This blog is devoted to remembrances and essays on general topics, including literature and writing. It has evolved over time, and some older posts on this site might reflect a different perspective and purpose.

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Tuesday, June 7, 2011

The Republican Dr. Strangelove Syndrome

            When Dwight Eisenhower was elected president in 1952 — the first Republican in two decades to hold that position — he had some blunt advice for the hotheads in his party.
            Don’t even think about trying to abolish the New Deal, he told them. It’s popular and it’s here to stay. Our job is to manage it better. His party took the advice for a while, but like Dr. Strangelove, it keeps trying to hit that mutual destruction button, attacking popular programs and blowing itself up in the process.
            Social Security (a New Deal program) and Medicare (a Great Society program) have been around for decades, and they aren’t going anywhere for a simple reason: They work, and probably 95 percent of the public understands, at some level, that it will at some point be helped by them. Forty years from now, President Obama’s health care plan will almost surely enjoy the same support.
            When Congressman Ryan of Wisconsin introduced his budget proposal, which called for turning Medicare into a voucher program, he was widely praised for being serious about its problems. That any responsible commentator would say such a thing is a sad commentary on the dysfunctionality of the punditry.
            Ryan’s plan wasn’t serious at all because any attempt to reform Medicare or Social Security is a political non-starter unless it accepts the basic premise of both programs and attempts reform within that premise.
            For Medicare that means that it will continue to be a universal, single-payer program that will provide basic care for people from the time they turn 65 until the time they die.
            For Social Security that means that it will continue to be a program that pays out a guaranteed defined benefit from a specified retirement age until death.
            Agree on that, and it becomes possible to undertake real reform with an eye toward fixing the two programs so they will remain in decent financial health and fulfill their mission. Medicare, for example, could be substantially reformed by looking at the ways other countries provide universal care and stealing their ideas. It would be far better to do that than to reinvent a system that has got the practice of delivering service down so well.
            It’s hard for Republicans to take this approach because, I am convinced, they fundamentally don’t like Social Security and Medicare. But the foundation of effective political action is accepting what you can’t change and working to change what you can. Persisting in an attempt to undo a popular and widely accepted program is a recipe for failure and an impediment to the reform that could and should be made.
            President Obama grasped this point perfectly in putting forward his health-care bill. A number of Democratic true-believers were incensed that he never proposed a universal, single-payer program. Like Congressman Ryan and his ideological colleagues, they failed to grasp that the perfect (from their viewpoint) was the enemy of the good.
            Obama understood that most middle-class voters already have a health plan, and that most are reasonably happy with it because they haven’t had a problem with it — yet. Anything that threatened to change people’s existing coverage would have been demagogued to a speedy death. In my view, what he came up with was not as good as a single-payer system would have been, but it got the country a near-universal health care plan, which is more than Truman, Kennedy, Johnson, Carter and Clinton were able to do. History will look kindly upon that.