If there were any doubt where Republicans in Congress stand on health care reform, their position should be abundantly clear by now. But if you haven't been listening, here's a hint: They're all about protecting the big profits of the greedy giants in the medical industry, and not concerned a whit about changing the system to benefit the 90 percent of Americans who struggle with soaring health care costs while their coverage falls off the cliff.
Here's how you can measure where the Republicans stand:
* They are body and soul for keeping the status-quo that chiefly benefits for-profit insurance giants. This is the industry that has doubled the price of health insurance in the past eight years; that heartlessly denies claims with every technicality they can find; that regularly forces even supposedly well-covered insured patients into medical bankruptcy; that cherry-picks the healthy and charges far more for individual coverage than for group plans; and that has forced health care providers to hire legions of office workers solely to contest insurers' denials for claims and treatment recommendations. (Then they have the nerve to run scare-talk ads about "bureaucrats controlling your doctor's decisions.")
* Despite such insurance industry practices, Republicans are lock-step with insurance companies against a public insurance plan, which is precisely comparable to the government-organized insurance members of Congress themselves receive. Never mind that a public plan would help level the playing field for America's stressed working families by providing a Medicare-style plan to individuals and families that can't afford comprehensive health care from the greedy, arbitrary private insurance market.
* Congressional Republicans are also standing solidly behind the price-gouging pharmaceutical firms that charge Americans double-to-triple what they charge every other country in the industrialized world for the top 50 prescription drugs, and that continue to exorbitantly mark up prices in America for their best-selling drugs.
* The Republicans particularly oppose changes to their 2003 Medicare "modernization" act -- the act they passed when they controlled both chambers of Congress and the presidency. But that act desperately needs changing. It was basically designed to enhance the profits and clout of the insurance and pharmaceutical industries while simultaneously eroding the role, coverage and financing of traditional Medicare's non-profit approach to a seniors market that accounts for huge chunk of the nation's health care spending.
* Republicans very clearly favor continuing to waste taxpayer money on federal subsidies to for-profit insurers' Medicare Advantage plans, their plum from the 2003 Medicare act. These subsidies are designed to make it profitable for private insurers to lure people permanently out of Medicare proper, while taking the $150 billion, 10-year-cost of the subsidies out of the traditional Medicare program.
These wasteful subsidies, according to the non-partisan Congressional Budget Office and the Medicare Payment Advisory Commission, cost 12 percent more than traditional Medicare's fee-for-service format, yet the Advantage programs often provide fewer services or less in benefits. The subsidies mainly pad insurers' profits and pay for marketing and overhead.
Because these subsidies are taken from traditional Medicare's budget, they have spurred cuts in Medicare reimbursements to doctors and hospitals that provide care to the people who remain in Medicare, jeopardizing the viability of Medicare's provider network.
* Republicans oppose lifting the ban, imposed under their 2003 Medicare modernization act, that makes it illegal for Medicare either to bargain with pharmaceutical companies for drug prices equal to what other industrialized countries pay, or to offer a model prescription drug formulary plan under basic Medicare.
Though Medicare obviously could offer a better and less expensive program without involving private insurers, Republicans favor continuing to force Medicare to send Medicare recipients into the confusing welter of scores of for-profit insurers -- each with its own constantly changing prescription drug formulary and co-pays -- to find a drug benefit plan that best fits their health care needs.
Republicans should be accountable for their industry-oriented Medicare policies. Yet they remain free to brazenly accuse Democrats of wanting to cut Medicare simply because they would end these senseless subsidies, which are nothing better than cozy corporate welfare made doubly bad because it was intended to erode Medicare's viability and public support.
Indeed, Senate Republicans had the gumption to publicly issue a letter Thursday that 35 of them (including Tennessee Sens. Bob Corker and Lamar Alexander, and both senators from Alabama and Georgia) signed and sent to Senate Majority Leader Harry Reid. Their letter urged Democrats to "protect this critical health care program for our seniors" by making sure that "any potential monies found through the reform of Medicare should only be utilized to secure the financial status of this program."
It goes on to talk about how "over 45 million senior citizens across the country depend on Medicare for their health care needs," and how Medicare's "long-term financial stability is in serious jeopardy."
All true. But given their record of eroding Medicare while claiming to do good, their letter is chiefly a brazen lesson in hypocrisy -- and one more way to gauge how insincere Republicans are about health care reform.