The Good Old Days? : The Republicans Would Have Us believe That The United States Has Gone Downhill Since The ‘60s--and Government is The Reason. But Medicare Alone Proves Government Can Do Good.

This year’s mainly Republican effort in Congress to roll back federal health, safety and environmental initiatives, while deep ly cutting welfare and Medicare, seems an attempt to return to the status quo of 1959, shortly before most such programs began. Until the dawn of the 1960s, received conservative political nostalgia now has it, America was a splendid place. No bureaucrats on our backs, no McGovernicks (as Newt Gingrich calls them) in office, no red tape restraining the economy. If only we could wipe out those well-meaning but failed government programs and return to the milieu of 1959--maybe with laptop computers and speed-of-light pizza delivery added--the national grandeur would be restored.

It’s hard to think of many ideas stranger than the notion that the United States has gone downhill since the 1960s. In several troubling areas--notably crime and the breakup of the family--trends of recent years have been steadily negative. But, by most measures, the United States of 1995 is a dramatically better place to live than the United States of 1959. The economy is more than twice as big, in real-dollar terms; poverty has declined, despite a larger population; most people are healthier and live longer; the environment has improved; most jobs are less dangerous; most formal discrimination has ended; education levels are at an all-time high; personal freedom has never been greater; conveniences once reserved for the rich, such as air travel, have become commonplace; the threat of nuclear war has dramatically declined; the list goes on.

These steady improvements in most aspects of American life happened during the very period when government regulations increased and government programs grew. In the current conservative, anti-government critique, we’d somehow be better off without federal programs. Yet, returning to the day before many such programs were enacted would mean a huge step backward in health, safety and prosperity.

Consider Medicare, the health-care program for senior citizens, that Republicans in Congress last month voted to reduce by $270 billion over seven years. Today, it is taken as a given in American politics that the elderly, as a group, are financially secure, with a lower poverty rate than other segments of the population and a generous allotment of federal health-care subsidies. But the reason the elderly have become financially sheltered is not market forces or social forces: Rather, it is government programs.

Social Security, created in 1935 and expanded dramatically in the 1970s, has ended most cases of senior-citizen impoverishment--a horrifying social problem of the 1950s and one that its victims, people at the end of their earning power, generally could do nothing about.

Medicare, created in 1965, has both extended the life expectancies of senior citizens and improved their quality of life--by making common such advances as removal of cataracts and heart surgery. In turn, because Medicare is generously funded, senior citizens can enjoy ever-improving health care without going into hock to pay for it. The statistical bottom line: In 1965, 28.5% of senior citizens lived below the poverty line; today, only 12.9% do.

By any reasoned assessment, U.S. senior citizens are much better off as a group in 1995 than they were in 1965. That does not mean Medicare should be untouchable; its budget growth is a clear problem. But cuts ought to be cautious, acknowledging a central truth: Medicare is a federal initiative that has worked very well, accomplishing what it was designed to do--namely, improving the health of a broad segment of society. Instead, most of this year’s rhetoric from Republicans in Congress has been to portray Medicare as just some ponderous government walrus wallowing in a pool.

Today, we can take for granted the existence of sound health care for those over 65 precisely because a big, expensive, sweeping federal program was enacted. Many Republicans in Congress won’t give an inch on this, pointing to Medicare’s cost as a proof of government failure, while saying little or nothing about the program’s accomplishments.

Where Medicare is quite effective on the key point of care delivery, Medicaid, the health program for the poor, often delivers care of dreadful quality. For two decades, most measures of the health of senior citizens have been pointed upward, while many measures of the health of the poor point down. Instructive here: Medicare is a federal program; Medicaid is run by the states. Yet, observing a successful federal health initiative compared with deeply troubled state health programs, many in Congress today ridicule federal efforts, while praising the states.

Similarly faulty logic can be seen in many currently fashionable forms of anti-government sentiments: taking for granted the good that government has accomplished, then assuming that good would continue if the programs did not. For example, most measures of environmental quality have shown remarkable improvements in the United States in recent decades. Since 1970, U.S. smog is down by one-third; twice as many lakes and rivers are now safe for fishing and swimming; acid rain is down by nearly half.

1970 was also the year of the founding of the Environmental Protection Agency, which put into place most of the rules that have caused environmental betterment. Some EPA regulations are infuriating, and must be streamlined. But most agency rules have proved surprisingly cost-effective and easy to live with--such as the inexpensive, barely noticed tailpipe controls that cause new cars to emit less than 5% as much pollution as 1970 models.

Many in the current Congress propose to throw out environmental rules en masse, with House Majority Whip Tom DeLay of Texas calling the EPA as bad as the “Gestapo.” It is assumed that environmental improvements magically happened, just as GOP critics of Medicare assume senior citizens magically got healthier.

The same sort of ersatz logic is applied to attempts to roll back regulations on food purity and workplace safety. Since U.S. food is safe and worker deaths are declining, the argument goes, who needs safety rules. Most food is safe, and workplace safety is improving--deaths of U.S. workers on the job peaked at 14,000 in 1965 and have declined steadily since, down to 8,500 in 1992, though total employment rose through the same period. But this did not happen by magic: The steady decline in workplace fatalities was coincident with the passage of strong worker-safety regulations and the creation of agencies such as the Occupational Health and Safety Administration. OSHA has passed a few silly rules, but most of its requirements are sensible--as the decline in worker deaths shows.

Hostility toward government has deep roots in American political culture, and ought to, given that the United States was founded in a rebellion that was largely an anti-government protest. Historically, most governments have been a cause of suffering for the average person--starting pointless wars, imposing despotism, expropriating property for the luxury of a few--rather than a source of improvements to daily life.

The notion that governments should attempt to improve the individual’s daily life is new in historic terms--tracing perhaps to Britain in the late 19th Century. The notion that the U.S. government should attempt to improve the individual’s daily life is more recent, tracing roughly to the 1930s and the recovery from the Depression, not becoming entrenched until the 1960s and the phase of expansion of federal and state programs.

Since the American inclination is to believe that government is an obstacle rather than an ally, it comes as no surprise that hostility to federal programs has recurrent popularity as a political theme. Some federal programs are dumb, or cost too much; some deserve to be abolished. But, in the main, America in recent decades has become a richer, healthier, safer and cleaner place--partly because most federal programs aren’t dumb. Rather, most have accomplished good for the country.

The current impulse to deny that government can accomplish good for its citizens evinces a desire by many conservatives to live in an unreal world--a dangerous inclination by any governing class. Trying to pretend that security for senior citizens, advanced health care, reduced pollution and other social achievements simply appeared out of thin air, and should not be credited to the underlying government initiatives, is a dishonest strategy on the part of conservatism. It may lead to the revival of problems we thought we had licked.