Wednesday, November 16, 2005

In the ongoing war of ideas, conservatives just earned some powerful new ammunition. This week, senior citizens began enrolling in the new Medicare prescription drug program, and early evidence suggests the market-oriented reforms Congress passed nearly two years ago are having a better than expected effect.

But the liberal counterassault is already underway. These critics oppose competition, empowering consumers, and want a larger role for the federal government. Liberals, for example, argue the pace of enrollment is too slow (proving, they will say, the new program is unpopular) or it’s too confusing (all these new options and choices are not good for seniors). The Left recognizes the stakes and is mounting ferocious attacks to discredit the prescription drug plan.

Conservatives, unfortunately, have focused almost exclusively on the potential cost of the program, ignoring the market-oriented reforms in the Medicare law. Republicans and conservatives need to shift emphasis, rethink their rhetoric and take credit for these early successes.

Market-oriented health care reform proponents have a huge stake in the successful rollout of this new program. If it thrives, the innovative changes provide new momentum for market-oriented,consumer-driven policies. If it fails, we move backward, to a government-run, one-size-fits-all program. We now stand at a fork in the road in American health care. Liberals understand that, but do conservatives? As President Bush noted in his radio address last Saturday, paying for prescription medicines can save the overall program money in the long run. Why should Medicare pay $100,000 to treat the effects of a stroke, when it can pay $1,000 for blood thinning medication to avoid one? But there is more. Conservatives need also to recognize that market-oriented reforms included in the Medicare legislation are now bearing fruit. Maybe more than they know. Principles that conservatives championed for generations are now being tested — and succeeding.

Consider the new drug benefit. Instead of one plan, with one co-pay and one deductible, seniors now have a menu of options to match their health needs. And competition among providers is driving prices down — about 15 percent less than experts predicted, according to the Bush administration. So because of the market-based principles included in the program, seniors have more choices, pay less, and the overall program will cost the government less money.

But critics will take a conservative principle — like providing more choices to seniors — and turn it around saying, “all these alternatives are too confusing.” A Kaiser Family Foundation report released last week illustrates this point, as did stories in the New York Times and The Washington Post this week. Liberals’ use of the phrase “too many choices” is a code to move us back to a government-only, one-size-fits-all program.

Opponents also attack the program because it’s not big enough. Paul Krugman at the New York Times is the poster child for this argument. He wants a larger program with more robust government involvement. “Politicians who don’t believe in a positive role for government shouldn’t be allowed to design new government programs,” he writes. These glass-half -full critics conveniently forget that before the new Medicare law, seniors’ prescription drug mug was empty. Mr. Krugman’s ideas would actually cost seniors more money (because of fewer, lower-premium options), offer a thinner array of benefits and cost taxpayers more in the process.

Conservatives need to challenge aggressively these critics on the Left. Medicare reform is one theater in the broader health care war. Blocking conservative solutions here stymies market-based, consumer-driven reforms of America’s broader health care system.

On the day the House passed the Medicare prescription drug bill two years ago, former Speaker Newt Gingrich addressed the Republican Conference, highlighting the importance of injecting choice, competition and more private-sector involvement in this health care program for seniors. But his pleas were mere promises at the time — adopt these ideas and realize positive results. But now real-world evidence proves he was right.

A war rages in health care — a serious battle of ideas. Those who want a government-run, price-controlled, heavily regulated system will brawl tirelessly to win this Medicare battle, trying to thwart other consumer-driven changes in health care. Conservatives not only have solid ideas, but new evidence that they work. This is a fight proponents of market-oriented health care reforms can win, but they must first realize they are in one.

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