The Medicare game

Grab some munchies, turn the television to C-SPAN, and get comfortable on the couch. The Super Bowl may be over, but another big game is under way, and you really shouldn't miss it.

Each year in Washington, the two political parties square off in a game called Medicare. Those who watch the annual debate over this huge and fast-growing program know that the players in the Medicare game-members of Congress-can be very intense and sometimes downright dirty. As Medicare continues to careen toward insolvency, this year's game features the two parties offering competing plans to add a prescription drug benefit to the program.

To first-time viewers, it may seem a little strange to pile more costs on an unsustainable program, but fans of the Medicare game recognize that this fits nicely within the rules that have developed over the years. So for the benefit of newcomers, here's a guide to the Medicare game's rules:

First rule: Facts are irrelevant.

It doesn't matter in the Medicare debate that those age 65 and older have a higher median household net worth ($158,500) than any other age group (Source: Institute for Social Research, University of Michigan). It also doesn't matter that the typical senior spends almost twice as much eating out at restaurants than he spends out-of-pocket on prescription drugs (Source: Bureau of Labor Statistics). Nor does it matter that federal spending on retirees already is spiraling out of control, to the point that after the baby boomers retire, the U.S. may turn into a giant France-i.e., a country taxed into routine double-digit unemployment rates.

Never mind all that. Only two facts matter in the Medicare game: Seniors vote, and they want what they see as their money. But it's actually other people's money, because of another unmentionable fact: A typical senior today receives thousands of dollars more from Medicare than he ever paid into the program (Source: Congressional Budget Office).

Second rule: Congress will not consider any reform proposal that reduces anyone's handout, even if the proposal only affects the wealthiest seniors.

Some renegade congressmen, noticing Medicare's dire future, have suggested that Congress raise the eligibility age for the program, or Òmeans testÓ it-i.e., make middle-class and wealthy seniors ineligible. The idea is that the healthiest and wealthiest seniors should be able to pay for their own routine, noncatastrophic medical expenses instead of burdening an already overburdened program.

But the rules of the Medicare game are strict on this point. Legislators can try to change the program's structure (as President Bush wants to do), but they cannot, under any circumstances, reduce any senior's take from taxpayers. In the Medicare game, it doesn't matter that the end result is relatively wealthy retirees taking money from the paychecks of relatively poorer workers.

Third rule: The Democrats are always on offense, and the Republicans are always on defense.

Republicans may have a reputation for being tough guys and Democrats for being softies, but that's not the case in the Medicare game. The Democrats are in constant, ruthless attack mode, while the Republicans cower in a corner. The GOP's fear is justified: Democrats have repeatedly used scare campaigns about Medicare (and her older sister, Social Security) to defeat Republicans at the polls. Former President Bill Clinton was the Michael Jordan of the Medicare game-a master player without parallel. He deftly orchestrated a scare campaign about Medicare to regain popularity after Democrats lost control of Congress in 1994. Gun-shy Republicans have learned the harsh reality of the Medicare game: GOP legislators who offend the senior lobby go directly to the private sector, do not pass go, and do not collect $200.

Fourth rule: The referees favor the Democrats.

The Democrats are on permanent offense in part because the refs in the Medicare game-the press-make sure of it. Reporters (most of whom vote for Democrats, according to surveys) regularly repeat Democratic anecdotes about poor seniors who desperately need expanded subsidies-like, say, a prescription drug benefit. The refs rarely stop to ask the Democrats why their Medicare proposals always benefit the wealthy and middle-class elderly, not just poor seniors. And the refs rarely question Democratic portrayals of Republicans as cold-hearted monsters for having, at one time, wanted to slow the growth of Medicare spending. The refs have a special rule for Democrats: lots of harm, no foul.

These are the rules for the Medicare game. As you observe the debate, notice how the players follow these rules with uncanny precision. And you may as well tune in and watch, because if you're a working taxpayer, you will pay for a ticket.