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Gonna Party Like It's 1965

My colleague Greg Sargent notes that Michael Steele isn't sounding so much like a Republican from 1994 as a Republican from 1964:

Steele, for instance, warned that “we need to prohibit government from getting between seniors and their doctors,” adding that “Republicans oppose any new government entity overruling a doctor’s decision about how to treat his or her patient.”

But back in 1961, Ronald Reagan, then an actor and prominent voice involved in Republican causes, said almost the same thing: “Today, the relationship between patient and doctor in this country is something to be envied any place. The privacy, the care that is given to a person, the right to choose a doctor, the right to go from one doctor to the other.”

Today, Steele wrote that the “government-run health-care experiment” that Dems propose “will create government boards that would decide what treatments would or would not be funded.”

But back in 1962, the American Medical Association made a strikingly similar assertion against Medicare, claiming that it would “put the Government smack into your hospitals” to set standards and decide who gets in.

Last month, Steele answered a question about whether the Dem proposal represents socialism this way: “Yes. Next question.” Back in 1961, Reagan warned that a traditional method of “imposing statism or Socialism on people has been by way of medicine.”

I'd add that Steele is pairing this with a rousing defense of Medicare, the very program that his predecessors swore would usher in an era of socialism and bureaucratic death panels. The cognitive dissonance is proving a bit intense even for the Republican Party, and Steele is now being criticized for pairing his attacks against an abstract single-payer system with a paean to an existing single-payer system.

The lesson here is not simply that Steele is a clown. It's that we've heard this stuff before, managed to ignore it, and now we have Medicare, which seniors love so much that even the chairman of the conservative party can't attack it. There's a lesson in that, and it's not that we need to oppose “government-run health-care experiments.”

By Ezra Klein  |  August 25, 2009; 10:31 AM ET
Categories:  History , Republicans  
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This would be more persuasive if Steele weren't in fact right. You've written any number of columns arguing that fee-for-service reimbursement for Medicare (i.e., where the Government pays for whatever the doctor decides to do) needs to change to some other model (where the Government reimburses the doctor in a way that discourages him/her from certain treatments).

Posted by: tomtildrum | August 25, 2009 10:41 AM | Report abuse

This is getting silly. Reagan was a major proponent of Medicare 30 years ago. The GOP proposed a few cosmetic cuts in the 90s, but nothing substantial.

I don't think it's a huge surprise that Medicare is popular among seniors - they are getting huge medical subsidies from the working population - 2.9% of all earned ordinary income. If there were a program that confiscated 2.9% of every other demographic's income and redistributed it to my demographic, I'd be quite happy with this program too.

Posted by: Dellis2 | August 25, 2009 10:52 AM | Report abuse

Medicare is liked, in part, because it forces someone else (children) to pay the bills incurred by others. I have yet to hear a great public cry of 'I am willing to give up x% of my salary, forever, to help those in need'.

In your last sentence, you obliquely make an interesting point that multiple parties are emerging. The monarchists are represented by a fringe of Democrats as rabble as the oligarchists represented by a fringe of Republicans. The remainder -- the constitutionalists -- includes a number of conservatives and non-conservatives which is about the same as the Nation itself. 'Conservative' and 'non-conservative' simply cannot be used as alternatives to 'Republican' and 'Democrat'.

It's interesting to note that (a) Abe Lincoln was the first Republican President... and he did that 'free the slaves' thing, (b) Bill Buckley vigorously advocated the legalization of marijuana, and (c) for many, a vote in the last election was more a vote against the memory of George W. Bush than a vote for non-conservatism.

Posted by: rmgregory | August 25, 2009 11:05 AM | Report abuse


The larger point you have conveniently omitted is that the reason that seniors are getting medical subsidies from the working population is that health care costs in general are growing at an unsustainable rate, and that has imposed a burden on everyone who has health insurance in the form of premiums that are increasing at 10% to 20% a year.

Yet the GOP is proposing no credible alternative to restrain that growth (nor did it do so when they controlled the government) and it is seeking to obstruct any attempt by the Democrats to do so.

Posted by: newjersey_lawyer | August 25, 2009 11:06 AM | Report abuse


a) Yet the party of Lincoln stridently opposed the passage of the Civil Rights Act of 1964.

b) Buckley was a libertarian. Few of today's movement conservatives are.

c) Similarly, many of the people who have voted for Republican presidential candidates aren't conservatives. What does conservative even mean at a time when balanced budgets mean nothing to Republicans when they controlled the Congress and the White House. They aren't opposed to starting unnecessary wars or engaging in nation building, and conserving the environment is an anathema to them.

Posted by: newjersey_lawyer | August 25, 2009 11:14 AM | Report abuse

As a sidenote, I'll add that James Strom Thurmond "changed from the Democratic to the Republican Party on September 16, 1964," quoting __Strom Thurmond & The Politics of Southern Change__ by Nadine Cohodas.

Some issues have a way of reshaping political parties.

Posted by: rmgregory | August 25, 2009 11:15 AM | Report abuse

First off, I don't think any of the proposed bills are going to substantially decrease the rate of health care cost growth. Second, Republicans have proposed a set of solutions that will unquestionably lower the rate of growth: medical malpractice reform; replacing the employer-only health insurance subsidy with a refundable tax credit; allowing individuals to purchase health insurance across state lines, etc. Democrats have opposed all of these vehemently. I personally believe that Medicare should be transformed into a bare-bones operation, but this isn't the standard GOP view. Nonetheless, it is false to assert that the GOP has not proposed a "credible alternative to restrain growth".

Posted by: Dellis2 | August 25, 2009 11:16 AM | Report abuse

"we have Medicare, which seniors love so much that even the chairman of the conservative party can't attack it. There's a lesson in that"

Lesson: people love their subsidized [FILL IN THE BLANK].

Posted by: ostap666 | August 25, 2009 11:17 AM | Report abuse


So you support the competition that a public option would create?

Medical malpractice contributes a very small percentage to health care premiums.

Health insurance for a family of four is about $17,000 a year. No one is proposing offering a refundable tax credit that is anything close to that.

You really need to start getting serious.

Posted by: newjersey_lawyer | August 25, 2009 11:29 AM | Report abuse

actually the lesson is that one you start an entitlement program you can NEVER stop it until its costs stop itself. Just like you can only tax up to 100% of a person's income.

Posted by: visionbrkr | August 25, 2009 11:39 AM | Report abuse

"There's a lesson in that, and it's not that we need to oppose “government-run health-care experiments.”"

One of the biggest problems with the filibuster is that it makes it far harder to learn by experimenting, to see first hand if the claims against a program or idea were false (or grossly, ridiculously false). It really hurts the U.S, when other advanced countries are far freer than us to experiment and learn, with their completely Democratic legislatures as opposed to our Senate, where Wyoming gets the same votes as California with about 70 times the citizens, and where, with the filibuster, senators representing only about 10% of the citizens can stop a bill favored by senators representing about 90%.

Posted by: RichardHSerlin | August 25, 2009 11:46 AM | Report abuse


Engage in strawman arguments much?

Posted by: newjersey_lawyer | August 25, 2009 11:48 AM | Report abuse

newjersey_lawyer is absolutely right about tax credits for health insurance.

Most people would not be able to pay the premiums for the insurance upfront. To get the tax credit, you have to be able to pay first and most simply will not be able to do that. You also have to ask: If you do away with the employer-provided health coverage, do you expect them to raise employee compensation to cover what they had been with their portion of premiums? Anyone with employer-provided coverage understands (or rather, they should understand) that they take reduce net pay because they get the benefit of coverage.

I sincerely doubt my employer would give me a raise equal to what is paid for my health coverage. I doubt any others would either.

Both arguments - tax credits and ending employer-provided coverage - simply don't make sense.

Posted by: | August 25, 2009 11:51 AM | Report abuse

"Just like you can only tax up to 100% of a person's income."

I'm waiting to see private health insurers spell out what people should be cutting from their budgets once it gets down to food, clothing and shelter. Parasites usually move on after strangling their hosts, but they sometimes end up killing themselves.

Posted by: pseudonymousinnc | August 25, 2009 11:56 AM | Report abuse


and you still think insurers set costs don't you? Which is it do insurers pay every claim and we need to rein in their costs with a strong public option or do they deny every claim you submit?? Please I'd love to hear you argue both side of it again.

and i love how i'm called out as the parasite but yet the ambulance chasing lawyer is the "champion for all that is good".

Someone needs to look at both of our bank accounts for the true story.

Posted by: visionbrkr | August 25, 2009 12:01 PM | Report abuse

Wow, what brilliance shown here. "Reagan changed his tune on Medicare when running for national office." Well, that changes everything. Even better is, "Lincoln was a Republican and freed the slaves." Well, I'm convinced -- the status quo rules!

Posted by: AZProgressive | August 25, 2009 1:26 PM | Report abuse

Dellis2 wrote: "Reagan was a major proponent of Medicare 30 years ago."

So, he was for the bill after he was against it?

Posted by: kcc3 | August 25, 2009 2:52 PM | Report abuse


a) Yet the party of Lincoln stridently opposed the passage of the Civil Rights Act of 1964.

Facts are so, so inconvenient. Actually, the major opposition to the Civil Rights AAct of 1964 was from Southern Democrats...

Posted by: Paladin7b | August 25, 2009 4:16 PM | Report abuse

The refundable tax credit that McCain advocated accounted for an amount equal to or greater than the amount that 95-98% of American households currently spend on health insurance.

Further, McCain has proposed drug reimportation through Canada. Obama has ruled this step out as part of his attempt to co-opt the drug industry to support his version of health care reform.

Posted by: Dellis2 | August 25, 2009 4:47 PM | Report abuse

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