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The Party of Medicare

Republican opportunism and irresponsibility is hardly a new development in the political world. But I have to say, RNC chairman Michael Steele's latest gambit--depicting the GOP as the party determined to protect Medicare from cuts or reforms or really any changes at all--absolutely takes the cake.

The new party line, unveiled by Steele in a Washington Post op-ed yesterday, and now emblazoned on the RNC site as a "Seniors' Health Care Bill of Rights," represents one of the most incredible flip-flops in living memory.

The antipathy of the GOP and the conservative movement towards Medicare goes back, of course, to the beginnings of the program, and even to its pre-history. Ronald Reagan, after all, made his political debut attacking proposals to create Medicare as "socialized medicine" back in 1961. Barry Goldwater, of course, opposed Medicare, but so too did future Republican presidential nominees George H.W. Bush and Bob Dole.

Though Medicare quickly became part of the national landscape and something of a sacred cow, Republicans in power could never resist the opportunity to go after it. That happened in 1981 after Ronald Reagan's election, and even more famously in 1995, with the advent of the so-called Republican Revolution led by Newt Gingrich. Efforts to pare back Medicare spending arguably contributed more than any other factor to the failure and eventual repudiation of said Revolution.

With that experience in relatively fresh memory, it came to pass in George W. Bush's presidency that Karl Rove decided on a bold move to win over senior voters with an actual expansion of Medicare via a prescription drug benefit. The initiative was clumsily handled and not terribly popular initially. But more importantly, the Medicare expansion almost immediately became exhibit number one in the conservative claim that Republicans had abandoned their principles under Bush, and were subsequently defeated in 2006 and then in 2008 because of (no, not Iraq or Katrina or the recession) "runwaway spending." Indeed, one of the few things (other than his Iraq policies) conservatives activists liked about 2008 Republican nominee John McCain is that he opposed the Rx drug bill.

After the 2008 elections, the we-lost-because-we-spent-too-much self-diagnosis of Republicans became holy writ. And in early policy blueprints for Republican "recovery," Medicare was once again in the bullseye, typically through proposals to "voucherize" the program, which would largely eliminate its risk-spreading function and in all likelihood reduce the money available for health insurance for most seniors. Suffice it to say that such an approach is vastly more of a change to Medicare than anything Democrats have proposed this year or in the past.

To be clear, there's no particular reason conservatives should like Medicare in anything like its current form. It is, after all, a single-payer program similar to the wicked socialist schemes employed in godless foreign countries like Canada. And it's the most natural thing in the world for conservatives to attack Medicare in the course of attacking Democratic proposals for universal health care. As Rep. Tom Price (R-GA), chairman of the conservative House Republican Study Committee, said in an op-ed just last month:

While the stated goal remains noble, as a physician, I can attest that nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.

I haven't seen Price's reaction to Steele's ukase making maximum defense of Medicare the GOP's badge of honor, but you have to figure he's not real pleased about it.

So who really speaks for the GOP on Medicare? It's hard to say right now, but I'm inclined to believe forty-plus years of conservative hostility to Medicare a bit more than Steele's pandering stunt.