Last night on Lawrence O’Donnell’s MSNBC program, I called the Democratic win in New York’s 26th district “a victory for socialism.” My tongue was planted firmly in cheek–I was mocking the radical Republican tendency to pin the S-word on anything that involves government participation…and Medicare does happen to be a single-payer government health care program, a “public option,” as it were, for seniors. I made that clear in subsequent comments. This morning, Drudge is featuring my remark…unironically, of course. Can Rush and Beck be far behind? Of course not.
To make myself perfectly clear: I don’t consider Medicare socialism. Unlike, say, the British system, the doctors aren’t public employees. They’re private contractors who get paid according to services rendered. That’s not socialism…although it wouldn’t be a bad idea to reform the program so that doctors are paid per capita rather than per service (as doctors are at the Mayo and Cleveland Clinics).
But to add some perspective: Medicare is a lot closer to socialism than the Romney-Obama style of health care, which is not single-payer and doesn’t even include a public option–and yet Medicare is perhaps the most popular government program out there. This is a conundrum for Republicans like Paul Ryan who want to gut it. Ryan was caught on tape yesterday boo-hooing to Bill Clinton that now nothing will be done about Medicare. That’s not necessarily true unless all new proposals have to conform to the extreme ideology of the current Republican Party. One thing we can do is pay doctors per capita, as I proposed above–certainly the system needs to be more efficient than it currently is.
And, in the end, there is the real answer: we can pay for it. If we really believe that providing no-fuss medical care for the elderly is the humane and proper thing for a civilized society to do–and the vast majority of Americans agree with that statement–then we can raise taxes to pay for it. Given the evidence of the past 30 years, there is absolutely no reason to believe that marginally higher taxes have any sort of drastic effect on the economy. And given the choice of paying a little more in taxes now–a form of insurance, really–in return for the guarantee of health care later on (without the burden of having to suss out the complexities of a health care “market” that isn’t much of a market at all).
Clearly, the answer to the medical entitlement “crisis” is a combination of reforms–some of which have already been proposed and included in the Obamacare bill–and tax increases. The myopic, extremist Republican decision to ignore that reality may have cost them a Congressional seat the other night; it certainly isn’t going to help them in the next election.