Last year John Boehner, as a Republican leader in the House of Representatives, asserted that we could cut taxes, avoid cuts to any popular program, and balance the budget. Last week, as Speaker of the House, he led the drive to pass H.R. 2, the Repealing the Job-Killing Health Care Law Act, even though the Congressional Budget Office (CBO) says repealing last year’s healthcare reform law would increase the deficit.
Claiming CBO was only voicing an opinion rather than releasing an analysis, Mr. Boehner produced his own analysis. His analysis actually reverses the CBO’s analysis, and claims healthcare reform increases the deficit. How? First of all, the Speaker’s analysis asserts that the true cost of reform includes the cost of the “doc fix” – an issue that stretches all the way back to 1997 when Congress enacted a formula to determine Medicare payments to physicians. The badly flawed formula lowered doctors’ payments to the point where they would lose money by accepting Medicare patients. Instead of changing the formula, Congress has consistently enacted 1-year fixes. Boehner’s analysis argues that the cost of future fixes, about $208 billion over the next 10 years, should be considered a cost of healthcare reform even though the same spending would still be necessary if we were to undo reform. The CBO analysis says healthcare reform will increase Social Security revenues and reduce Medicare costs. But the Boehner’s analysis says these sums don’t count because the savings realized would extend the life of these programs’ trust funds, and so shouldn’t be counted as savings because eventually the money will be spent anyway.
The logic is so fuzzy that one can only conclude that either Mr. Boehner and the Republican right have lost it, or they are trying to muster excuses to support what is, in fact, an ideology. Neither Boehner nor the Republican right are opposed to reform because it will increase the federal deficit or kill jobs. They are opposed to reform because it would cover the uninsured. It’s not about the money at all. The modern GOP’s ideology holds that the suffering of the unfortunate isn’t a proper concern of government, that each individual must provide for him/herself in a free society; that the only proper role of government is to protect property rights, adjudicate disputes, and provide a legal framework that protects economic activity. Therefore, all efforts by government to redistribute wealth are improper; thus, alleviating suffering at taxpayer expense is immoral regardless of how little or how much it costs. We are having a logical debate about the benefits and costs of healthcare reform. We are, in fact, fighting a battle of ideologies.