12.12.09

The GOP's New Health-Care Hoax

Shame on John McCain—and every other Republican who says the Senate health deal would foist single-payer on the country.

It’s no surprise that Republicans want to halt the march to historic health-care reform with any calumny they can muster. But their latest attack on the new Senate deal—the charge that allowing Americans aged 55 to 64 to buy into Medicare would lead the country to a single-payer system—is as laughable as it is misguided. It’s ironic that this shameful stone is being hurled by the nation’s most prominent life-long recipient of government-run health care: John McCain.

McCain’s invocation of the single-payer libel is particularly galling, since he’s been on government-run health care practically his entire adult life.

There’s only one thing you need to know to understand why the GOP single-payer charge is a hoax: The Democrats’ proposed health-care reform represents the biggest subsidized expansion of private-insurance coverage in American history. Let me repeat that: The Democrats’ proposed health-care reform represents the biggest subsidized expansion of private-insurance coverage in American history. This choice was made by Barack Obama at the start, when the president said we should build on what works in today’s system, plugging gaps in coverage while reining in costs. The Senate and House bills thus devote more than $400 billion over 10 years to subsidize the purchase of new private-insurance policies. Can the road to single-payer really be paved with massive new markets (and profits) for the insurance industry?

McCain’s invocation of the single-payer libel is particularly galling, since he’s been on government-run health care practically his entire adult life: first in the military; then as a veteran; then as a member of Congress, where for over 25 years he’s enjoyed the same choice of private-insurance plans that the new Senate compromise would make available to ordinary Americans.

Suppose McCain had been voted out of office in 1992 after the Keating Five savings-and-loan scandal sullied his reputation. He was then 56 years old. And suppose that McCain didn’t have his wife’s enormous wealth to insulate him from the exorbitant health premiums a man with his pre-existing conditions would have faced. Or that he couldn’t go back to work and enjoy access to group health coverage at the giant beer distributorship his wife’s family owns (where McCain worked before he first ran for public office). In such circumstances, you can bet McCain would have been grateful for the chance buy into Medicare to protect himself and his family from medical and financial ruin.

If every aging, displaced worker in America had McCain’s incumbency or inherited wealth to fall back on, it’s true—the ability to buy into Medicare would be superfluous. But most Americans aren’t in the Senate or married to an heiress. For most Americans, losing a job (and health coverage) in your late 50s or early 60s spells catastrophe. For McCain to set aside the obvious empathy he must feel for this vulnerable group in order to score cheap political points is dishonorable.

But then that’s pretty much what Republican health-care opposition now comes down to. With one damning exception aside—their indefensible refusal to fix our broken malpractice system for fear of offending their paymasters in the plaintiff’s bar—Democrats have struggled to expand coverage, boost quality, and craft reforms that could bend the cost curve over time. In other words, Democrats have been struggling to govern. Republicans, by contrast, sit back and take pot shots at whatever emerges, giddy with the freedom that comes from having no responsibility for anything but their own thirst to return to power. A week ago, Republicans were against cutting Medicare, saying it would endanger senior citizens, and now they're against expanding it. If you see no way to bridge these two views besides political opportunism, you're beginning to understand modern GOP political philosophy.

According to the Republicans’ current logic, if letting 55 to 64 year olds buy into Medicare is a threat, why doesn’t the GOP ask for Medicare eligibility to be moved back to age 75? That would keep us safe from socialism. Or better yet, repeal the damn thing altogether! Then we’d be back in the capitalist glory days of the early 1960s, when elderly Americans were routinely ruined by medical costs because private insurers wouldn’t go near them.

So don’t let the GOP assault confuse you: Far from leading us toward single-payer, Democrats are poised to deepen the central role private insurers play in American health care. For the multitudes of near-elderly Americans who aren’t married to Cindy McCain, however, and whom private insurers would otherwise shun, an early Medicare buy-in is a modest lifeline that can help avoid immense and unnecessary suffering.

Matt Miller, a former Clinton White House aide and senior fellow at the Center for American Progress, is the host of the public radio program Left, Right & Center and the author of The Tyranny of Dead Ideas. In recent years he has given paid speeches or paid advice to doctor groups, hospitals, pharmaceutical firms, and insurance companies, as well as to low-income advocacy groups promoting universal coverage.