Speaking of Bill Clinton's power to seduce: He is luring the GOP Congress into surrender on Medicare.
The 1997 budget deal contained an implicit promise from Clinton and the Democrats to observe a truce on this issue -- no tricks, no campaign-trail taunts. And implausible as it seemed, Republicans fell for this seduction, forgetting how Democrats have used Medicare as a tire iron against them in every election since 1980, forgetting how Clinton had deceived them in the 1995 budget negotiations, forgetting how he and other Democrats had blatantly lied about Republican plans for Medicare.
In the '97 budget deal, Clinton and Congress agreed to trim future Medicare expenses by $ 115 billion over five years and to convene a bipartisan commission to handle the issue. The deal appeared to offer full political cover in 1998: a moratorium on attacks against imaginary Medicare cuts, plus a boring commission that would stifle volatile debate about Medicare's future. (The program is headed toward insolvency in 2007.)
Then came the double cross. The president announced this month his intention to offer Medicare coverage to a group of people called the "near- elderly," a small cohort of Americans (fewer than 14 percent of the general population, according to the Census Bureau) who, for various reasons, cannot obtain health insurance. Clinton intends to allow all Americans aged 62 to 64 to buy into Medicare for $ 300 a month. And he wants to charge the unemployed who are 55 and older $ 400 a month for the same privilege.
"They came back from the budget deal with a flimsy piece of paper on Medicare," says one Republican strategist. "The leadership has been Neville Chamberlained." Clinton's proposal is indeed as shrewd a trap as he has laid on Medicare -- far shrewder than the ostensible cease-fire he offered last year.
To begin with, the Clinton proposal makes Medicare an issue once again, with mid-term elections looming. Already, Republicans are girding for Medicare attacks in congressional districts where they had counted on a free pass. This doesn't mean those candidates will lose; but it does mean Republicans will have to raise more money and devote more time to building a rhetorical defense, which will distract them from, among other things, pushing for tax cuts.
Republicans who believe that Clinton's Medicare parry is merely a sop to his disgruntled Left are deluding themselves. As senior presidential adviser Rahm Emanuel explained it to the New York Times, "The Republicans want to talk numbers. We will talk about individual real-life stories. And we will keep pounding the Republicans until Congress approves our proposal." It appears that Clinton wants a year-long debate on Medicare as the rescuer of 300,000 or so distressed "near-elderly."
His transparent goal is to force Republicans into ritualistic denunciations of Medicare expansion. And Senators Trent Lott and Phil Gramm have already obliged. The terms of the debate are thus established: Clinton is compassionate; Republicans are not. The president will hammer this theme in his State of the Union address -- he now has more incentive to do so than ever -- and Democrats in the House chamber will thunderously applaud. (What Republicans will do, we can only imagine: hiss? scowl?)
Though objections to Clinton's proposal are mathematically foolproof, they are politically problematic. Gramm correctly points out that those willing to pay annual premiums of more than $ 3,600 for Medicare are probably facing serious health costs -- otherwise it would make no sense for them to pay so much for an annual check-up and flu shot. He and others argue that these new recipients will consume far more health care than they pay for. "Any time you expand an entitlement, the costs go up," says Rep. Dan Miller, a Florida Republican and party leader on Medicare.
Moreover, to encourage people to retire before age 65 is to aggravate the problems of both Medicare and Social Security, which feed off payroll taxes of 15.4 percent. Also, an extension of Medicare coverage could lead the private sector to dump some of its "near-eligible" employees from its health- insurance rolls. Last, if Republicans ever concede that the "near-eligible" need help in obtaining coverage, Democrats will demand subsidies for the unemployed 55 and older and those 62 to 64 who can't afford Clinton's pricey premiums. This would further drive up Medicare costs and accelerate the program's grim march toward insolvency. But, for the Democratic party, it would be mighty good politics.
Despite the testimony that objective health-care experts have already given -- testimony that validates GOP objections -- many Republicans are fearful that voters will dismiss such criticism as "green-eyeshade Republicanism" and warm to Clinton's promise of guaranteed health coverage.
"I don't delude myself into not believing that the president's proposal will be very, very popular," Gramm says. But so far, a politically nimble response to Clinton has not emerged. Rep. Dennis Hastert of Illinois is in charge of assembling a task force on the subject. Some strategists are pushing for a replay of the "government takeover of health care" mantra used in 1994 against ClintonCare. But that won't do. Clinton's current proposal isn't nearly as big as Hillary's sprawling dreams, and he has the fig-leaf of premiums to argue that he's being fiscally responsible.
No, Republicans need to come up with a plan of their own. They might call for (1) an expansion of Medical Savings Accounts, (2) tax breaks for individuals who buy their own health care (similar to those corporations now receive), and (3) flexibility in portability laws, allowing individuals to purchase high-deductible health coverage when they change jobs. All three of these counter-proposals would give individuals more power to shop for their own health care and seek prices and coverage that fit their needs.
Clinton is betting that Republicans won't marshal such arguments and that they will instead put up a meager defense until the political tide becomes irreversible, after which they will capitulate. It is, sad to say, a tried and true formula for the president. But this time, Republicans should stiffen their spines: If they fail to mount a strong, market-oriented campaign against the Clinton gambit, they will not only jeopardize Medicare's future, they will have foreclosed any possibility of privatizing Social Security. After all, if you can't make a case for privatizing Medicare (where anxiety over insolvency is relatively high), how can you expect to make a case for privatizing Social Security (where anxiety over insolvency does not exist)?
Clinton is eager to debate the future of Social Security shortly after the 1998 elections. If he cows the Republicans on Medicare, he will surely find them a soft, trembling foe in the next round.
Major Garrett is a Washington, D.C., author and journalist.