The previous congressional majority managed to jam Obamacare down the throats of an increasingly resistant nation. Now the fight against Obamacare may have delivered a shock to the system that goes beyond this single issue.
Public-opinion polls consistently reveal an extremely poorly informed public with no coherent commitment to reducing the role of Big Government. The average citizen is happy to delude himself into thinking that the United States can balance the budget by cutting foreign aid even though it is a trivial part of spending. Politicians who challenge the real cost drivers of the federal budget — especially Social Security or Medicare — face the prospect of a short career.
As William Voegli of the Claremont Institute recently reminded us, conservatism has “clear, categorical arguments against permitting American government to take up any task it did not perform during Jefferson’s presidency.” However, “In 1936 and 1964, the Republicans’ presidential candidates, after repeatedly expressing their commitment to these principles, lost with 36.5 percent and 38.5 percent of the popular vote, respectively.”
This undoubtedly explains why the current Republican caucus on Capitol Hill is so reticent about introducing real reform to these entitlements. It is pretty easy to get seniors onboard the anti-Obamacare Express by simply attacking the cutting of half a trillion dollars from Medicare to finance Obamacare. Also Republican “founding mythology” does not provide strong grounds for rolling back the entitlement state.
A full 81 of 102 Republican representatives and 16 of 25 senators voted in favor of the Social Security Act in 1935. As for Medicare and Medicaid, a narrow majority of Republicans in the House voted in favor of the 1965 Social Security amendments, as did almost half of those in the Senate. When Ronald Reagan had to deal with Medicare, he accepted an increase in payroll taxes and imposed centrally fixed prices for medical procedures, laying ground for today’s ridiculous, never-ending sequence of “doc fixes.” Let’s not get started on the Medicare Part D drug benefit, a solely Republican expansion of Medicare passed in 2003.
But the ground may be shifting. The latest Pew Research Center survey of voters’ budget-cutting priorities shows that Americans are far less enamored of surrendering control of their access to medical care to the federal government than they once were. Yes, 40 percent want to increase Medicare spending, versus only 12 percent who want to cut it. But this is a reduction of one-quarter from the 53 percent who wanted to increase spending in 2009.
I suspect the time is coming when politicians in general and Republicans in particular will take more risk on health reform and entitlements. They could propose replacing employer-monopoly benefits with individual tax credits, voucherizing Medicare and Medicaid, or eliminating entirely the federal role in regulating private health insurance. Such a politicians might discover — with surprise — that they are pushing against an increasingly open door.
John R. Graham is director of Health Care Studies at the San Francisco-based Pacific Research Institute (www.pacificresearch.org).
