Happy Birthday, Medicare Part D! Now Die! Die! Die!


Economist Bruce Bartlett, an occasional Reason contributor and a pariah to many for (accurately) calling George W. Bush a phony fiscal conservative, reminds us that one of the absolutely biggest pieces of crap legislation has a birthday come Monday: Medicare Part D, the prescription drug plan that gives relatively wealthy seniors near-free drugs.

According to the latest actuaries' report, Medicare Part D will cost taxpayers — beneficiaries pay virtually nothing — $62 billion this year. This figure is expected to rise sharply in coming years to $150 billion in 2019. By 2030, Part D alone will cost taxpayers 1 percent of GDP. In present value terms, Medicare Part D adds almost $16 trillion to our national indebtedness. (That's how much would need to be in a trust fund today to pay all the benefits that have been promised over and above the trivial premiums paid by beneficiaries.) That is why former U.S. Comptroller General David Walker has called the unfunded prescription drug benefit "the most fiscally irresponsible piece of legislation since the 1960s."

You got that right, Bruce. The prescription drug plan is about the worst giveaway you could imagine, just a pure, unadulterated sop to a bunch of politically connected voters. When the plan was first being discussed, seniors were paying a whopping 3.2 percent of their income on pills annually - less than they did on entertainment. As Bartlett points out, George Bush and the House Republicans (including Speaker-elect John Boehner and budget whiz Paul Ryan) who voted overwhelmingly for it didn't even bother to pretend they were going to pay for it with tax hikes or spending cuts (kudos to Sen. John McCain and the handful of other Republicans who voted against it in the Senate). Just an awful plundering of the young and relatively poor to give booty to the old and relatively flush.

Bartlett argues that the GOP learned how to stop worrying and love Medicare after they got their asses handed to them after the mid-'90s shutdown. The shutdown in large part was a result of a Clinton-Gingrich bitch fight over a GOP plan to cut back on what Ronald Reagan used to demonize as "socialized medicine." Since, then, says Bartlett, the Republicans have never been slow to gild Medicare. Most recently, they did this during their attacks on ObamaCare. The prez, they warned, would pay for his evil plan to socialize medicine by taking money from…Medicare! As a matter of basic fact, they are correct. But precisely how Medicare, especially that goddamn prescription drug plan, is worth saving at all is beyond me.

Bartlett is right to claim that the GOP of the past 10 years (at least) has never proven itself serious about cutting deficits. And I think he's right when he says:

Prodded by their new-found allies in the Tea Party movement, Republicans may have no choice but to make a serious assault on federal spending…. At some point they must address Medicare if they are serious about cutting federal spending. But then they risk throwing away all the hard-earned support they gained by adding trillions of dollars to the public debt with their unfunded Medicare Part D expansion…. A key test of whether the Tea Partiers mean what they say about cutting federal spending, or whether they are just blowing smoke, will be what they do on Medicare. If they have any guts, they'll make repeal of Medicare Part D their first order of business.

Rage on, Cousin Brucie, rage on! And Tea Partiers, don't be misled by bullshit spectacles like votes to cut NPR's funding. I'm all for that, but if the GOP doesn't get real serious real soon about cutting spending, well, it's time to start looking elsewhere (again).

Whole Bartlett thing here.