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Republicans try and fail to justify voting for Medicare Part D

Charles Babington of the AP thinks back to the long-ago days of 2003, and the Medicare drug benefit that the then-dominant Republicans passed into law. Better yet, he asks some of them about it, and gets some rather peculiar responses in return.

When Republicans controlled the House, Senate and White House in 2003, they overcame Democratic opposition to add a deficit-financed prescription drug benefit to Medicare. The program will cost a half-trillion dollars over 10 years, or more by some estimates.

With no new taxes or spending offsets accompanying the Medicare drug program, the cost has been added to the federal debt.

All current GOP senators, including the 24 who voted for the 2003 Medicare expansion, oppose the health care bill that's backed by President Barack Obama and most congressional Democrats. Some Republicans say they don't believe the CBO's projections that the health care overhaul will pay for itself. As for their newfound worries about big government health expansions, they essentially say: That was then, this is now.

Six years ago, "it was standard practice not to pay for things," said Sen. Orrin Hatch, R-Utah. "We were concerned about it, because it certainly added to the deficit, no question." His 2003 vote has been vindicated, Hatch said, because the prescription drug benefit "has done a lot of good."

Sen. George Voinovich, R-Ohio, said those who see hypocrisy "can legitimately raise that issue." But he defended his positions in 2003 and now, saying the economy is in worse shape and Americans are more anxious.

Sen. Olympia Snowe, R-Maine, said simply: "Dredging up history is not the way to move forward." She noted that she fought unsuccessfully to offset some of President George W. Bush's deep tax cuts at the time.

In order: Hatch admitted that when Republicans controlled Congress, "it was standard practice not to pay for things." How this qualifies as a defense of the behavior then or a justification of the hypocrisy now is left as an exercise for the reader.

Voinovich says that "the economy is in worse shape" now, which is another way of saying that few in the Senate are even glancingly familiar with economics. You add to the deficit when the economy is in worse shape in order to stimulate demand. You pay for your spending when the economy is in better shape in order to keep deficits low precisely because you want the flexibility to deficit-spend in bad years. And beyond all that, both Medicare Part D and health-care reform were spending commitments, not single-year programs. The relative health of the economy in the year they were passed should not have been a big consideration when designing programs that we expect will operate 20, 30, and 50 years into the future.

As for Snowe, she's right that dredging up history isn't the way to move forward. But looking at Snowe's past record is a good reason to ask why she refuses to move forward on health-care reform, when she voted to move forward on a Medicare Drug Benefit that does much more damage to every principle she professes to hold dear.

By Ezra Klein  |  December 28, 2009; 8:48 AM ET
Categories:  Health Reform  
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they dont appear to be haunted by conscience, or gnawing ambivalence, over their decisions
it must be an easier life to glide through decisions with such a self-convincing sense of certainty and vindication.

Posted by: jkaren | December 28, 2009 9:33 AM | Report abuse

This twisted logic of party-line partisanship is "Exhibit A" of why politicians of both major parties are so disliked and distrusted.

If they believe what they are saying, shame on them. If they don't really believe what they are saying, double shame on them.

Posted by: hapster | December 28, 2009 9:53 AM | Report abuse

These are two totally different situations and Ezra should be smart enough to know it. Medicare Part D simply modernized an existing program by bringing its benefits out of the 60s. There were very little drugs back then and now we use drugs to deal with health problems.

This health care reform is much more dramatic. It adds an existing entitlement to millions upon millions for perpetuity.

The size of these two health care bills are not even comparable.

Posted by: lancediverson | December 28, 2009 10:20 AM | Report abuse

Ezra convieniently fails to mention the Democrats opposed Medicare Part D because they claimed it was not generous enough.

The whole mess started over the fact that a handful of seniors (some estimates put the number as low as 2.5 million) faced difficulty paying for prescription drugs. The liberals were rallying around this as the club to use against Bush in 2004. Various solutions were discussed in public and private, including a simple federaly funded charity program to help very low income seniors buy drugs. Unfortunately, this was not acceptable to the liberals who demanded a broad based prescription drug program as the price for any votes (remember it took 60 votes to get throught the Senate than as well as now). In the end, most of the liberals walked away from the deal anyway, hoping to be able to use the issue in 2004. This left the administration twisting arms to get every last vote possible out of Republicans and making crazy compromizes with both the AARP (overly broad coverage) and fiscal conservatives (donut hole) to produce a bill that removed the issue from the 2004 elections.

In practice, Medicare Part D has been slighly less expensive than feared but it remains an example of how not to write legislation. But to use it as an example of Republican hypocrisy, while ignoring the cynical manuverings of Democrats who wanted an issue more than a solution, is itself an example of the bias I have come to expect from Ezra. He is highly intelligent with occaisionally good analysis but almost always distorts or ignores facts or history that do not support a far left agenda.

Posted by: WoodbridgeVa1 | December 28, 2009 10:47 AM | Report abuse

Just one little correction, Ezra:

The primary reason that the government should run a surplus during good years isn't to permit it to run deficits in lean years. Certainly, that's a useful function. But its not the primary function for countries which have the wherewithal to borrow at non-usurious rates, like the U.S.

The primary function is to limit inflation - and to a lesser extent, to stamp out bubbles that occur when flight from safe investments during a period of cheap credit moves the value of a company beyond its fundamentals. In a good economy, the free flow of credit tends to increase the money supply. Banks are healthier, and thus more willing to bet on marginal credit risks. People and companies who once were marginal risks now are good credit risks and more able to get loans. This substantial growth of the real money supply creates inflation.

Posted by: jesmont | December 28, 2009 10:58 AM | Report abuse

It is hypocrisy. But the cause isn't being Republicans as much as it is being in power and the need for the party in power to cater to the incessant and inconsistent public desire for fiscal responsibility with free lunches.

Of course seniors want federally funded drug coverage. Perhaps even a majority of the rest of the public thinks it's a good idea. But no one wants to pay for it, or want someone else to pay for it. So rather than do the fiscally responsible thing and ask whether those supporting the policy are willing to do something to help make it happen (pay higher taxes or give up some of their own benefits), they do the politically expedient thing and have no one pay for it.

This tactic may win elections in the short term, but allows the minority party to point to rampant fiscal irresponsibility. And opposing fiscal irresponsibility also has substantial majority support with the public and so is a useful tool to regain a legislative majority. The problem is that when the minority party becomes the majority party, they're still faced with the problem that most people still seem to want more programs without paying for them, and so the cycle will start over again with the parties reversed (and perhaps with "tax cuts" substituted for "programs").

The cycle will continue until enough people start taking responsibility for what they say they want from their government. So it's both our own fault, and the bipartisan fault of our elected officials who fear to ask us to take that responsibility, to remind us that government isn't "them," it's "us," no matter how much we'd like to pretend otherwise.

When we remember that we are ultimately responsible for what our government does, then perhaps government will act in a more responsible manner. It is a representative democracy, after all.

Posted by: dasimon | December 28, 2009 11:26 AM | Report abuse

Repeal Part D now. It's a criminal act. Stop stealing my money.

Posted by: staticvars | December 28, 2009 12:04 PM | Report abuse

staticvars: "It's a criminal act. Stop stealing my money."

Sorry, I probably shouldn't bother, but...

It's not a "criminal" act. We don't get to opt-out of paying for government expenditures we disagree with. I'd like to get my money for the building and maintenance of B-2 bombers back. But I lost that vote. If people want to stop having their money spent on a program, organize and put pressure on elected representatives to stop spending the money. As I wrote above, it's a representative democracy, and we have (an admittedly imperfect version of) majority rule. The fact that some of us are in the minority and lose votes doesn't make expenditures "stealing"; it means you lost the vote.

Second, it's not our money, and that's the problem: we didn't pay for Medicare Part D. It's going on the nation's credit card for future generations to pay off.

Posted by: dasimon | December 28, 2009 12:21 PM | Report abuse

The reason it's relevant to bring it up, is because a huge complaint by republicans about health care reform is it is going to "bankrupt" the US. But, when they wanted to pass their priorities (tax cuts, wars, and in this example Medicare Part D), they didn't have to worry about bankrupting the US.

Posted by: ChicagoIndependant | December 28, 2009 12:37 PM | Report abuse

Also... "You add to the deficit when the economy is in worse shape in order to stimulate demand. "

Unless, you were already massively adding to it when times were "good". There is a limit to the effectiveness of that strategy, and now that Krugman is slipping into dementia, he has forgotten that.

Posted by: staticvars | December 28, 2009 3:51 PM | Report abuse

@daismon "It's not a "criminal" act."

Yes it is. Just look at where the person that pushed it through, Billy Tauzin is.

Let's amend that stupid plan now and limit the plan to generic drugs only. Those at least seem to safe, versus the Vioxx style monstrosities pushed on a willing public.

It's basically stealing money from my retirement to pay people to buy name brand crap.

Unlike a B-2 bomber, this is not a public good that is being bought. It's a Ponzi scheme where I am supposed to trust future generations to pay me the same benefit.

Posted by: staticvars | December 29, 2009 9:26 AM | Report abuse

staticvars: "@daismon 'It's not a "criminal" act.'

"Yes it is. Just look at where the person that pushed it through, Billy Tauzin is."

Ah, what's the "crime"? You don't like it. Perhaps I don't like it. But that doesn't make it a crime. It's politics. As far as Billy Tauzin goes, what "crime" did he commit? Lobbying can ugly but it's not a crime. You don't like it? Advocate stricter lobbying rules. But there's no crime here.

"It's basically stealing money from my retirement to pay people to buy name brand crap."

Sometimes the "name brand crap" is the only item on the market (you know, exclusivity so companies have an incentive to make the stuff in the first place) that will save a person's live. Maybe yours, someday. And "basically stealing" doesn't make it "stealing." Or is every tax a theft now?

"It's a Ponzi scheme where I am supposed to trust future generations to pay me the same benefit."

Again, the problem isn't related to anything "Ponzi." The problem is that it wasn't paid for at all. By that reasoning, it would seem that any deficit spending is a Ponzi scheme, but that's obviously not true.

And I'm not sure I see the difference between drug benefits as a "public good" and public education. Public schools provide education for those who could not otherwise pay for it. Medicare provides health for those who might not otherwise be able to afford it. Is public education a Ponzi scheme too because it involves an intergerational transfer to pay for it?

Posted by: dasimon | December 29, 2009 10:48 AM | Report abuse

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