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Heighten-the-Contradictions: From the Center, It’s No More Convincing

[ 64 ] December 10, 2012 |

Dayen has this covered fairly well (although I don’t endorse the ad hominem bits), but I still have a some things to say about Jon Chait’s call for a pre-emptive surrender on raising the Medicare eligibility age. First of all, Yglesias is right that it’s impossible to evaluate the concept without knowing what we’re getting in return, and it’s true that to get something in a negotiation you generally have to give something. But this really helps Chait only in the most theoretical sense. Not only because Chait is offering to make what everyone agrees would be a really, really terrible policy concession without explaining what Republicans have to give up for it, but because nothing that’s being discussed would make remotely it worth it. Sure, if you could really substantively strengthen the ACA by trading the eligibility age for a robust public option and more money for Medicaid that would provide greater incentives for recalcitrant states, that might be worth doing. But there’s no plausible scenario in which Republicans will actually offer anything like that. The actual deal apparently being discussed — trading terrible Medicare policy changes for less than you’d get in upper-class tax rate increases if you just did nothing — would be an incredibly bad deal that suggests that Obama hasn’t learned anything about dealing with congressional Republicans. Right, you have to give something to get something — but the expiration of the Bush tax cuts and the defense cuts in the sequester already provide plenty of leverage.

So why on earth are we talking about making a major policy concession on Medicare in exchange for unspecified concessions that Obama can probably get using the leverage derived from the sequester? Chait offers a couple of unconvincing justifications. The first argument is that raising the eligibility age has a “weirdly disproportionate symbolic power, both among Republicans in Congress and establishmentarian fiscal scolds. Mitch McConnell and Erskine Bowles alike would regard raising the retirement age as a sign of serious belt-tightening and the “structural reforms” conservatives say they need.” I don’t really buy it. Bowles might like it, but he doesn’t actually have any meaningful constituency. In terms of congressional Republicans I’m much less convinced. Again, I need to know what I’m getting in exchange for this, and there’s nothing Republicans seem to be offering that wouldn’t be plausibly attainable by offering middle-class tax cuts and restoring some defense spending after January 1. (And I’d rather compromise on tax rates than by weakening the welfare state, particularly since any win on raising the top marginal rates will last until the next time the Republicans control the White House and the House of Representatives simultaneously.)

There’s a second justification, which is essentially a heighten-the-contradictions from the center. The policy change will be so bad that it will be good because people will agitate to make it better:

What’s more, raising the Medicare retirement age would help strengthen the fight to preserve the Affordable Care Act. Republicans may be coming to grips with their lack of leverage over the Bush tax cuts, but their jihad against universal health insurance lives on. Having narrowly lost their wildly tendentious legal argument for striking down health care, they are devising newer and even more implausible ones. Republican governors continue to turn down federal funding to cover their poorest uninsured citizens and refuse to set up private insurance exchanges.

The political basis for the right’s opposition to universal health insurance has always been that the uninsured are politically disorganized and weak. But a side effect of raising the Medicare retirement age would be that a large cohort of 65- and 66-year-olds would suddenly find themselves needing the Affordable Care Act to buy their health insurance. Which is to say, Republicans attacking the Affordable Care Act would no longer be attacking the usual band of very poor or desperate people they can afford to ignore but a significant chunk of middle-class voters who have grown accustomed to the assumption that they will be able to afford health care. Strengthening the political coalition for universal coverage seems like a helpful side benefit — possibly even one conservatives come to regret, and liberals, to feel relief they accepted.

As with most heighten-the-contradictions arguments, this is unconvincing in the extreme. First of all, particularly given that a significant number of states haven’t bought into the Medicaid expansion and aren’t in any hurry to establish functional exchanges, this will create a lot of suffering for people while we wait for 66- and 67- year olds to work their political magic and convince Republicans to strengthen the ACA. (We’re also assuming that seniors in deep-red states will blame Republicans rather than the ACA for losing their insurance, which seems…optimistic.) And second, as Dayen says in his follow-up response, the idea that “that the reliance of those aged 26-64 on insurance exchanges to deliver affordable health care is not enough of a constituency behind the program, but adding in those aged 65 and 66 will simply put it over the top” isn’t well-founded. A leftist who took their own heighten-the-contradictions rhetoric against the PPACA seriously might favor the Ryan voucherization program and would have logically opposed Medicare when it was passed.  As we saw during the debates over the PPACA giving everybody over the age of 65 single-payer made assembling a coalition for better heath care policy going forward much more difficult, since a class of people disproportionately likely to vote had nothing to gain and things to fear from universal health care reform. (Fortunately, most lefties making h-t-c arguments don’t really take them seriously, and since Medicare wasn’t signed into law by Barack Obama but by a previous Democratic president whose compromises can be forgiven, the suffering-now-because-magic-ponies-later logic isn’t compelling to anybody.) Even so, this would be a terrible idea because getting European-style health care (whether in hybrid or single-payer form) would be enormously difficult even with more people over 65 on your side; the most likely outcome of not doing Medicare would have been worse coverage for seniors and nothing for everyone else, not Medicare for all. It’s hard to imagine what political power 66- and 67- year olds alone will add to your coalition that could make this kind of concession worth it, and moreover it can “work” only by completely screwing them over in the short-term for benefits that may or may not materialize. I’ll pass, thanks.

…Cohn has more.

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  1. snarkout says:

    As a semi-defender of Chait, the thing he’s missing that makes this notional deal Vernon Wells-level bad isn’t the policy, where Democrats are not going to receive value for any even semi-plausible deal they broker where they raise the Medicare eligibility age, but the politics, where for the next ten years Republicans are going to have something else to point to when they insist that they, not Democrats, are the true defenders of Medicare, Republican attempt to voucherize Medicare notwithstanding. Just a boneheaded column on Chait’s part.

  2. Walt says:

    You mention to the key issue, which is that this would be a gigantic win for the Republicans. They would get to damage the welfare state, and pin the blame on the Democrats. Fox News will run stories day and night on how it’s all the fault of the ACA.

  3. Tybalt says:

    Thank you for pointing out that Bowles has no constituency. The whole Bowles roadshow is a stalking horse for complete surrender and nothing more.

    Anyone who would be in any way persuaded by Bowles’s endorsement of a compromise would be equally persuaded by that of the Congressional Republicans.

  4. Murc says:

    Chait is generally one of the good guys, but he’s… I mean, he’s so wrong on this the only conclusion I can reach is he got hit on the head or something.

    The nicest thing I can say is that he seems to entered the fantasy world where the Republicans are a grown-up political party that wants to govern. They are not. They have at their disposal the awesome power of not caring. This grants them enormous freedom.

    They closest thing they have to something they want is that they want to torch the New Deal and that a few of them have some vague interest in keeping the lights on. That’s it. You’re not going to get anywhere productive thinking about them without keeping those facts in mind.

    Chait also falls into the trap of thinking “if Democrats do X, the Republicans can’t attack them for not doing X.” That requires facts not in evidence.

    This is the charitable interpretation of Chait’s actions. The uncharitable ones assume that he actual somehow thinks raising the eligibility age is a minor concession of only symbolic importance. I’ve meant a lot of otherwise sharp, sensible people who think this. They tend to either be young, or have intellectually fulfilling and physically undemanding jobs they plan to be doing into their 70s anyway. They also tend to buy into the lie that life expectancy at 65 has gone way, way up over the last half-century.

    • Scott Lemieux says:

      Chait also falls into the trap of thinking “if Democrats do X, the Republicans can’t attack them for not doing X.” That requires facts not in evidence.

      Right. The response of the Pain Caucus to this Medicare sellout wouldn’t be “see, this proves that the Democrats are Serious,” it would be “surely, we can now reach a bipartsian agreement on raising the eligibility age for Social Security to 74.”

      • JKTHs says:

        No it’ll be more like “Look Medicare spending still goes way up so we have to do way more on Medicare.” And remember that provider/prescription drug price cuts don’t count.

        • Murc says:

          They can do both!

        • A says:

          Elaborating JKTH’s point: Indeed, there are side effects of increasing the Medicare eligibility age, which Republicans like:
          - The younger (65to67-) and therefore, on average, healthier Medicare beneficiaries and payers are removed from the Medicare program; hence the remainder of Medicare will be more expensive, per person.
          - Some of the 65to67- set will defer needed or preventative treatment, making it more expensive to treat once they are eligible for Medicare, making Medicare more expensive.
          => So Medicare looks worse, “We cannot afford it.”
          - Now those of the 65to67- who join Obamacare, being older than the rest of those covered by Obamacare, will increase the cost of Obamacare.
          => So both Medicare and Obamacare will look worse. What’s a Republican not to like about it? More so, if presumably one dollar saved in Medicare requires the 65to67- set to pay two dollars for Obamacare. That fits in nicely with the propaganda point, that “Obamacare will destroy Medicare.” And it is done by Obama himself.
          (I hope not. If he does, get the pitchforks ready).

    • Stan Gable says:

      I get a little frustrated that folks like him and Ezra Klein seem wayyy too willing to take everything at face value. This is a terrible policy that’s been floated by McConnell and other R’s – how many elected D’s are on record saying that they’d be open to considering this?

      My guess is that it’s floated to Chait/Klein to try to goad Republicans into formally proposing a hideously unpopular policy.

      • thusbloggedanderson says:

        Klein’s blog is at least posting stuff to explain what a bad idea the age hike is.

        When Chait’s good, he’s very good. Here, he is not good.

        • Stan Gable says:

          I think that they’re both allowing themselves to become part of a misinformation campaign, which I don’t think is the business that they’re supposed to be in.

          I don’t think either one of them has mapped out why they think this is a plausible outcome other than that some high-profile administration folks have told him they’d consider a deal off the record.

          I can maybe see Boehner squeaking this through the house but I have a hard time imagining how this passes the Senate.

  5. TT says:

    Wait, wasn’t FDL an epicenter of anti-ACA screeds at a moment when passage was very much in doubt? And didn’t they employ the same “magical ponies” BS justly castigated and demolished here and elsewhere, i.e. if we kill the ACA then the healthcare system will become so terrible that the revolution will come and bring single-payer, France/Singapore, etc. with it? And now they and others have the stones to lecture Chait about wanting to inflict misery on others?

    Look, I agree wholeheartedly that Chait offers up some preposterously unconvincing rationales for justifying a move that would be both terrible policy on the merits as well as an unforgivably stupid negotiating concession. But spare me the lectures about misery and suffering from FDL, Digby, and others who’ve done nothing but shit all over the ACA before, during, and after its enactment, and who were perfectly willing to let untold numbers of people they allegedly care about go bankrupt and/or die for another generation just to make a point.

    • Scott Lemieux says:

      Well, yes, there was a lot of terrible h-t-c horseshit about the ACA. It’s also a site with many writers, and that some writers got the ACA wrong is a dumb reason not to link to arguments that are right (just as I’m happy to give approving links to Chait when he’s right.)

  6. JKTHs says:

    Note the lack of concern for the 65 and 66 year olds living in non-expanded Medicaid states.

  7. I would not even discuss any increase in eligibility age nor any reduction in any Medicare or Social Security benefits until McConnell and Boehner state, in public, on camera, that “We, the Republican Party, and all Republicans agree, that demand that Medicare and Social Security benefits be reduced and that 65 and 66 year old people should not be eligible for Medicare. We demand that this be done, or we will never agree to any compromise on taxes.”

    Let them put that on the record and we can go from there.

    If Obama, who impressed me with how well he handled his re-election campaign, is interested in being an effective and popular president, he will do nothing to reduce benefits or raise eligibility. There are too many better choices and there is nothing, not one thing, politically or economically, to be gained by reducing benefits or raising the eligibility age.

    That’s all I have to say on this.

    • mpowell says:

      I have to agree on this point. Chait is being an idiot by proposing that Dems offer this up front. Let the Republicans screech and demand it and see what they are offering, then you can consider it. But only then. And my actual opinion is that they have no interest in raising the medicare eligiblity age. In general, these Republicans have no interest in actual governance, so picking things to cut holds no interest to them, but raising medicare eligibility is not something their voter base wants (as opposed to their financing base).

      I also think Chait simply overlooks the fact that raising the medicare age is terrible policy. Many people are confused about the fact that medicare costs much less than private healthcare and this is a truth that goes beyond budgetary balance issues. Reducing the federal deficit by raising the eligibility age makes the economy worse, even in a situation where reducing the federal deficit would normally help the economy.

  8. Josh G. says:

    Ezra Klein’s proposal makes no sense at all. It amounts to preemptive surrender. The Republicans get the top tax rate at 37% (instead of the 39.6% already set to take effect automatically on Jan. 1) *and* they get to take away two years of Medicare. What do Democrats get in return? Ezra seems to think that having Republicans actually sign off on the tax changes is some kind of meaningful compromise. But this doesn’t actually matter a damn; the rates are going into effect whether the Republicans want them or not. They are already baked into the cake. If they want rates on top earners to be any lower than 39.6%, then *they* will have to give up something. Maybe if they were willing to *lower* the Medicare eligibility age to 62 in exchange for a 37% top rate, it would be worth it.

    • Hogan says:

      It’s not Ezra Klein’s proposal; it’s what people are telling him is the deal on the table. He’s not a fan.

      • Josh G. says:

        Even if the White House was stupid enough to go for this (which I do not believe), how do they expect to get the needed votes among Congressional Democrats? President Obama won’t be running for election again, but most members of Congress will. Democrats in solidly Democratic districts will be against this because it’s terrible policy that the party base hates, and Democrats in swing districts won’t want to open themselves up to “he voted to cut Medicare” attack ads.

  9. catclub says:

    “and there’s nothing Republicans seem to be offering”

    Can anyone say what the Republicans ARE offering?

    All I have seen is some vague words on deductions, but mostly, aren’t they just still waiting for concrete surrender from the Democrats. No concrete proposals of their own?

    • somethingblue says:

      All I have seen is some vague words on deductions, but mostly, aren’t they just still waiting for concrete surrender from the Democrats?

      Well, and why wouldn’t they? If Klein can be believed, the Democrats are eager to oblige. We’re in for another round of making preemptive concessions “in hopes” of appealing to putatively pragmatic Republicans.

      Seen this movie before, didn’t care for the ending.

      • If Klein can be believed, the Democrats are eager to oblige.

        Of course, he said the same thing in July 2011, and that ended with no such surrender on entitlements, as well as the same sequester cuts and the Republican political rout that give the Democrats so much more leverage this time around.

        Once again, looking very serious about wanting a deal on these things is part of sticking the Republicans with the blame for the stalemate.

  10. Murc says:

    To be perhaps overly fair to the Republicans, they’d be dumb to offer up concrete proposals of their own. Both the Congressional Dems and the White House have spent many years demonstrating a willingness to negotiate with themselves. If I were a Republican negotiator, I would want to see really hard proof that they’ve stopped doing this before I started offering up my own deals.

    John Boehner sounds arrogant when he says things like “Well, we want the White House to pitch us rather than put our own deal down” but really, that’s just being semi-intelligent. If he ends up needing to put his own proposal down he’s lost nothing, and if the White House decides to actually do as he says he’s won.

    • Josh G. says:

      The Democrats in Congress have been fairly clear and consistent since the election in stating that cuts to Social Security or Medicare are not acceptable.

      • somethingblue says:

        It’s cute that congressional Democrats think they have leverage here. Republicans control the House and there are 47 Republican senators. Conrad, Lieberman and Nelson (all retiring, not that Lieberman would care anyway) + Biden get you to 51.

        • JKTHs says:

          Sure, but in January there will be 45 Republican senators and nobody will be retiring in the immediate future.

          And that’s not to mention what else would be different (tax cuts expired etc.)

        • Stan Gable says:

          If there’s a decent bloc of Democratic Senators who hate this idea (and I think there are) then there’s very little chance that this can get through in the next 21 days.

          Opponents can slow-walk the hell out of it and run out the clock, this is particularly true in that there is no deal right now that we know of and I can’t imagine that Reid would even try to open debate unless the bill had actually been passed by the House (given the GOPs unpredictability).

    • NonyNony says:

      Yeah but the White House did put a proposal down. Geithner went and told them what it was and everything.

      I’m still trying to figure out where all of these other proposals are coming from, because the starting point that the White House came from the other week didn’t look anything like what people are talking about, and Republicans haven’t come back with anything other than bluster.

      • catclub says:

        “Republicans haven’t come back with anything other than bluster”

        I thought so, but was just asking to make sure I had not missed something.

      • FlipYrWhig says:

        Yeah, I don’t get what this is all about either. It sounds to me like something wonks are kicking around, like, “If something like this WERE the deal, would we like it? Let’s see.” But across the blogosphere it’s being taken as A Trial Balloon from inside the negotiations.

        • FlipYrWhig says:

          That’s what I get from the original Ezra Klein key phrase: “Talk to smart folks in Washington, and here’s what they think will happen.” I don’t see that “smart folks in Washington” are anyone of consequence to the actual deal, rather than wonks parsing public statements just like the rest of us do.

          • parsimon says:

            Indeed, as far as I can tell, Klein and Chait are the only people talking about this. We’re to believe their reporting on what’s being said behind the scenes.

            Or have I missed some rhetoric from conservatives, somewhere?

  11. [...] Here’s Scott Lemieux with a nice short comment on the state of the negotiations: The actual deal apparently being discussed — trading terrible Medicare policy changes for less than you’d get in upper-class tax rate increases if you just did nothing — would be an incredibly bad deal that suggests that Obama hasn’t learned anything about dealing with congressional Republicans. Right, you have to give something to get something — but the expiration of the Bush tax cuts and the defense cuts in the sequester already provide plenty of leverage. [...]

  12. scott says:

    Why not endorse the ad hominem bits? Personally, I think if people offer up bad arguments in favor of policies that could make millions of people miserable they ought to suffer some personal villification. Ridicule and shame are powerful things, and I can’t think of many more appropriate reasons to use them than when some pundit offers up the lives of millions of (other) people in exchange for Very Serious Person cred. So-called progressives seem all too willing to participate in the fun pundit parlor game of making granny starve to prove how tough they are, and they ought to pay a price in social shunning and embarrassment for it.

  13. Bill Michtom says:

    A few things …

    an incredibly bad deal that suggests that Obama hasn’t learned anything about dealing with congressional Republicans.

    I don’t think the problem is what Obama has learned. History tells me that he’s pretty much fine with screwing the masses while talking pretty. That’s how he gets elected, as this demonstrates:

    If Obama, who impressed me with how well he handled his re-election campaign …

    And Bowles has a constituency, the guy who appointed him and the other safety-net haters to the Cat Food Commission.

    Finally, what is h-t-c?

    • Hogan says:

      Shorthand for “heighten the contradictions.”

    • Scott Lemieux says:

      You seem to be assuming that this deal Chait advocates is already done, when not only has Obama not agreed to it, he hasn’t even proposed it, and the president of CAP trashed the idea on MSNBC (an odd move indeed if the administration favors it.)

      • tonycpsu says:

        It’s frustrating that the leftosphere doesn’t have much of a choice except to rend its collective garments when a rumor like this comes out, no matter how flimsily-sourced (“Ezra Klein says ‘smart people in Washington say’…”) As Digby says, if you don’t say “awww hell no!” very loudly, the sources of the trial balloons will assume that silence is acceptance.

        I know Klein would describe himself as just a reporter, but by catapulting this particular propaganda, he’s actively increasing the chances of a shittier deal. Talking about the possibility of this deal as if it’s really on the negotiating table shifts the Overton window, and suddenly if a deal comes out that keeps the Medicare age at 65 but only raises the top marginal rate to 37%, much of the public will see that as a win.

        • JKTHs says:

          The shifting the Overton window is like during the debt ceiling when the Republicans were referring to the debt ceiling increase as an Obama “win” and not just the prevention of total catastrophe. That way, they could try to make it sound as if the final agreement was a deal and not a ransom.

      • Perhaps “History” tells him that Obama favors the deal that he’s never endorsed.

  14. wengler says:

    This outlines the strategy that I mentioned awhile ago. The Republicans will pit Medicare against Obamacare again and again. Their sponsors will secretly prefer Obamacare of course, but the whole point will be to create a ‘Democrats in Disarray’ narrative.

    • Ed says:

      ….but the whole point will be to create a ‘Democrats in Disarray’ narrative.

      And to use Obama’s wish to protect his centerpiece legislation to get concessions from him on the social safety net. That way, they have some cover, just as Obama’s previous offer affords them cover.

  15. [...] other things being equal, raising the Medicare eligibility age is nuts. There might be some overall deal that is just so great that could allow me to swallow that [...]

  16. parsimon says:

    I find the nested comments system here difficult, by the way. Can’t tell where the newest comments are without a great deal of scrolling. Maybe there’s some method by which I might simplify this.

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