Republicans for socialism

Things got all turned around and twisted up last week in Washington, even more than usual.

Republicans, who never before much believed in Medicare, stood up for it. Democrats, who created it and have always championed it, found themselves in the ironic position of defending cuts to it.

When Medicare was created in 1965, Republicans in Congress overwhelmingly opposed it. They called it, get this, socialized medicine. They wanted old sick people on fixed incomes to fend for themselves for medical care.

Now, to try to defeat health care reform in subservience to the health insurance industry, Republicans reach for new heights, which is to say lows, in cynical opportunism and rank hypocrisy.

Owing to Republican and corporate propaganda, seniors get more worried by the day about the continued vibrancy of their Medicare benefits. Republicans are about to scare them half to death with alarms that Democrats would cut their Medicare benefits to pay for subsidizing health care for low-income younger people.

It all goes back to the underlying principle of Republican opposition to universal health care, which Republicans cannot dare say outright: It is that we need a system of class and privilege in medical care in order to make it work. If every Tom, Dick and Harry has health insurance, then doctors' waiting rooms will be covered up in riff-raff and our physicians won't be able to give the vital time and attention and preventive care services they now give to people well-off enough to have good private insurance.

There's your health care debate in one paragraph.

What Republicans can do, though, is shed crocodile tears in Senate Finance Committee hearings over proposed Medicare cuts, even though, three years ago, they cheered $500 billion worth of proposed Medicare cuts by their president at the time, George W. Bush.

Back then, as small-government fiscal conservatives, supposedly, they held forth on how Medicare was going to bankrupt us all unless we got hold of it.

So now Democrats, in order to make universal health care work fiscally, propose similarly sized reductions. So Republicans have turned 180 degrees, saying that grandma is being thrown under the bus by evil Democrats.

Republicans in the Finance Committee invoked somber, angst-ridden tones last week in opposition to a Democratic proposal to create a new commission to make binding changes in Medicare reimbursements for doctors and hospitals, independent of congressional political pressure.

That is an idea Republicans embraced days ago.

Rather artfully, Republicans manage to defend a government health insurance plan while couching their opposition in their usual championing of the private sector and the individually fortunate.

You see, some of these Democratic cuts would come in the Medicare Advantage program, by which Medicare assists in the purchase by some seniors of a transcendent private Medicare policy that offers more generous benefits. In some cases, these Medicare Advantage plans -- sometimes called "boutiques" -- use Medicare subsidies from the government to offer such extras as eyeglass allowances and no-cost health club membership coverage.

These are good and progressive plans, quintessentially American mixtures of public assistance and private services.

But fiscal experts have long agreed that Medicare can't go on contributing public dollars to the extent it has been.

So when Republicans tell you that Democratic plans would pull the lifeline on grandma, that's not going to be so. More possible, though, is that Democratic plans conceivably could force her to ante up a few more dollars of her own if she wanted her private plan to keep covering her gym or spectacles.


John Brummett is an award-winning columnist for the Arkansas News Bureau in Little Rock.