Medicare reform
Nov 27th 2003 | WASHINGTON, DC
From The Economist print edition
This week’s law-making may have helped George Bush win next year’s election—providing voters don’t do the sums
ACCORDING to Otto von Bismarck, the making of laws, like the making of sausages, should never be watched. Congress this week illustrated his point. The Republican leaders were very keen to pass two laws that would help the White House—the energy bill and a huge extension of the Medicare programme—before adjourning for Thanksgiving. To do so, they subjected the world’s most powerful democratic body to a messy mixture of arm-twisting, procedural manipulation and special-interest politicking.
Despite these sterling efforts, the Republicans actually failed on energy. Some 40 senators, including six Republicans, stood firm against the proposed law, enough to delay it by filibuster if necessary. A costly law that does little for America’s energy problems, but piles subsidies and tax breaks in the lap of every conceivable business connected to energy, has been shelved—at least until January.
The mammoth Medicare bill, however, squeaked through. It passed the House of Representatives at 5.53am on Saturday, November 22nd, after an unprecedented three hours of voting. Normally, congressmen have 15 minutes or so to cast their votes. This time, the House Republican leaders held the roll-call open for three hours while they bullied the fainthearted. George Bush, just back from Britain, stayed up unusually late on Friday to lobby congressmen, and was woken before dawn on Saturday morning to plead with a few more. Disillusioned Democrats accused the Republicans of “stealing” the vote, just as they were supposed to have stolen the 2000 election.
The vote in the Senate was less dramatic. The Democrats’ attempt at another filibuster was fended off, and the Medicare bill passed by 54 votes to 44 on November 25th, to the White House’s jubilation.
More than any other piece of Mr Bush’s domestic agenda, the expansion of Medicare to include prescription drugs is seen as the key to electoral victory next year. This is the biggest expansion of the government’s health-care plan for the elderly since it was introduced in 1965, and the elderly may account for one in four of the votes cast in the election. By bundling a big new benefit into Medicare, Mr Bush has shown that he gets things done in Washington (unlike those useless Democrats, who talked about drug coverage for years but failed to deliver).
Health care is a leading issue for many voters; it ranks higher than tax cuts, for instance. In the Democratic primary debates the contenders queue up to bash Mr Bush’s bill. Not only has health care been seen as Democratic turf, but also older Americans especially have distrusted the Republicans on Medicare, believing they meant to undermine the entitlement. After all, didn’t Newt Gingrich once hope in the 1990s that Medicare’s bureaucracy would “wither on the vine”?
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