The Senate Rises to Its Intended Stature in the Vote on Medicare

Tuesday, June 24, 1997, was a good day for James Madison. Also for Alexander Hamilton and few dozen of the other fellows who endured a couple of sultry summer months in Philadelphia in 1787 to give us a Constitution. Included in the document was an institution that mimicked Parliament: a Congress with a lower, common house and an upper chamber, its members insulated from the voters by being elected by the state legislatures to six-year terms (unlike, thankfully, the lifetime benefices of the House of Lords). And while indirect election was scrapped in 1913, the six-year term remains, and it will provide protection for some of the senators who on Tuesday uncorked the political equivalent of a vial of Ebola virus by voting to boost the age of eligibility for Medicare from 65 to 67 and to raise the monthly premiums for affluent seniors. The most courageous supporters of the reform were those senators who are seeking reelection in 1998, among them Republicans Don Nickles of Oklahoma and Kit Bond of Missouri and Democrats Fritz Hollings of South Carolina and Bob Graham of Florida.

Efforts in the past to even slightly modify the benefits received under Medicare and Social Security have been scuttled, not by the poorest seniors, but by the more prosperous elderly, who are not only organized under the banner of the American Assn. of Retired Persons, but also the age group most likely to vote.

A stab at reform in the 1980s aimed at allowing the IRS to take taxes up front on interest and dividend payments rather than have the Treasury wait until April to get its money. It met with defeat at the hands of retired coupon-clippers in league with the banks and brokerage houses.

A proposal to briefly defer--not reduce, but just postpone--Social Security cost-of-living adjustments required an elaborate political cover operation that began with a bipartisan commission headed by Alan Greenspan, the agreement of a Democrat-controlled House, a Republican-controlled Senate and Republican President Ronald Reagan before it could be enacted.

The most spectacular evidence of all of the political muscle of the prosperous seniors was the fate of the law providing coverage for catastrophic illness for the impoverished elderly that was to be paid for by raising Medicare premiums on the golf and martini set. On a visit to his district in Chicago, Rep. Dan Rostenkowski, chairman of the committee that had written the bill, had his car mobbed by enraged seniors. Congress ended up doing something it almost never does: It voted to repeal the law. But what is even more remarkable, the catastrophic illness insurance proposal had been backed by the AARP.

The sorry history of attempts to reform entitlements for the elderly, even in the interests of long-term solvency, underscores the resoluteness and good sense shown this week by a solid majority of members of the Senate. They grasped the nettle even though adoption of the reform is unlikely: The House will almost certainly not follow the Senate’s lead, and the White House has spoken out against the legislation. Also, the Senate’s action, for all its boldness, is not part of the overall balanced budget agreement reached on May 2.

In the Senate, Democrats Pat Moynihan and Bob Kerrey were as influential in fashioning the Medicare reform bill as were Republicans Bill Roth and Phil Gramm. That the effort was bipartisan is emblematic of the Senate, where the distinction between majority and minority is not so deeply graven as it is in the House, a place where Democrats are barely accorded the protections given to prisoners of war.

In the face of almost-certain political retribution from the gated communities and condos of the Sunbelt, as well as the predictable demagoguery by liberals like Ted Kennedy, Democrats and Republicans alike went on record that Medicare needed to be put on the path of long-term survival.

Why did the Senate vote for what is surely good policy but might end up being bad politics? The simplest answer is that the Senate enjoys a unique constitutional mandate to exercise statesmanship when the occasion demands it, and that the best senators recognize and from time to time act upon that warrant.

What the majority of senators did Tuesday hardly merits a Purple Heart, but it demonstrated something important: In an age when elected officials generally are seen as cowering before powerful interests that have the money and the votes to back up their demands, there remains in at least one place in government a heartening measure of wisdom and fortitude.