Fighting Over Medicare May Not Be Good Policy, But It Can Be Good Politics

There are an awful lot of reasons why Medicare reform has been stalled. But one of them is that some elected Democrats aren't interested in working on any sort of Medicare deal as long as it remains an effective cudgel to use against the GOP during election season. President Obama has suggested in the past that he might be open to changing the seniors' health. And Politico reports that some Democrats on Capitol Hill are worried the president might actually pursue those changes in a second term because they believe it would hurt their chances at the polls in 2014:

What bothers Democrats on Capitol Hill, but not a lame-duck White House, is that any compromise that includes Medicare cuts would deprive the party of a significant issue heading into 2014.

"Look at the senators who are up next time," said the congressional Democrat, citing the many red-state and swing-state Democrats up for reelection in two years. "You'd chop them off at the knees right before they start running."

This isn't the first time Democrats have grumbled about the political problems they faced if they started to negotiate a deal on Medicare. Last year, The Washington Post reported that senior Hill Democrats were griping behind the scenes that agreeing to Medicare cuts would "risk squandering the major political advantage Democrats have built up on the issue."

Obviously, Democrats aren't alone in playing on fears of Medicare cuts to win votes. Republicans did it all throughout the ObamaCare debate. And the Romney campaign has been particularly aggressive about criticizing President Obama for reducing planned Medicare spending by $716 billion in order to fund the health care law's expansion of insurance coverage. But it does highlight the extent to which many of perenial entitlement fights are driven not by data-driven policy considerations or even basic concerns about what might be best for constituents, but by naked political self interest. The war over Medicare may not be good for the budget or for seniors, but it can be useful for those who want to get elected, which is one of the reasons why that war is likely to continue. 

That's a barrier to reform of a deeply dysfunctional entitlement program. It's also a barrier to creating and maintaining a functioning, effective, results-driven health care system. And it's a big reason why we ought to always be cautious about pushing for greater government interference in the health care sector: Inevitably, politicians end up pursuing their own interests instead of everyone else's.