the program faces and Democrats have responded by accusing them of wanting to fundamentally transform the program.

    That’s because Paul Ryan’s plan unquestionably does “fundamentally transform” Medicare and Medicaid. And other interpretation is a willful misreading of Ryan’s intent. Next:

    Since these attacks tended to work — see, for example the uproar that occurred in the wake of President Bush’s relatively modest Social Security reform proposal in 2005

    “Relatively modest”? He wanted to fundamentally change Social Security into a privatized system! From the NYT:

    Two decades later, Mr. Bush’s desire to change Social Security intersected with the promotion of private accounts by well-financed interest groups and conservative research organizations, which viewed the concept as innovative if ideologically explosive. What was once a fringe proposal has been propelled to the forefront of the national agenda in one of the biggest gambles of Mr. Bush’s political career, and in one of the most concerted challenges since the New Deal to liberal assumptions about the relationship of individuals, the government and the market.

    Highly-rated. Helpful or Unhelpful: Thumb up 32 Thumb down 0

  3. Tsar Nicholas says:

    Yeah, on this point the GOP not only jumped the shark tank they added a few twists and a half-gainer to boot.

    The real problems with Obamacare are that it’s a massive taxing and spending program that actually will reduce coverages and coverage packages for large numbers of existing workers, it’ll have the net effect of increasing premium costs both for businesses and individuals, it won’t improve quality of care, inevitably it will result in various degrees of “mission creep,” and of course it’ll keep a lid on net hiring for as far as the eyes can see. That it also does a Peter-Paul trick regarding Medicare is incidental.

    That said, however, politics ain’t a game of hearts and sometimes when you’re in Rome you have to do as the Romans would do. I don’t approve of the hypocrisy, nor the lowest common denominator pitches, but I do realize that politics is a dirty business and that there are no prizes for 2nd place.

    Like or Dislike: Thumb up 2 Thumb down 15

  4. racehorse says:

    For an excellent perspective on the Obama health care plan, read Michael Gerson’s excellent perspective: http://www.washingtonpost.com/opinions/michael-gerson-john-robertss-alternate-universe
    Also, David Brooks gives some sensible alternatives to the Obama care problems:
    http://www.nytimes.com/2012/07/03/opinion/brooks-a-choice-not-a-whine.html?_r=1&ref=davidbrooks

    People forget that Congress can make changes to the Health Care plan that make more sense, are reasonable, and won’t drive the economy further down the drain. Note that the plan now runs at least 2500 pages of legalese language.
    “I’ll read it after I vote for it” Pelosi

    Like or Dislike: Thumb up 2 Thumb down 15

  5. That it also does a Peter-Paul trick regarding Medicare is incidental.

    Medicare is the biggest robbing Peter(The people in the working age) to pay Paul(Seniors, that disproportionally vote) in the world. The idea that if you are over 65 you have a VERY SUBSIDIZED Health care provided by the government while you get nothing if you are among the most productive members of the society a few years younger is insane.

    Like or Dislike: Thumb up 12 Thumb down 1

  6. gVOR08 says:

    Let’s take a long step back to the root of Laffers premise.

    Back when the Ohio BMV was largely paper and a mainframe , if you chose to renew your plates at lunchtime on the last weekday of the month they could be pretty slow. Otherwise they were pretty easy to do business with, and in the internet age they’re a breeze.

    For 45 cents, I can drop a letter in a convenient slot near my home and the USPS will take it and within a couple of days deliver it to pretty much any random street address I choose in some remote podunk town clear across the country. That’s really a pretty good deal.

    I once got a postcard from UPS telling me UPS couldn’t find my address. Really? I thought that was hilarious.

    I expect I’ll get some horror stories in response, but really, Arthur Laffer, I wish a lot of the private businesses I deal with were as good as the USPS and the DMV. It is amazing that the mighty right wing Wurlitzer has been so successful in selling the idea that the government can’t work, in the face of daily dealings with parts of the government that work quite nicely, thank you.

    And seriously, why hasn’t Arthur Laffer been laughed out of the country?

    Highly-rated. Helpful or Unhelpful: Thumb up 27 Thumb down 3

  7. Modulo Myself says:

    @André Kenji de Sousa:

    There are obviously numerous problems with how much it costs to get old in this country. But taking somebody for whom the government is paying the costs of an assisted living center, a hip replacement, or a super-expensive machine at their bedside, and saying that this somebody getting the good end of a financial deal is pretty base.

    Nobody is mooching here. It’s not a case of welfare moms with 500 inch plasma screen televisions. If the ordinary person is getting screwed, it’s because of the endless bureaucracy of our private/public HMO-run debacle, not because an octogenarian wishes to have comfort.

    Like or Dislike: Thumb up 4 Thumb down 2

  8. Scott O says:

    @racehorse:

    For an excellent perspective on the Obama health care plan, read Michael Gerson’s excellent perspective:

    That link didn’t work, it’s here. But it’s not about “the Obama health care plan”, it’s about Roberts’s decision.

    Brooks gives us sensible alternatives? Like this?

    Third, the Republican approach would encourage experimentation in the states instead of restricting state flexibility.

    Thanks Mr. Brooks, you’ve been very helpful.

    Like or Dislike: Thumb up 6 Thumb down 0

  9. swearyanthony says:

    @racehorse: Brooks gives sensible alternatives? I doubt that, very, very much. Would this be the same Brooks who was just telling PBS Newshour how fabulous Romney’s secret healthcare plan is? And who gave no details? Hm. I would have thought when you’re a journalist/writer at one of the top papers in the US, and you know about an unannounced healthcare policy of a presidential candidate, you might consider telling everyone else what it is…

    Like or Dislike: Thumb up 8 Thumb down 1

  10. James says:
  11. Stan says:

    Like many other products, the price of medical care depends on the bargaining power of the buyer. Medicare and Medicaid pay less for the same procedures than private insurance companies, and insurance companies pay less than individuals. This is well documented in the medical economics literature. To see the original study of this topic and follow-up articles, Google “It’s the Prices, Stupid”.

    David Brooks knows this stuff, I’m sure, so his recent op-ed piece on the subject is an example of dishonesty rather than ignorance. If most medical care is paid for out of pocket, as envisioned by Paul Ryan and others, we’ll have a lot less medical care at much higher prices. How this benefits the country is beyond me.

    Like or Dislike: Thumb up 8 Thumb down 0

  12. steve says:

    The cuts in Medicare spending in the ACA come primarily from cutting Medicare Advantage (MA). MA is the privately run Medicare which was started because the GOP claimed it would be better at controlling costs. Instead, MA costs on average about 14% more than standard Medicare. Any plan that wants to address Medicare costs will have to do something about MA costs to bring them down to, at least, in line with standard Medicare costs.

    This illustrates part of the difference between the Democrats and the GOP. The Democrats took the risk and passed the ACA which cut MA. It also has provisions that could cut Medicare costs further. The GOP used those cuts to win an election. In return, they only propose cuts to Medicare when they are not in power. They knew there was no chance the Ryan plan would be passed. It pleased the base/Tea Party, but didnt risk losing any votes from the elderly.

    What does the GOP actually do when in power and able to pass Medicare bills? It passes Medicare Part D, the largest unfunded spending bill in our history. In time for the 2004 elections, but that may have just been a coincidence.

    Steve

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  13. Ron says:

    Sadly, collectivism has become ingrained in our lives so deeply, that it will take a complete collapse of our economy before we can start divorcing ourselves from the collectivist mentality.

    The left/right political arguments are just varying degrees and targets for collectivist governing.

    Like or Dislike: Thumb up 2 Thumb down 15

  14. Scott says:

    Justifying Medicare on the basis of its popularity is stupid. A study by fellows at the Urban Institute think tank estimate that a two-wage earner couple retiring with $89,000 in income will have paid about $114,000 into Medicare. Yet, on average, they are expected to collect about $355,000 in benefits.

    http://www.washingtonpost.com/wp-dyn/content/article/2011/01/02/AR2011010203213.html

    I’ve seen other studies showing the average benefit/premium ratio is closer to 2:1. Whether it’s 3:1 or 2:1, it’s on a disaster course. If you are able to withdraw either $3 or $2 from a non-interest bearing bank account in which you only deposited $1, I’m pretty sure that is going to be a very popular bank while it is solvent. Unfortunately, it won’t be solvent very long. Neither will Medicare.

    Like or Dislike: Thumb up 1 Thumb down 3

  15. OzarkHillbilly says:

    It’s the reason why we’re never able to solve our long term problems until their right on top of us, and that’s a problem we’ve had for decades now.

    I think it was Winston Churchill who said, “Americans always do the right thing, but not until they’ve tried everything else first.”

    Like or Dislike: Thumb up 5 Thumb down 0

  16. al-Ameda says:

    In today’s San Francisco Chronicle there’s a very interesting article on how Romney’s aides gave then Governor Schwartzenegger advice on how to proceed in the aftermath of ACA.
    In part, here it is:

    California officials are moving quickly to deliver services to millions of people as a result of crucial legislation signed two years ago by former Republican Gov. Arnold Schwarzenegger.

    Here’s the twist: Schwarzenegger consulted with advisers to Mitt Romney, the former Massachusetts governor and presumptive GOP presidential nominee, before signing a package of seven health care bills after Congress passed the federal Affordable Care Act.

    Among other things, the 2010 legislation made California the first state to establish a health insurance exchange aimed at giving residents more affordable choices. Now, residents of California – home to 7 million uninsured people, more than any other state – are expected to be able to sign up for health care coverage beginning in October 2013.

    Daniel Zingale, who as a senior aide to Schwarzenegger was deeply involved in the process, said, “We flew (Romney’s) people out here and we learned a lot from them” in developing what would become the foundation of the state’s key health care reforms.

    “I genuinely believe that California will benefit hugely from its implementation,” said Zingale, now a senior vice president of Healthy California, part of the California Endowment, a statewide health foundation.

    Like or Dislike: Thumb up 3 Thumb down 0

  17. Racehorse says:

    “I’ll read it after I vote for it” (Pelosi)
    Good reason to have every bill read in its entirety before a vote.
    All bill should be written in everyday, middle working class language, not some sort of legalese.

    Like or Dislike: Thumb up 0 Thumb down 7

  18. KariQ says:

    Paul Ryan and other members of Congress have proposed plans that are meant to address the long-term solvency issues that the program faces and Democrats have responded by accusing them of wanting to fundamentally transform the program.

    I’m sorry, Doug. I really wanted to read the whole article, but I couldn’t get this piece of demagogic misdirection. As James said, the Ryan plan does fundamentally transform medicare. Now, you may think that fundamentally transforming the program is a good idea and that would be a reasonable point to make. But to wave your hands and pretend that changing a fee-for-service plan to a “premium support” plan isn’t a fundamental transformation is dishonest.

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  19. al-Ameda says:

    @KariQ:.

    Now, you may think that fundamentally transforming the program is a good idea and that would be a reasonable point to make. But to wave your hands and pretend that changing a fee-for-service plan to a “premium support” plan isn’t a fundamental transformation is dishonest.

    It would represent a massive transfer of health expenditures to future retirees. A premium support plan for an age group that insurance companies do not want to insure would amount to an enormous gift of federal resources to private insurance companies.

    There’s a reason that the Ryan Plan sets privatization for a younger demographic – he figures that the older voters will throw younger voters under the bus. And he’s betting that younger voters don’t care about MediCare.

    Like or Dislike: Thumb up 7 Thumb down 0

  20. An Interested Party says:

    There’s a reason that the Ryan Plan sets privatization for a younger demographic – he figures that the older voters will throw younger voters under the bus. And he’s betting that younger voters don’t care about MediCare.

    The Republican response to PPACA in a nutshell…fills you with confidence to put these guys in charge of the federal government, eh?

    Like or Dislike: Thumb up 5 Thumb down 0

  21. al-Ameda says:

    @An Interested Party:

    The Republican response to PPACA in a nutshell…fills you with confidence to put these guys in charge of the federal government, eh?

    I’m worried that the voters might well turn the entire federal government over to Republicans and run economy over the cliff. And no, I do not have confidence that voters won’t put those guys in charge.

    Like or Dislike: Thumb up 5 Thumb down 1

  22. KariQ says:

    @al-Ameda:

    I was making a guess at Doug’s opinion, not stating my own. My point was that if this is a policy direction he approves of, he should simply say so and not pretend that it wouldn’t be a major rework of an existing program.

    Like or Dislike: Thumb up 2 Thumb down 0

  23. al-Ameda says:

    @KariQ:

    I was making a guess at Doug’s opinion, not stating my own. My point was that if this is a policy direction he approves of, he should simply say so and not pretend that it wouldn’t be a major rework of an existing program.

    I figured as much, and I agree with you.

    Like or Dislike: Thumb up 1 Thumb down 0

  24. Michael Robinson says:

    @Scott:

    I’ve seen other studies showing the average benefit/premium ratio is closer to 2:1. Whether it’s 3:1 or 2:1, it’s on a disaster course.

    Of course, you’re overlooking the fact that by age 65, the average American worker is 50% dead.

    Like or Dislike: Thumb up 1 Thumb down 0

  25. Hazel says:

    @Tsar Nicholas: The real problem is that it’s a giant giveaway to make sure insurance companies and hospital systems keep getting paid while the payer and the consumer remain far removed, removing any reason for the consumer to care about the costs or for the payer to care about the quality.

    Like or Dislike: Thumb up 3 Thumb down 0