Republicans Should Quit with ‘Mediscare’

November 4, 2009 • Commentary
This article appeared in the Orange County Register on November 4, 2009.

What profiteth a political party if it gains congressional seats but loseth its soul?

Among the many Republican complaints about Democratic health reform plans, one – chiefly heard of late from Senate Minority Leader Mitch McConnell – is that it would “cut Medicare.”

That McConnell can go home and sleep at night after uttering that charge is a grand testament to the jaded, disconnected, and often surreal nature of Washington politics.

What McConnell is doing is engaging in the time‐​honored tradition of “Mediscare”: pandering to seniors – a crucial political constituency because they are well‐​organized and turn out to vote in high numbers – by suggesting that one of their pet entitlement programs is imperiled.

This effective tactic has most often been the bailiwick of Democrats, back when Republicans were the party of fiscal discipline and made pronouncements about getting federal deficits and entitlement spending under control (boy does that seem like a long time ago now). That McConnell and the GOP have now embraced it with gusto demonstrates how screwed we are as a country, because neither main political party is at all serious about facing fiscal reality.

Now, let’s be clear. The Democrats do cut Medicare, by more than $500 billion under the bills now being considered. And, while the Democrats claim that all they are doing is eliminating “fraud, waste, and abuse,” the reality is that under the Democratic bills, seniors will get less.

For example, roughly 10.2 million seniors currently receive their health care through the Medicare Advantage program. That program offers many seniors benefits not included in traditional Medicare, including preventive‐​care services, coordinated care for chronic conditions, routine physical examinations, additional hospitalization, skilled‐​nursing facility stays, routine eye and hearing examinations and glasses and hearing aids.

The bills currently making their way through Congress would cut payments to Medicare Advantage plans by $100 billion to $150 billion. In response, many insurers are expected to stop participating in the program, while others will probably increase premiums. Millions of seniors will likely be forced off their current plans and back into traditional Medicare. The Congressional Budget Office makes it clear that, at the very least, the cuts “would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans.”

The Democratic cuts also hit traditional Medicare. For example, the bills would reduce reimbursements for diagnostic imaging – things like CT scans, MRIs and X‐​rays – by as much as 25 percent. And the Senate Finance Committee’s bill would penalize doctors who perform too many procedures or tests. Providers whose utilization is in the 90th percentile or above, compared with national averages, will have their Medicare reimbursements cut.

The whole point of such provisions is to reduce services. But none of this justifies the Republican’s hypocrisy on this issue.

For example, Republicans just finished voting unanimously against an attempt to block a Democratic proposal to stop a 21 percent reduction in Medicare provider payments scheduled to go in effect next year, the so‐​called “doc fix.” And, earlier this year, Republicans released an alternative budget that contained even bigger reductions in Medicare spending than the Democrats now propose.

That was the fiscally responsible position to take. The “doc fix” was not paid for and would have added an additional $250 billion to the federal deficit. That’s why 13 fiscally responsible Democrats joined Republicans in voting against this bill.

And, Medicare is already facing unfunded liabilities of $50 trillion to $100 trillion. As a percentage of GDP, Medicare costs are expected to rise from 2.7 percent today to 9.4 percent by 2050. Unless we are prepared to completely mortgage our children’s future, Republicans were right to propose cuts in their budget proposal.

But now, sensing political advantage, Republicans are in danger of reverting to the fiscally irresponsible “big‐​government” conservatism that all but destroyed the Republican brand during the Bush years.

There are many good reasons for opposing the Democrat’s health reform. It is government takeover of the health care system that would dramatically increase both taxes and insurance costs, while all forcing millions of Americans into a government‐​run system. There is no need for Mediscare – especially for a party that so desperately needs to return to its fiscally responsible, limited‐​government roots.

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