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GOP: Try Again on Medicare

A Commentary by Froma Harrop

Nice try, Republicans, running a political protection racket to push your Medicare scheme. Scrubbed of the sweet talk about saving Medicare, your offer boiled down to this: You older folks support us, and we won't touch a hair on your government health-insurance plan. Only those 55 and under get whacked.

Somehow this appeal to greedy geezer-ism didn't go over so well. Perhaps it was too blatant. Perhaps older people are not greedy -- they worry about the coming generations. And perhaps these voters looked a couple of moves ahead on the chessboard and figured that a radical shrinkage in health care security for today's younger workers would imperil the cushy benefits they enjoy. After all, with each passing year, there will be more voters born after the 1957 cutoff and fewer born before.

Anyway, the reception to the plan was less than friendly. The angry ones who beat up on Democrats during last year's town hall meetings seemed to do a U-turn and waved their fists at Republicans. In response, GOP leaders wisely backed away from their deficit plan, which in essence, would balance budgets by going after Medicare with an ax.

To recap: The proposal would end government responsibility for paying the medical bills of the elderly and disabled. Instead, Medicare recipients would be handed vouchers with which to buy coverage from private insurers. And here's the big squeeze: The size of the vouchers wouldn't nearly keep up with projected hikes in health care costs.

Of course, Medicare spending cannot continue spiraling upward at the current rate, and waste and fraud do plague the program. Republicans were no doubt thinking that in addition to capping the taxpayer's obligation to Medicare, a voucher system would wring out its famous inefficiencies as insurers sought to maximize profits. This was another of their government-can't-do-anything-right, let-the-private-sector-straighten-things-out formulations.

However, the history of for-profit players in Medicare does not inspire such confidence. The private Medicare Advantage plans cost taxpayers 12 percent more per head than the traditional program would have. And the government-run Department of Veterans Affairs pays 40 percent less for prescription drugs than do the private insurers in the Medicare drug benefit.

We must thank Republicans for showing us how to balance budgets and reduce government's role in health care without raising taxes: Have corporate interests make the health care decisions and arbitrarily cut how much you give them to do so. And we admire the party's House leaders for courage in passing this fiscally honest and politically risky proposal with only four of their members voting against it.

But with the reviews for their vision a two-thumbs-down, Republicans should try another approach. For starters, they can stop maligning the health care reform law, which does include mechanisms to curtail Medicare spending (while preserving the government's role as guarantor of promised benefits).

As one example, the law promotes Accountable Care Organizations -- networks of doctors and hospitals that care for patients and share in any savings. As another, it funds comparative effectiveness research, which studies various treatments for the same condition and identifies those that do the job as well for less money.

Finally, Republicans should stop ignoring the revenue side of budgeting. Tax collections as a percentage of the gross domestic product are the lowest they've been in decades. The things Americans want must be paid for, and they want Medicare.

Accusing political opponents of trying to scare old people has not succeeded. Americans see the Republican plan for the attack on Medicare that it is. And pitting one generation against another is not an attractive strategy. In any case, it appears not to have worked this time. Republicans, let's try again.



See Other Political Commentary.

See Other Commentaries by Froma Harrop.

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