NPR's Morning Edition show aired a rather disturbing segment today on how President Lyndon Johnson's political chicanery and outright lies got Medicare (socialized medicine for seniors) through Congress. The segment featured an interview with James Morone, co-author of The Heart of Power: Health and Politics in the Oval Office. Morone cheerfully explains LBJ's Medicare duplicity:

Johnson maneuvered every step of the way getting this bill through Congress, and one of the things he did — and this is a little dicey in today's climate — was suppress the costs. So this young kid gets elected from Massachusetts, Ted Kennedy, in 1962, and Johnson is explaining to him [over the phone] how you get a health bill through. And what he tells him is don't let them get the costs projected too far out because it will scare other people:

"A health program yesterday runs $300 million, but the fools had to go to projecting it down the road five or six years, and when you project it the first year, it runs $900 million. Now I don't know whether I would approve $900 million second year or not. I might approve 450 or 500. But the first thing Dick Russell comes running in saying, 'My God, you've got a billion-dollar program for next year on health, therefore I'm against any of it now.' Do you follow me?"

We believe, after looking at the evidence, my co-author [David Blumenthal] and I, that if the true cost of Medicare had been known — if Johnson hadn't basically hidden them — the program would never have passed. America's second-most beloved program would never have happened, if we had had genuine cost estimates.

As history has shown even LBJ's carefully hidden projections of Medicare's costs were way off base. As the Cato Institute's Michael Tanner and Chris Edwards point out, the Congressional Budget Office and other agencies have a history of wildly underestimating future government medical program expenditures:

A further concern is that initial cost estimates of federal health programs are usually very optimistic. When Medicare was launched in 1965, Part A was projected to cost $9 billion by 1990, but ended up costing $67 billion. When Medicaid’s special hospitals subsidy was added in 1987, it was supposed to cost $100 million annually, but it already cost $11 billion by 1992. When Medicare’s home care benefit was added in 1988, it was projected to cost $4 billion in 1993, but ended up costing $10 billion. Or consider that when Massachusetts Commonwealth Care was put into place in 2006, it was expected to cost about $725 million annually, but the expected cost for 2009 is now almost $1 billion.

The NPR segment was intriguingly titled, "Democrats Could Learn From LBJ's Medicare Push." I have no doubt that many Democrats who are pushing health care reform, especially the government-run insurance option, know that their cost projections are wildly underestimated. But like LBJ, contemporary Democrats don't care because they also know that once their health reform programs are enacted they will be almost impossible to kill. Enacting government health care is more important than telling their constituents the truth about what it will cost them. Plus ça change, plus c'est la même chose! 

Bonus Ronald Reagan quote from NPR segment:

"One of the traditional methods of imposing statism or socialism on a people, has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project — most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it. Now, the American people, if you put it to them about socialized medicine and gave them a chance to choose, would unhesitatingly vote against it."

Hearteningly, recent polls suggest that this may still be true.