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The Wrecking Crew Does Medicare

In ramming their massive Medicare restructuring plan through Congress in the final days of the fall session, the Bush administration and its Republican congressional allies offered the nation a shocking display of ideological zealotry and bare-knuckles political ruthlessness. The bill passed by the two houses is — to the extent that anyone fully understands the 681-page behemoth, hammered out largely in secret — a near-perfect combination of everything that is worst about the governing style of the wrecking crew currently ruling the roost in Washington.

Under the guise of helping ordinary Americans, the bill offers a few limited benefits to selected groups — mainly a cramped, bizarrely convoluted prescription drug benefit — while paving the way for corporate power-grabs down the road. Critical services like cancer care and AIDS drugs will be reduced, as Hadassah, the women’s Zionist organization, noted in a brave statement after the vote. The bill’s most important innovations are incentives and experimental programs aimed at moving seniors out of Medicare and into the private insurance market, so as to reduce the government’s already undersized role in protecting the nation’s sick and elderly. The bill’s biggest beneficiaries, ultimately, are the pharmaceutical and insurance industries.

For all that, the plan promises to swell the federal deficit, not shrink it. The bill will add nearly $400 billion to the budget over the next 10 years, and the added costs are likely to balloon in the decade after that to nearly $3 trillion, according to the non-partisan Congressional Budget Office. But that may be the point; analysts say the bill’s built-in spending caps will eventually force the program to cut benefits and raise premiums as costs rise, driving more and more people to the mercies of the private market.

One of the worst features of this misguided reform, though, is the way it was moved through Congress. Democrats were shut out of the negotiating process at nearly every turn, prevented from offering amendments and then held to a comically truncated floor debate, ostensibly so the measure could be brought to a vote before recess. Finally, once the House Republican leadership found it lacked the votes for passage, the House stretched its customary 15-minute electronic voting period to an unprecedented three hours to give the leadership time to strong-arm a few stragglers. The last time the Democrats tried a stunt like that — a mere 15-minute extension back in 1987, under then-speaker Jim Wright — it was denounced as “the most arrogant, heavy-handed abuse of power that I’ve ever seen” by a Republican congressman named Dick Cheney.

Once again, Republicans have used their paper-thin majority to muscle through a sweeping, ideologically-driven remaking of government for which they lack any real mandate. The voters didn’t send them to Washington to tear down our basic protections. Sooner or later they’re going to find that out. We can only hope that happens before the damage gets much greater.


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