When the nonsense messages about "deathpanels" and assisted suicide are swept aside, the most consistentRepublican argument in the health care debate is that reform will somehowendanger Medicare. The Democrats, who created Medicare and have protected theprogram from Republican presidents and legislators for the past five decades,were suddenly determined to destroy it with budget cuts. Only the Republicans,who opposed Medicare from the beginning, could now be trusted to preserve theprogram from the dastardly president and his allies in the congressionalmajority.
Republican leaders have articulated that messagewith remarkable unanimity from day one. During the initial debate over healthcare reform in the Senate Finance Committee, Mike Enzi of Wyoming warned that"(Democrats) are cutting hundreds of billions from the elderly," aclear reference to Medicare. The House minority leader, John Boehner, steppedforward to frighten senior voters with the claim that if reform reducedprojected spending on Medicare, the result would be "fewer choices andlower health care quality for our nation's seniors." The Senate minorityleader, Mitch McConnell, accused Democrats of seeking to "raidMedicare."
As usual, the Republican National Committeechairman, Michael Steele, went the furthest, buying television spots to raisealarms about "a government-run health care experiment that will cut over$500 billion from Medicare to be used to pay for their plan." Withoutpausing to notice the ironysince Medicare is the nation's premier"government-run health care experiment"Steele posed as the saviorwho would protect Medicare by promoting a "seniors health care bill ofrights."
Ryan Wants to Leave Seniors at the Mercy ofPrivate Insurers
But last week, this charade ended when Rep. PaulRyan of Wisconsin, author of the House Republican budget proposal, revealedthat nothing had really changed. Like every right-wing Republican, Ryan stillwants to kill Medicare, leaving seniors at the mercy of the insurance industry.His budget plan proposes a "defined benefit" voucher system thatwould eventually abolish traditional Medicare in order to control futuredeficits.
The Republican Study Committee, an influentialconservative caucus of House Republicans, favors the same kind of proposal. Infact, converting Medicare into a subsidy for insurance companies has been a keyobjective of Republican legislators ever since Newt Gingrich served as Housespeaker, when he pushed a plan that he promised would let Medicare "witheron the vine." (Lately, Gingrich has refashioned himself as a Medicaredefender, too, by insisting that costs must be controlled somehow withoutcutting the program's budgetbut then, he is probably dreaming of anotherpresidential run.)
Unfortunately for Republicans like Ryan, there areat least two essential flaws in their plan to privatize Medicare. The first isthat Medicarethat government-run experiment, now almost 45 years oldremainsexceptionally popular across all income, ideological, geographical and agegroups. It is especially popular when compared with private insurers, beatingthem on measures of customer satisfaction, security and trust by 20 percentagepoints or more.
The second flaw is that Medicarethat costly,budget-busting entitlementcontinues to exceed private-sector providers inefficiency by well more than 10%. Only with lavish subsidies have the so-calledMedicare Advantage private plans been able to compete for customers. And manyelderly consumers have returned to traditional Medicare because the privateinsurers dropped their coverage when they actually became ill.
So what do the Republicans really intend forMedicare? Are they truly its staunchest defenders? Or do they plan to decimateits benefits and have it devolve into private vouchers as soon as they regainpower? Perhaps there is one answer for the voting publicand another for theinsurance companies.
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