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THE DO-NOTHING CAUCUS.
Long ago, my then-colleague Sam Rosenfeld coined the term the "Pain Caucus" for the peculiar strain of establishment wise men (and women) who seem to think the only truly courageous policy reform is the policy reform that causes immense pain to people who aren't them. Watching a group of chin-strokers on Capital Gang pat each other on the back for their courage in championing cuts in Medicare, Rosenfeld wrote:
This belief on the part of the centrist liberals on the panel is not, of course, grounded in empirical reality, but rather a particular, long-outdated conception of what responsible policymaking entails and what kind of political action should be deemed courageous...The pain caucus included such stalwarts of independence and bipartisan sobriety as John Breaux and Bob Kerrey, the latter of whom in particular made something of a fetish out of championing policy prescriptions that maximized the ill effects on those dependent on the support of federal entitlement programs. For his efforts he was rewarded with a reputation for fiscal responsibility and political courage by the establishment Beltway press...Fortunately for the Democrats, most of the self-styled pain caucusers in their midst have retired. But the pundit class that encouraged their "eat your vegetables" temperament is still around.
These are the benefit cutters and means testers and age raisers -- folks who loudly champion a set of painfully austere entitlement reforms despite the fact that the government's fiscal worries are a) not about Social Security and b) driven by health care spending, not Medicare promises. It is, in other words, an aesthetic posture more than a policy argument, but it's utterly pervasive in Washington.
Take Robert Samuelson's column today, exhorting the young -- and hey, kemosabe, I am the young -- to "get mad" over the unsustainable course of government spending and start picketing outside AARP (I'm not kidding, that's actually one of Samuelson's suggestions). "You face a heavily mortgaged future," says Samuelson. "You'll pay Social Security and Medicare for aging baby boomers. The needed federal tax increase might total 50 percent over the next 25 years...There are three basic ways of reducing the costs of Social Security and Medicare: increase eligibility ages; trim benefits; and require recipients to pay more for their Medicare benefits (higher premiums, co-payments or deductibles)."
Number one: There is no such program as SocialSecurityandMedicare. It doesn't exist. There is Social Security, which is a pension program predicted to endure manageable cost growth in the foreseeable future. It poses no threat to the federal budget. Claims that it is in crisis are a lie. Claims that it requires sharp cuts in benefits or hikes in the retirement age are a lie.
Then there is Medicare. Medicare is a trickier problem. Because it's not the problem: The American health care system is. As Henry Aaron, the centrist Brookings health care expert has testified, our fiscal threats "derive entirely from projected increases in national health care spending, not from problems peculiar to government health care or entitlement spending." As such, "materially slowing the growth of Medicare and Medicaid apart from general health system reform is impossible." In other words: Raising the eligibility age or cutting benefits does not solve the problem. It does not solve the problem for the private sector, of course, but it does not solve the problem for the public sector, either. The problem is driven by rapid growth in health care costs. If you do not arrest that growth -- in both the public and private sectors -- and you instead raise the eligibility age for Medicare, you will just have to do it again. And again. And again. When wise men like Samuelson write columns arguing that the government must cut benefits or raise eligibility, they are arguing for doing nothing about the central fiscal problem facing the government. And frankly, on behalf of my generation, I resent that.
COMMENTS (18)
Boatloads of academic economists and international policy 'experts' derived nearly sexual pleasure the market fundamentalists got out of recommending tough "belt-tightening" programs of "austerity" and "structural adjustment" on South American and Africa throughout the 1980's.
Such approaches have now been rejected throughout much of the 3rd world, but the same types get excited about the opportunity to do the same here.
http://tinyurl.com/CEPR-Africa-Struct-Adjust
Posted by: El Cid | October 22, 2008 10:28 AM
Check out the latest Alaskan poll -- McCain Palin only up 11 points... sound like someone with 80% approval rating??? wonder what is really is now.
http://www.anchoragepress.com/articles/2008/10/21/news/doc48fe45ae7c782835927877.txt
Bush won by 31 points in 2008
Posted by: Anonymous | October 22, 2008 10:34 AM
Aren't the Blue Dogs basically the Pain Caucus?
Posted by: eRobin | October 22, 2008 10:59 AM
These are the benefit cutters and means testers... [snip] folks who loudly champion a set of painfully austere entitlement reforms
I imagine this is what it's like to use government services in Texas. Can anyone confirm or disprove my suspicion?
Posted by: ThresherK | October 22, 2008 10:59 AM
But remember that the pain caucus only wants to inflict pain on certain classes of people. The pain that would be inflicted on insurance companies by forcing them to honor their contracts, or on people making more than a million dollars a year by taxing them at mid-1960s rates (even adjusted for inflation), or on CEOs by limiting their compensation to a mere 300 times that of their lowest paid workers just won't do it for them. It has to be good, solid working-class pain.
Posted by: paul | October 22, 2008 11:45 AM
Does anyone out there know how much it would cost to nationalize the health insurance industry? That's a serious question. We can nationalize banks and investment banks to the tune of $1 trillion. How much would it cost to flat out purchase the health insurance industry?
Posted by: Rob Mac | October 22, 2008 11:55 AM
Bush won by 31 points in 2008
Man, only in Alaska.
Posted by: Allen K. | October 22, 2008 12:23 PM
Can you unpack this a little, Ezra? If the problem with Medicare is the general health care system, what will health care reform actually do to reduce the growth in Medicare spending in the next few decades? I assume you don't mean some kind of magic whereby health care reform makes people so healthy that they no longer require expensive medical procedures when they become older.
Posted by: Ron E. | October 22, 2008 12:47 PM
How much would it cost to flat out purchase the health insurance industry?
something like negative 350 billion. obviously we can't afford to save that much money.
Posted by: tatere | October 22, 2008 1:01 PM
For a fascinating look at the long history of the "pain caucus" in political philosophy (and practice), I super-duper highly recommend Marilynne Robinson's book Mother Country. She's best known as a novelist (Houskeeping, Gilead, and the recent Home) but to my reading she shines even brighter as an essayist. Mother Country is something of an old fashioned book-length polemic. She begins with the question: can we make sense of the fact that the UK government simultaneously provides socialized medicine and socialized leukemia (through the radioactive releases from the Sellafield nuclear reprocessing facility)? To answer the question, she goes through the entire history of British political/economic philosophy from the onset of the original Poor Laws (Platonic ideals of the "pain caucus"). Taking a page from Marx, she dares to read all the original writings of those she's analyzing. Amazing stuff.
Posted by: Jonathan Teller-Elsberg | October 22, 2008 1:48 PM
ooooooooohhh noes! not the mean-testers! those awful people who want to reduce the transfers of wealth to the upper-middle class grannies! anything but means testing!
Posted by: jamie | October 22, 2008 10:33 PM
Hey Ron E., read this article from Jon Cohn for the unpacking you desire:
http://tinyurl.com/6gth9x
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Posted by: baby changing stations | October 24, 2008 3:54 AM
It's not possible! It'll take too much money to nationalize the health insurance.
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Totally agree. We really need to undergo health care reform.
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