Wednesday, August 26, 2009

The GOP Domestic Agenda

WaPo's Steven Pearlstein runs the numbers on Michael Steele's "GOP Patient's Rights Plan" announcement yesterday and comes up with the number zero, as in the number of domestic programs the GOP plan will allow for besides Medicare in 2035.
The plan came to light as a result of an op-ed piece this week in The Washington Post in which the party chairman committed the GOP to spending an ever-increasing share of the federal budget, and the national income, on Medicare. When combined with other Republican promises -- to balance the budget, protect defense spending and never, ever raise anyone's taxes -- the inescapable inference is that the government would run out of money for every other domestic program sometime around 2035.

Steele's stunning announcement brings the conservative strategy of "starving the beast" to a new level. Under the guise of protecting the elderly, Republicans hope to realize their dream of eliminating half a dozen Cabinet agencies, firing tens of thousands of government workers and ending government regulation as we know it.

Steele's op-ed was the latest salvo in his party's campaign to defeat President Obama's health-care reform effort at all costs and build public support for a Republican alternative that remains, to this day, a closely held secret. The new Seniors' Health Care Bill of Rights, however, hints at the outlines of the GOP domestic strategy.

Steele promised that under the Republican health plan, runaway Medicare spending would continue unabated. Not only would that mean no cuts in benefits, but it would ensure that reimbursement rates to doctors, hospitals and drugmakers would continue to rise faster than inflation, regardless of how much they earn or how unnecessary or wasteful the services they provide. Any effort to contain future spending growth, Republicans now believe, is nothing more than a "raid" on Medicare, the government-run health plan that Republicans were against before they were for it.

The country's top Republican official also vowed to cut off all federal funding for research to determine what are the most effective treatments for heart disease, cancer, diabetes and even that new scourge, restless leg syndrome. Left unclear was whether he prefers to have such research done by the pharmaceutical and medical-device industries, but one suspects that is the case.

On the issue of end-of-life care, Steele was uncompromising: In a Republican world, no government funds could be used to pay doctors to provide information about living wills, hospices or palliative care, whether seniors and their families ask for it or not.

"Government programs that seem benign at first can become anything but," Steele explained in articulating the new philosophy. Once back in power, look for Republicans to apply the same approach to issues such as flu vaccinations, disaster relief and air traffic control.

War and Medicare. Everything else, let the private sector handle. And no, I don't believe Pearlstein is being hyperbolic here. Pledging zero cuts for Medicare and zero tax increases means other things will have to be eliminated eventually, period. It's simple mathematics.

But that's Republican math for you.

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