It’s the GOP’s turn to flip-flop on health care

Flip-flopping is an equal-opportunity sport in American politics. This time, it seems to be the Republicans’ turn.

Congressional Republicans have opposed the Obama administration’s health care bill because it will increase the federal government’s role in U.S. health care and increase government outlays by tens of billions of dollars per year.

But in 2003, most of these same Republicans voted for establishing a Medicare drug benefit despite the fact that it would increase the federal government’s role in health care and increase federal outlays by tens of billions of dollars per year.

Bruce Bartlett, a former Reagan and George H.W. Bush administration official, gives his fellow Republicans a tongue lashing for this inconsistency in a recent column in Forbes magazine.

Bartlett’s criticism is right on. But the responses of some of his party’s leading lights, as quoted in a recent Associated Press article on the issue, illustrate broader patterns in the electoral politics of economic policy — ones that, over time, transcend party lines.

Take Sen. Orrin Hatch’s defense of his vote for the drug benefit despite the fact that all the program’s outlays added to the national debt. The benefit, Hatch says, “has done a lot of good.”

That is another way of saying “people who get windfall subsidies like them.” Farmers who receive large checks believe crop subsidy programs “do a lot of good.” College students feel the same way about Pell grants and college professors about Fulbright fellowships. So do small-town officials about grants to upgrade sewer and water systems. Any sort of government action that gives some group of people more money than they would have without the government program “does good,” at least in the eyes of the recipients.

By that criterion, government action to extend health insurance to people not currently covered will do good. So if the good senator was in favor doing good in one case, why is he opposed to it in another?

Two factors stand out. First, people 65 and older who benefit from the Medicare drug program are much more likely than average to vote. In contrast, those currently without health coverage are less likely to vote than average.

Second, a higher proportion of those over 65 vote Republican than those under 65 without health insurance. Pleasing your own supporters and disappointing those of your opponents has been a rule in politics for centuries.

It is no accident the Medicare drug bill passed when it did. Seniors groups had become increasingly vocal in calling for one. It was clear that Democrats would use the issue to beat up on Republicans in the 2004 congressional races if nothing happened.

So, just as Republican President Richard Nixon had gotten into an electoral bidding war with powerful Democratic congressman Wilbur Mills 30 years earlier on increases in general Social Security benefits, a bloc of congressional Republicans got into a bidding war with Democrats in 2003 to see who could offer the most lucrative package.

This was virtually a no-lose situation for the Democrats. It was only a minority bloc of anti-spending Republicans together with President George W. Bush who kept the program from being more of a giveaway than it actually is. Bush, riding high on his success in invading Iraq, did not feel the same electoral threat as his fellow Republicans in Congress.

Why was adding to the debt not an issue? As Hatch explains, in 2003, “it was standard practice not to pay for things.” Yes, federal deficits once again were rising after having shrunk from 1992 through 2000. But noneconomic issues like the Iraq war were much more important to the average voter than the debt, and the economy, home values and stock prices all were rising. Deficits and debt were not deemed important electoral issues by either party.

Can we learn anything from all this? Sen. Olympia Snowe, R-Maine, argues not. “Dredging up history is not the way to move forward,” she says. I’m not so sure. It all depends on how citizens see their own role in all of this.

For those who always see newly elected officials as somehow betraying the voters as soon as they get to Washington, Snowe’s argument may be true. More thoughtful people may recognize that politicians’ votes usually represent the perceived majority wishes of their constituents back home.

The lesson of 2003 is that voting in a major new entitlement without doing anything to pay for it was a safe strategy in electoral terms back then. That says at least as much about the U.S. electorate as it does about the candidates they elect. What, if anything, we learn from this lesson will affect how our nation gets out of the economic hole it has dug itself into.

© 2009 Edward Lotterman
Chanarambie Consulting, Inc.