Economists already are picking over the plan's dubious statistics, but — as The Times reported Friday — the nonpartisan Congressional Budget Office has outlined what adoption of this proposal to supplant Medicare with vouchers and private insurance exchanges would mean. The overall cost of healthcare would go up, and retirees' out-of-pocket medical expenses would double — an increase that would push tens of millions of people living on fixed incomes over the financial brink.
We all know how well that's worked out, but it does fix this plan firmly in the line of initiatives that, over the past 30 years, have dramatically increased social and economic inequality.
As former Labor Secretary Robert Reich said on National Public Radio this week, "In the 1950s, the top marginal income tax rate was 91%. Now it's 35%.... Meanwhile, capital gains and dividends — a big chunk of [wealthy people's] income — were taxed at 35% as recently as the late 1980s. Now, they're taxed at 15%."
Forty-six years ago, President Johnson signed the bill that expanded the Social Security system to include Medicare and Medicaid. Those two programs were the jewels of an avalanche of social legislation that built on the legacy of the New Deal and that found inspiration in an unlikely place — a book, published in 1962, called "The Other America" by the writer and public intellectual Michael Harrington.
The book explored the poverty that then afflicted nearly one American in three and, like Upton Sinclair's "The Jungle," it changed the political landscape.
Among the millions who read it and embraced its message was the president, John F. Kennedy. Johnson subsequently tackled the issue with all his consummate legislative skill. Harrington would come to feel that Medicare and Medicaid were the most lasting achievements of LBJ's epochal presidency, because — along with other changes in Social Security — they reduced old-age poverty to statistical insignificance, extending not just the lives of millions of our elderly, but also the vitality of their old age.
Harrington said that when he began his research into poverty in the late 1950s, "for most Americans to be old was to be poor."
And those who were poor and old, as he wrote in "The Other America," were likely to suffer: "The aged members of the other America are often sick, and they cannot move. Another group of them live out their lives in loneliness and frustration: They sit in rented rooms, or else they stay close to a house in a neighborhood that has completely changed from the old days. Indeed, one of the worst aspects of poverty among the aged is that these people are out of sight and out of mind, and alone."
Harrington's biographer, Maurice Isserman, wrote in 2008 that "what remains fresh and vital in 'The Other America' is its moral clarity." That quality is precisely what the debate over Medicare and Medicaid cannot be without.
In his introduction to "The Other America," Harrington noted that his exploration necessarily would involve "statistics, and that offers the opportunity for disagreement among honest and sincere men. I would ask the reader to respond critically to every assertion, but not to allow statistical quibbling to obscure the huge, enormous and intolerable fact of poverty in America. For, when all is said and done, that fact is unmistakable, whatever its exact dimensions, and the truly human reaction can only be outrage."
Backers of the Ryan plan are relying on the cold self-interest that so often dominates our era to mock the urgent solidarity expressed in that passage as quaint and naive. But because Harrington and those who shared his anger succeeded, the elderly and poor are no longer invisible.
And outrage is precisely what we ought to feel at this cruel attempt to push them back into want's dark shadow.