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The GOP's Top Chef Starves a Beast and Poisons a Debate

By Steven Pearlstein
Wednesday, August 26, 2009

Michael Steele, chairman of the Republican National Committee, this week revealed a secret Republican plan that would end up eliminating all federal farm subsidies; closing down Yellowstone and Yosemite national parks; selling off the interstate highway system; and canceling Head Start, subsidized school lunches and the entire college loan program.

The plan came to light as a result of an op-ed piece this week in The Washington Post in which the party chairman committed the GOP to spending an ever-increasing share of the federal budget, and the national income, on Medicare. When combined with other Republican promises -- to balance the budget, protect defense spending and never, ever raise anyone's taxes -- the inescapable inference is that the government would run out of money for every other domestic program sometime around 2035.

Steele's stunning announcement brings the conservative strategy of "starving the beast" to a new level. Under the guise of protecting the elderly, Republicans hope to realize their dream of eliminating half a dozen Cabinet agencies, firing tens of thousands of government workers and ending government regulation as we know it.

Steele's op-ed was the latest salvo in his party's campaign to defeat President Obama's health-care reform effort at all costs and build public support for a Republican alternative that remains, to this day, a closely held secret. The new Seniors' Health Care Bill of Rights, however, hints at the outlines of the GOP domestic strategy.

Steele promised that under the Republican health plan, runaway Medicare spending would continue unabated. Not only would that mean no cuts in benefits, but it would ensure that reimbursement rates to doctors, hospitals and drugmakers would continue to rise faster than inflation, regardless of how much they earn or how unnecessary or wasteful the services they provide. Any effort to contain future spending growth, Republicans now believe, is nothing more than a "raid" on Medicare, the government-run health plan that Republicans were against before they were for it.

The country's top Republican official also vowed to cut off all federal funding for research to determine what are the most effective treatments for heart disease, cancer, diabetes and even that new scourge, restless leg syndrome. Left unclear was whether he prefers to have such research done by the pharmaceutical and medical-device industries, but one suspects that is the case.

On the issue of end-of-life care, Steele was uncompromising: In a Republican world, no government funds could be used to pay doctors to provide information about living wills, hospices or palliative care, whether seniors and their families ask for it or not.

"Government programs that seem benign at first can become anything but," Steele explained in articulating the new philosophy. Once back in power, look for Republicans to apply the same approach to issues such as flu vaccinations, disaster relief and air traffic control.

According to Steele, Republicans will also seek to outlaw "any effort to ration health care based on age." You don't have to be a lawyer like Steele to understand that would effectively make it a federal crime for any hospital to refuse a heart transplant to a 95-year-old, or for any doctor to refuse to prescribe Viagra to a sexually precocious seventh-grader. Although Steele did not indicate what the penalty would be, he did not rule out the death penalty.

Indeed, Republicans seem determined to preserve the uniquely American system under which health care is rationed today -- on the basis of employment status and ability to pay. According to the respected Institute of Medicine, this market-based approach to rationing has held the number of untimely deaths each year to a mere 18,000 uninsured souls. Thanks to Medicare, all of those victims are younger than 65, but apparently that is the kind of age-based rationing that real Republicans can embrace.

After reading his broadside, one is left wondering exactly what health reform plan Steele thought he was attacking. At one point, Steele claims that Democrats would prevent Americans from keeping their doctors or an insurance plan they like. Later, he warns that government will soon be setting caps on how many heart surgeries could be performed in the United States each year. Where is he getting this stuff? Has the chairman of the Republican Party somehow gotten hold of a top-secret plan for a government takeover of the health-care system that GOP operatives snatched during a break-in at Democratic National Committee headquarters?

If all that sounds spurious and unsubstantiated, it is. And like many of the overstated claims in this column, its purpose is to highlight the lies, distortions and political scare tactics that Steele and other Republicans have used to poison the national debate over health reform.

Have you no shame, sir? Have you no shame?

Steven Pearlstein will host a Web discussion at 11 a.m. today at washingtonpost.com. He can be reached at pearlsteins@washpost.com.

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