GOP Chairman Michael Steele loves Medicare but hates government.

How to fix health policy.
Aug. 25 2009 4:14 PM

The Medicare-Isn't-Government Meme, Part 3

GOP Chairman Michael Steele loves Medicare but hates government.

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Republican National Committee Chairman Michael Steele. Click image to expand.
Michael Steele 

The emerging Republican strategy to kill health reform is slightly less brazen than supply-side economist Arthur Laffer's initial tactic of pretending that Medicare was not a government program (see "The Medicare-Isn't-Government Meme"). Increasingly, the trick is to acknowledge (as backhandedly as possible) that Medicare is a government program but then to talk about it as if it weren't. Rush Limbaugh and Glenn Beck were early adapters (see "The Medicare-Isn't-Government Meme, Part 2"), and now GOP Chairman Michael Steele has taken it to the next level with a "Health Care Bill of Rights" for senior citizens.

"As the president frequently, and correctly, points out, Medicare will go deep into the red in less than a decade," Steele wrote in an Aug. 24 Washington Post op-ed. This was a formalistic nod to Republicans' past complaints about the growing cost of the government's social-welfare programs in general and of Medicare in particular. (Steele himself called for Medicare cuts as recently as 2006.) "But he and congressional Democrats," Steele continued, "are planning to raid, not aid, Medicare by cutting $500 billion from the program to fund his health-care experiment." This statement suggests that the GOP disagrees with the White House and congressional Democrats not over the need for Medicare cuts but merely over the amount. Sure, Medicare costs are out of control, but cutting $500 billion is way too much!

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But as the liberal Web site Think Progress has pointed out, Steele's own Republican National Committee took to the airwaves in 1996 to support a resolution in the Republican-controlled Congress mandating $270 billion in Medicare cuts over seven years. That works out to $39 billion in cuts per year, which (factoring in inflation) would be equivalent in 2009 dollars to $53 billion in cuts per year. The $500 billion in Medicare cuts projected in the House health reform bill would occur over 10 years. That works out to $50 billion in cuts per year. The GOP is therefore sounding the alarm over Medicare cuts that, on an annual basis, are smaller than cuts the GOP itself has called for in the past.

Steele next drew an implicit (and entirely specious) rhetorical distinction between "Medicare" (which is good) and "government" (which is bad):

[W]e need to prohibit government from getting between seniors and their doctors. The government-run health-care experiment that Obama and the Democrats propose will give seniors less power to control their own medical decisions and create government boards that would decide what treatments would or would not be funded. Republicans oppose any new government entity overruling a doctor's decision about how to treat his or her patient.

Simply put, we believe that health-care reform must be centered on patients, not government. [Italics mine here and below.]

Steele went on to oppose comparative effectiveness research (i.e., the collection of data to find out which medical procedures work and which don't) on the grounds that it "could actually lead to government boards rationing treatments based on age." (Memo to Mr. Steele: The government, simply by virtue of there being a Medicare program, already rations treatments based on age. It will pay for your treatment if you're older than 65 but not if you're any younger.) Steele also wrote that "we need to prevent government from dictating the terms of end-of-life care":

Obama's government-run health "reform" would pay for seniors' meetings with a doctor to discuss end-of-life care. While nonthreatening at first, something that is quite normal for a family to do becomes troublesome when the government gets involved. Seniors know that government programs that seem benign at first can become anything but. The government should simply butt out of conversations about end-of-life care and leave them to seniors, their families and their doctors.

You want to know who's behind those death panels? The government! Not Medicare. Medicarewould never do anything so thoughtless and mean.

The greatest irony of the GOP's new Claude Pepper-ism is that, by promoting a seniors' "Health Care Bill of Rights," the Republicans are endorsing a view of government-funded health care that Democrats have shied away from for fear of sounding too left-wing. Democrats dare not declare that anyone has a right to demand that their government give them health care. Instead, the Democrats suggest meekly that subsidizing health insurance for those who can't afford it would be kind of a nice thing to do. But the GOP is willing to pronounce that senior citizens have a God-given right to government-funded health care. Too bad that right exists solely as a club to preventanyone else from getting medical treatment, even as a favor.

Update, 10:15 p.m.: On Fox News today Steele abandoned the Medicare-good, government-bad distinction and admitted that he just can't stand Medicare:

The reality of it is, this single-payer program known as Medicare is a very good example of what we should not have happen with all of our health care. The reality of it is, how many times have we been at the trough of bankruptcy and no money for the Medicare program, where Congress is running around like chickens with their head cut off, trying to figure out how to fix a program that they've already mismanaged? So now you want to do that, Congressman, on a larger scale? You want to include all of us. You're talking about taking our senior population, and expanding it to all of the population? Government cannot run a health care system. they've already shown that. Trust the private markets to do it the right way.

To summarize: Medicare is a terrible government program. It should therefore be inviolate.

Update, Aug. 28: You have to wonder whether Steele is starting to wish he'd never brought this subject up. In an Aug. 27 interview with National Public Radio's Steve Inskeep, Steele tied himself into knots trying to explain his true feelings about Medicare:

Q: It sounds like you don't like Medicare very much at all. ...

A: No, I'm not saying that. No, Medicare—

Q: But you write in this op-ed that you want to protect Medicare because it's politically popular. People like Medicare.

A: No, no, no, no, no. Please, don't—

Q: That's why you're writing to protect Medicare.

A: Well, people may like Medicare, and liking a program and having it run efficiently is sometimes two different things. And the reality of it is simply this: I'm not saying I like or dislike Medicare. It is what it is.

Eventually the interview degenerated into a Marx Brothers routine, with Inskeep playing Groucho and Steele playing Margaret Dumont:

A: [S]ure, there are issues in the insurance market that we can regulate a little bit better and that we can control better to maximize the benefits to the consumers. That's something that, yeah, we can rightly reform and fix. If the—

Q: Wait a minute, wait, wait. You would trust the government to look into that?

A: No. I'm talking about the—I'm talking about private—I'm talking about—

Q: Who is—

A: Citizens. I'm talking about—

Q: You said that's something that should be looked into. Who is it that should look into that?

A: I'm talking about those who—well, who regulates the insurance markets?

Q: That would be the government, I believe.

It's well worth listening to the whole thing.

Timothy Noah is a former Slate staffer. His  book about income inequality is The Great Divergence.

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