The Republican Death Wish

Forty Senate Republicans have now joined their colleagues in the House to support Paul Ryan’s plan that would turn Medicare into vouchers that funnel money to private health insurers. They thumbed their nose at the special election in upstate New York earlier this week that delivered a victory to Democrat Kathy Hochul, who made the plan the focus of her upset victory.

So now it’s official. The 2012 campaign will be about the future of Medicare. (Yes, it will also be about jobs, but the Republicans haven’t come up with any credible ideas on that front, and the Democrats seem incapable of doing what needs to be done.)

This spells trouble for the GOP. Polls show an overwhelming majority of Americans — even a majority of Republican voters — want to preserve Medicare. They don’t want to turn it over to private insurers.

It would be one thing if Republicans had consistency on their side. At least then they could take the high road and claim their plan is a principled way to achieve the aims of Medicare through market-based mechanisms. (It isn’t, of course. It would end up squeezing seniors because it takes no account of the rising costs of health care.)

But they can’t even claim consistency. Remember, this was the same GOP that attacked the President’s health-reform plan in 2010 by warning it would lead to Medicare cuts.

Former President Bill Clinton warns Democrats not to conclude from all this that Medicare is fine the way it is. He’s right. But instead of talking about Medicare as a problem to be fixed, Democrats should start talking about it as a potential solution to the challenge of rising health-care costs — as well as to our long-term budget problem.

Can we be clear about that budget problem? It’s driven not by Medicare. It’s driven by the same relentlessly soaring health-care costs that are pushing premiums through the roof and causing middle-class families to shell out more and more money for deductibles and co-payments.

Some features of Obama’s new healthcare law will slow the rise — insurance exchanges, for example, could give consumers clearer comparative information about what they’re getting for their insurance payments — but the law doesn’t go nearly far enough.

That’s why Democrats should be saying this: We need to allow anyone to sign up for Medicare. Medicare is cheaper than private insurance because its administrative costs are so much lower, and it has vast economies of scale.

If Medicare were allowed to use its potential bargaining leverage over America’s hospitals, doctors, drug companies, and medical providers, it could drive down costs even further.

And it could force the nation’s broken health-care system to do something it must do but has resisted with a vengeance: Focus on healthy outcomes rather on costly inputs. If Medicare paid for results — not tests, procedures, drugs, and hospital stays, but results — it could give Americans better health at lower cost.

Let the GOP go after Medicare. That will do more to elect Democrats in 2012 than anything else. But it would be wise and politically astute for Democrats to go a step further. Don’t just defend Medicare. Strengthen and build upon it. Use it to reform American health care and, not incidentally, rescue the federal budget.

About Robert Reich 545 Articles

Robert Reich is the nation's 22nd Secretary of Labor and a professor at the University of California at Berkeley.

He has served as labor secretary in the Clinton administration, as an assistant to the solicitor general in the Ford administration and as head of the Federal Trade Commission's policy planning staff during the Carter administration.

He has written eleven books, including The Work of Nations, which has been translated into 22 languages; the best-sellers The Future of Success and Locked in the Cabinet, and his most recent book, Supercapitalism. His articles have appeared in the New Yorker, Atlantic Monthly, New York Times, Washington Post, and Wall Street Journal. Mr. Reich is co-founding editor of The American Prospect magazine. His weekly commentaries on public radio’s "Marketplace" are heard by nearly five million people.

In 2003, Mr. Reich was awarded the prestigious Vaclev Havel Foundation Prize, by the former Czech president, for his pioneering work in economic and social thought. In 2005, his play, Public Exposure, broke box office records at its world premiere on Cape Cod.

Mr. Reich has been a member of the faculties of Harvard’s John F. Kennedy School of Government and of Brandeis University. He received his B.A. from Dartmouth College, his M.A. from Oxford University, where he was a Rhodes Scholar, and his J.D. from Yale Law School.

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5 Comments on The Republican Death Wish

  1. Could not agree more with most of what Mr. Reich has stated.
    While it might be appealing rhetoric for the GOP to play to their base on Medicare cost or revamping… this is the same third rail of politics that social security is and the GOP will lose badly if they make it a plank in their strategy.

    They would be wise to back away from it as a campaign play… if they do not they will strengthen the Democrats position. The Dems can focus all their energy on the ads that show Grandma/pa being killed off due to those bad GOP guys policy, and everyone in the center will forget about everything else…

  2. Bob, with all due respect, why don’t you move far away and take your “long-term budget concerns” and fellow Clintonistas with you (and please, pack up Bob Rubin and Larry Summers first; Orszag and Gale second).

    Let’s be honest: you Clinton-era luminaries are just as bad for our economic future as the GOP. Both parties have the ‘willingness and capacity’ and ignorance to suck the life out of the US economy yet again; you just differ over which teeth deserve the (totally unecessary) root canal.

    Clinton retreads like you are going to be Obama’s downfall in 2012.

  3. Mr. Reich,

    What makes you think, or any American for that matter, that Medicare is an efficient system for delivering healthcare? If it is a great system worth protecting why is it estimated that up to 30 percent of monies are either waste or fraud? As for seniors, why is it okay to spend 250,000 on cancer care for a 75 year old smoker but we can’t fund prenatal care? Your arguments are so old and tired but you can take credit for being a part and driving force of the generation that bankrupted the U.S. I am part of the generation who expects so little from my government and detests the people who feel so entitled but have contributed so little culturally, intellectually, and especially financially. You really epitomize the “me” generation. Keep spinning your lies. In the end you won’t have to pick up the pieces. Nor all those seniors that want me to foot the 500 a month bill for their meds even though they’re obese smokers who didn’t save and blame the food companies and banks for their weight problem and their ridiculous debt because of a second mortgage. Oh but any suggestion of touching their entitlement is cause for bashing and then you cite the election as proof on why trying to cure the insanity of Medicare is wrong just shows how whacked you are.

  4. “Can we be clear about that budget problem? It’s driven not by Medicare. It’s driven by the same relentlessly soaring health-care costs that are pushing premiums through the roof and causing middle-class families to shell out more and more money for deductibles and co-payments.”

    Oh and those dasterly republicans had me to believe it was government spending more than it took in that caused the budget problems…but it is me shelling out more and more money for my deductible??….say what? Mr. Reich, you and your ilk are thieves looting the producers of this country under the guise of government.

  5. Why are you so sadly uninformed when it comes to the way a market-based economy works? I see you on ThisWeek, and I cringe whenever you open your mouth. Have you ever even had economics 101? Your ignorance astounds me, and what is even more astounding is that people invite you on to their programs to discuss the economic crisis, as if you had even an inkling of a clue about how to solve the problems we’re currently facing. Keynesian economics is the past, Mr. Reich, because it has failed miserably. Austrian economics is what you should spend your time on–business cycle theory: Have you ever heard of it? Please stop toeing the party line and try to be objective.

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