What’s good for the donkey is good for the elephant — or at least as politically effective.
For years, Democrats hampered Republican efforts to overhaul Social Security by making three main arguments. First, reform was a just a euphemism for kill, thus Republicans were violating the social-insurance contract with older Americans Second, building a new Social Security system around personal investment accounts would subject peoples old-age to the vagaries of the financial markets. Third, there was no Social Security crisis, only a successful, decades-old program that merely would need a couple of tweaks down the road (presumably when Democrats again controlled the White House and Congress).
Did these argument hold water? Not really. Various Republican ideas would have changed the program only for younger people. And if you don’t think the stock market is a good long-term investment, then you’re also betting that the American economy will underperform, thus calling into question the country’s ability to meet its long-term Social Security obligations. Finally, it is indisputable that Social Security is underfunded and benefits will need to be cut or taxes raised sharply.
Whatever the accuracy of their arguments, Democrats were able to stymie Republican efforts to fix Social Security, most notably President George W. Bush’s 2005 attempt. Now Republicans are using the same playbook to stop President Barack Obama’s plan to reform America’s healthcare system.
Today’s arguments are similar to those from 2005. Healthcare reform would eviscerate Medicare for the elderly by making cuts to pay for expanded coverage for younger Americans, and that’s unfair since seniors have paid for their benefits. Treatment decisions would be left to the vagaries of Washington bureaucrats. And hey, there really is no crisis since a) polls show most people are satisfied with their current healthcare plan, and b) even if healthcare spending takes up a greater share of GDP in the future, it’s not a big problem since the entire American economy will be much bigger.
But Republican arguments are just as flimsy as the Democrat version four years ago. Rising costs mean less take-home pay for American workers, and Medicare, to a great degree, is what’s driving those costs since it makes using pricey, premium medicine seem cost free to seniors. (And despite Republican claims, the average senior will get $100,000 from Medicare than what he puts in.) What’s more, the U.S. could be spending far less on healthcare, including Medicare, and getting equally good results. Still, those economic realities are just a distraction when your goal is more about political victory than solving a national problem.
The politics may be dicey, but anyone truly serious about overhauling the American healthcare system needs to acknowledge that total spending must be reduced and that any aspect of the system — including Medicare and employer-based health insurance — that distances patients from the true costs of their healthcare is part of the problem. Republicans could even, theoretically, support a bare-bones public option if it had low premiums but high deductibles and co-payments to increase consumer awareness. (Just as Democrats should be able to support a system based on more private health insurance if there were substantial subsidies for the poor.)
Of course, that would be sound economic policy and the current debate has precious little to do with that.