The Peril of Positioning Dems as Managers, Not Leaders

Senate Democrats are celebrating the fact that, in their rush to come up with a scheme to pay for health-care reform, they have blocked an effort to preserve payments to home health agencies that provide nursing care and therapy to homebound Medicare beneficiaries.

Dumb move.

Medicare is one of the most popular, and well-run, health care programs in the world.

It may not be as efficient as it should be.

But this public program is dramatically better run than private insurance firms. And it produces far better results for Americans.

Perhaps most significantly, the Americans for whom Medicare produces results for those older Americans who remain the steadiest voters in off-year elections.

Of course, Saturday's attempt by Republican senators to restore about $42 billion in funding to Medicare's home health-care programs was cynical.

The Grand Old Party has a long history of wanting to slash rather than expand Medicare.

But the Democratic "strategy" of paying for health-care reform by nickle-and-diming Medicare is a fool's errand.

There is no question that Medicare programs can and should be improved. And, yes, efficiencies can be achieved -- especially if profiteering by the private-sector recipients of Medicare money is controlled. Senate Finance Committee chair Max Baucus, D-Montana, may even be right when he says of the assault on home health benefits that: "We are getting the waste out."

But, somehow, that just not have the same ring as the declaration by Senator Mike Johanns, R-Nebraska, that: "The cuts will hurt real people."

No matter which side is right about the details of these particular cuts, a plan to pay for health-care reform by squeezing Medicare makes no sense when there are so, so, so many better places -- such as the bloated Department of Defense budget or allocated-but-as-yet-unused funds for "rescuing" financial-service industry speculators -- to find money to pay for expanding access to health care.

To begin the health-care debate in the Senate with Democrats celebrating their successful defense of Medicare cuts is madness. What next? Reform education by slashing day-care funding? Address the mortgage crisis by bailing out big banks? (Oops.)

After the GOP amendment failed -- having gained just 41 votes from Republicans and four centrist Democrats -- Senate Majority Leader Harry Reid, D-Nevada, tried Saturday to put things in the best light, saying, "The fact is that our bill will, in short, save lives, save money, and save Medicare," Reid said. "It will make it possible for each and every American to afford to live a healthy life. We can't afford not to do this."

But that the GOP television ads in next year's tightest Senate races -- including Reid's reelection race in Nevada -- will talk about Democrats cutting Medicare.

The problem with cutting Medicare to find money for health care reform is that is positions the Democrats as managers rather than visionaries, as bean counters rather than reformers.

That's not a fair characterization, especially when contrasted with the GOP's "Party of No" behavior.

But if the Democrats score many more victories like the one they achieved on Saturday, they are going to suffer the fate of parties that manage decline rather than lead for change. And it is not a pretty one.

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