Why Am I Guessing That Topsy-Turvy Positions on Medicare Will End Up Costing Us More Money?

One of the main ways that virtually any health care reform currently under discussion plans to achieve its cost-cutting goals is by cutting Medicare spending. Which has metastisized like about the biggest tumor you can imagine, plus 1,000 percent.

Despite President Bush's creation of the massive prescription-drug benefit (which got a good share of support from his party), the Republicans, in general, have long been in favor of cutting Medicare spending. To wit:

Ronald Reagan proposed cutting $1 billion in Medicare spending while president in 1981, when the program cost just $40 billion a year.

In the mid-1990s, congressional Republicans proposed deep cuts in Medicare and Medicaid to pay for tax cuts. That sparked a backlash and gave President Bill Clinton his best weapon to fight back against the Republican "Contract With America."

Incidentally, congressional Republicans did not propose "deep cuts" in Medicare (would that they had). Rather, they proposed slowing the rate of spending increases, which passes for budget discipline in Washington. Now, though, the GOP is singing a very different tune. In August, the GOP unveiled its "seniors' health care bill of rights" which opposes any cuts in Medicare.

And what about the forces that typically support Medicare spending and bitch and moan about even the smallest cuts? The Wash Post reports that

The hospital associations, AARP and other powerful interest groups that usually howl over Medicare cuts have also switched sides. Last week, they stood silent as the Senate Finance Committee debated a plan to slice more than $400 billion over the next decade from Medicare, the revered federal insurance program for people over 65, and Medicaid, which also serves many seniors.

The Post further notes that "Cutting Medicare does not necessarily mean reducing spending but rather slowing its rate of growth."

To translate this into worst-case-scenario politicalese: Get ready for more spending on Medicare than you've ever seen, now that you've got the GOP on record as opposing any cuts and the Dems making a full-court press on insuring the uninsured. Somewhere somehow, I'm betting that the final outcome will be what it always is: a pile of money shoved toward seniors, who are making up something like 20 percent of the electorate, and a pile of money shoved at everyone else at the table.

You, me, and the rest of us who are more than 10 years from retirement are not at the table. Which means we can pay for the drinks and motorized scooters.

A note about Medicare that should transfer immediately into any discussion about government-run or mandated coverage plans: The president's own Council of Economic Advisers has determined that "Nearly 30 percent of Medicare's costs could be saved without adverse health consequences." Put another way, the program, the most relevant model of a single-payer system we have in the U.S. (one that's been around since 1965), is wasting close to one-third of its dollars. That's the program the GOP has now pledged to support with a "Bill of Rights." And it's one that the Dems are looking to foist on the rest of us.