Settling Scores Can Be Dangerous

Democrats are seeking to reduce this program because Republicans rightly regard this as their signature act of the last 6 years.

And, they are right, especially from the perspective of the Iraq War, the handling of Katrina, the clumsy effort to thwart Democratic get-out-the-vote efforts by firing U.S. attorneys more cognizant of the law than Republican electoral needs, and the unfolding subprime loan fiasco.

And the Medicare Modernization Act, which created the prescription drug program under Medicare Part D and revitalized what is now known as the Medicare Advantage program, has been successful because of the ability of the health insurance industry to accomplish a goal from a standing start over a short period that is comparable to the job being done by the Centers for Medicare and Medicare Services.

Yet, House Democrats supported the cutback in the MA program despite the fact that both Republicans and the health insurance industry can rightly point to the MMA as an achievement.

Moreover, the MA program has broad support in Congress, especially among members of Congress serving rural areas in Western states who have disproportionate representation in the Senate.

Even Democrats in far western states, like Oregon and Washington, support the program because it has resulted in upgraded medical care in rural areas.

There is some legitimacy to the fact that the MA program is a little more expensive. But the fact is that the Democrats who wrote the CHUMP Act also imposed onerous enrollment, financial and reporting mandates on insurers as well as greater oversight on their marketing practices.

The reasons for this are clear: Democrats are seeking to take advantage of voter discontent with the cost and restrictions of private health insurance plans in order to settle accounts with the insurers for their refusal to support the Democrats' universal health proposal in 1994 and to undermine Republicans for their unwillingness to engage Democrats in the writing of the MMA in 2003.

It is clear that Republicans used the "Harry and Louise" ads fashioned by the health insurance industry to gain control of Congress in 1994, leaving Democrats on the sidelines, especially in the House, for more than a decade.

And, Republicans were clearly heavy-handed in their handling of the MMA in 2003.

But settling accounts is a dangerous business, especially when it puts your current political aspirations in question, and has the potential to affect the health of children and the elderly. Isn't it time to move on?