Pushing a Progressive Agenda for the Democrats
    By Dean Baker
    t r u t h o u t | Perspective

    Wednesday 08 November 2006

    The Democrats have scored an important electoral gain for the first time in 14 years. It is now incumbent on progressives to ensure that this victory is not squandered.

    In addition to maintaining pressure for a hasty withdrawal from Iraq, there is a long list of economic items that we should be pushing the Democrats to support. At the top of the list must be the demand to carry through on one of the Democrats' key campaign promises: reforming the Medicare prescription drug benefit. The solution here is simple: allow Medicare to negotiate prices directly with the pharmaceutical industry and offer its own prescription drug plan.

    If Medicare could negotiate the same price for prescription drugs as the Veterans Administration or the Canadian government, it would possible to eliminate the $2,850 "doughnut hole" gap in coverage. We could also save taxpayers tens of billions of dollars every year from the cost of this benefit.

    The Republicans have fought against reforming the benefit, claiming that there would be no savings from having Medicare negotiate directly with the industry because the insurers already pay such low prices. The Republicans differ on this point, with their financial backers in the pharmaceutical industry. A representative from PhRMA, the industry lobbying group, was quoted recently in the New York Times complaining that it would not be fair to allow Medicare to negotiate prices with the industry, because the government has too much market power. The spokesperson went on to say, "the government doesn't negotiate prices - it dictates prices."

    The drug industry is right on this one and the Republicans are wrong. There would be huge price savings if Medicare were allowed to offer its own drug plan, which is why the public should demand that Congress reform the benefit.

    This is only the beginning. It is time that the Democrats start to move forward on President Clinton's 1992 campaign promise to provide universal health care coverage. A simple way to increase coverage would be to allow everyone (both individuals and employers) to buy into Medicare. This would allow everyone in the country to take advantage of Medicare's low administrative costs and its market power in keeping down the prices charged by health care providers.

    Opening up Medicare is a simple, but important, first step. It is also one that provides little cause for objection. If premiums are set at the cost of coverage, then this step requires no additional taxpayer dollars. It also is entirely optional - the people who are happy with their current insurance have the option to keep it. Opening up Medicare to everyone is simply giving people an additional option that they did not previously have. What's wrong with giving people a choice?

    Over time, we could look to create a system of subsidies for low and moderate income families that will allow everyone in the country to be included in the Medicare system, but the immediate task is to get the basic structure in place. Opening Medicare to the entire population will be a big step down that path.

    There is also a larger agenda of items that could make a huge difference in the lives of millions of working families. This includes a higher minimum wage, increased support for child care, access to paid time off (sick leave or vacation days), and promoting flexible work schedules. There have been many useful initiatives in these areas that may have some chance of advancing in a Democrat-controlled Congress.

    There is also the fallout from the imminent crash of the housing bubble that the Democrats must be prepared to address. There is not going to be an easy answer here - the crash of the housing bubble will cause considerable pain - but it will be important to have a plan in place to boost employment and get the economy back on its feet. At least part of this plan should be a set of tax credits to promote conservation and low cost alternative energy (e.g. increased home insulation and installing solar paneling). In the downturn following the crash of the housing bubble, such tax credits would both help to re-employ dislocated construction workers and reduce greenhouse gas emissions and dependence on foreign oil.

    There is a much larger list of items that should be addressed, including a new dollar and trade policy and re-orienting the focus of the Federal Reserve Board toward maintaining high rates of employment, but fixing the drug benefit and opening up Medicare should be a good start. These are simple policies that will make a large difference in the lives of tens of millions of people. The Democrats should be prepared to embrace them. If the Republicans manage to obstruct progress, there is another election in two years.