does no one remember the prescription drug benefit?
I was reading this reader email to Andrew and I really had to wonder– was this person railing against cost overruns and budget deficits when the prescription drug benefit was passed?
It’s hard to imagine a starker divide between the anger over the cost of health care reform and the very recent history of the prescription drug bill. You know, that absolutely enormous entitlement expenditure that may be literally unprecedented in terms of expense for social spending, when all is said and done. Where were the protests then? The screams of socialism? The (metaphoric) blood in the streets? I’m not saying that this protest now is entirely illegitimate, although you know my feelings on the content of the issue. But I do think that the contrast is extreme, and troubling.
Compounding this bizarre turnaround are a couple of supplementing facts. First, there was never any talk of the prescription drug benefit paying for itself, or anything resembling such a thing. The degree to which we can actually pare down costs with health care reform is of course a matter of controversy. But a lot of smart people think we can; it’s on the table; it’s something we acknowledge that, in a country which spends 17 cents of every dollar earned on health care, we need to attempt. There wasn’t ever any hint that the prescription drug bill would be anything other than a massive, permanent public expenditure. Second, the moral, compassionate argument for reform– the one that I am frequently told is somehow illegitimate or unserious– simply was the argument for the drug bill. Seniors couldn’t afford their medication, and they were being driven to bankruptcy, and they had to drive to Canada, and in America, we couldn’t allow that to happen. Strange how much compassion and sacrifice are contingent upon concerns of sect and party.
Look, I think we all know why the prescription drug bill wasn’t fought against where health care reform is: the elderly are a protected political class, and those without health care are not. But few people are willing to admit to such naked horse race concerns behind their policy preferences. So what can people who are explicitly opposed to health care because of concerns of fiscal responsibility say in defense of the prescription drug benefit?
If you are blogging or writing politically now, and you weren’t then, you get a pass. If you have some separate reason for resistance to reform other than the expenditure, that’s ok too. But if you are specifically arguing that you don’t like health reform because it’s too expensive or fiscally irresponsible, and there’s no record of you arguing similarly against the wildly expensive prescription drug bill, it’s hard not to see that as hypocritical and partisan. Fair?