Books such as What’s The Matter With Kansas note how people vote against their economic self-interest by voting Republican. The thought is that lower income individuals vote Republican despite the fact that Republican economic policies only benefit the ultra-wealthy. (They provide some token benefits for those making over $250,000, but to really benefit from the Republican it is necessary to make over $600,000.) This week’s activity in Congress shows that it isn’t only lower income voters who are taken for a ride by GOP, but also doctors.
Historically doctors have tended to vote Republican, with this trend weakening in recent years as more affluent voters have been voting Democratic. I do not agree with the idea that people should only vote based upon their economic self-interest. If people in the religious right feel that stopping gays from getting married is more important than having health care for their children I feel their values are severely warped, but in such a case it would make sense for many people in Kansas to vote Republican. On the other hand, why should doctors vote for the party which is anti-science and supports the teaching of creationism?
We certainly should not vote Republican based upon economic reasons. This week Democrats Harry Reid and Michigan Senator Debby Stanbenow tried to pass a measure to fix the Medicare payment formula which everyone agrees in flawed. Reid expected to receive some Republican support for a measure which fixes a problem harming the medical profession. The Republican Party, along with a dozen Democrats, blocked the bill.
Republicans are basically playing politics at the expense of physicians and Medicare patients here. Every year Congress has voted to override the pay cuts which the payment formula called for, and in reality eliminating the formula would cost no more money than we actually spend. Failure to override the formula would lead to most doctors no longer being able to see Medicare patients. While eliminating the payment formula makes sense, this allows Republicans to falsely claim Democrats are increasing spending. The Republicans hope to have the fix for the Medicare payment formula included in the health reform legislation. This would falsely increase the expense of health care reform on paper, giving the Republicans another talking point against. it.
The lesson here is that doctors should note that Republicans are not our friends. The same can be said by most other people in the country.
There is also an opportunity for Barack Obama here. He made a mistake in promising that health care reform will be budget neutral. Republicans did not consider the budget when they went to war in Iraq, or when they passed the Medicare D program, which provides massive subsidies to reward the pharmaceutical and insurance industries for their support.
Sometimes when there is a program which would be as beneficial to the country as health care reform we should spend what is necessary to do it right. Democrats have been far more fiscally conservative in recent years, but the Republicans continue to attack them with false claims that they are the fiscally responsible party. Democrats are going to be attacked for spending whether it is true or not, so they might as well spend money where it is beneficial. This would be the perfect time for Obama to say that he had wanted to make health care reform budget neutral but that is no longer possible because of the games being played by Republicans to inflate the costs of health care reform on paper.
