Wednesday, November 16, 2011

By A Thousand Cuts

Now that Michele Bachmann, Rick Perry, and Herman Cain all have had their fifteen minutes of fame, Newt Gingrich is settling in as the main rival to Mitt Romney.

More earthbound than the wild-eyed Bachmann and more substantive than Perry or Cain (analogous to saying Richard Dawkins is more religious than the late Madalyn Murray O'Hair), Gingrich is more dishonest and narcissistic than

Romney but appears to be ideologically akin to the former Massachusetts governor. In May, the former Speaker characterized the Paul Ryan Medicare destruction plan as "too big a jump" and remarked

What you want to have is a system where people voluntarily migrate to better outcomes, better solutions, better options, not one where you suddenly impose it. I am against Obamacare imposing radical change, and I would be against a conservative imposing radical change.

Gingrich took a little heat from ultra-conservatives for his comments, not because he wanted Medicare to bleed to death but because any criticism, implied or otherwise, of any aspect of the far-right worldview is off limits. But the thrice-married Gingrich had proposed a pretty slick way of irredeemably weakening Medicare, and Mitt Romney seems to have been listening. An Arizona Republic columnist recently opined

Mitt Romney recently stepped more bravely into the entitlement-reform minefield. He basically endorsed Congressman Paul Ryan's plan to transform Medicare from a program that pays for the medical bills of seniors to one that gives them financial support to purchase health insurance.

This is not as radical of a reform as depicted by opponents.

Seniors wouldn't be left to the ravages of predatory private insurance companies. The government would sponsor a purchasing pool for seniors. All insurers participating would have to meet benefit requirements and accept all enrollees at the same price without medical underwriting.

Actually it is fairly radical- and politically cagey, as was Gingrich's approach. Even if insurers were required to accept everyone regardless of medical condition, the healthiest portions of the elderly population would migrate to the private (non-Medicare) plans. The burden on the Medicare system would grow as the least healthy of old people would opt for that program. Medical insurance for the elderly no longer would be seen as an earned benefit, but as a subsidy for the most needy, akin to welfare. The most needy would be disproportionately poor, reinforcing the notion.

Allotments for Medicare would be reduced as the GOP continues its push to make the Bush tax cuts permanent with the intention of drowning government in the bathtub. While health care costs continue to rise, Medicare costs would grow even faster, giving conservatives and the mainstream media fodder to argue still that Medicare- rather than health care generally- is driving up health care costs to unsustainable levels.

Newt Gingrich is not likely to be the GOP presidential nominee and probably wouldn't win a general election against Barack Obama. But either he or Mitt Romney will be the Repub standard-bearer and both know how to package a radical idea as mainstream.

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