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Former advisor to Bill Clinton, Paul Begala, has summed up the GOP’s approach to Medicare exactly:

Republicans don’t want to “fix” Medicare or “reform” Medicare. And Lord knows they don’t want to “modernize” it or—as the deeply disingenuous Paul Ryan says—“protect and strengthen Medicare.” No, they want to end it.

Even before the program was created in 1965, some of the biggest names in the Republican Party opposed providing health care as an earned benefit for seniors. The appropriately named senator Roy Blunt summed up what most Republicans believe: “Well, you could certainly argue that government should never have gotten in the health care business…”

Despite Republicans’ firm convinction that seniors are being deprived of the pleasure of spending the last few years of their life wrangling with private insurers, Medicare is an unmitigated success. Before the program about half of seniors had no health insurance—today nearly all are covered. And Medicare is more efficient and popular than private insurers. A 2011 poll found that 88 percent of Americans believe that Medicare has been good for the country.

After spending a few years trying to play the defender of Medicare, the GOP is as determined as ever to kill or at least mortally wound the program’s guarantee. Here are five times they’ve done their best to end one of the most popular things the federal government ever created.

Reagan Tries To Abort Medicare


Before he became governor of California, Ronald Reagan’s political claim to fame was helping to defeat the immediate precursor to Medicare, the King-Anderson bill. His warnings about a guaranteed health benefit for pensioners were dire, and reeked of neo-McCarthyism. If such a system was created, he promised that “you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” Of course, by the time he ran for president in 1980 he embraced the program, and as president embraced Diagnosis Related Groups, which implemented cost savings much like those Republicans attacked in Obamacare.

Newt Gingrich Wants To Let Medicare ‘Wither On The Vine’


For 30 years, Medicare was relatively safe. There had been no substantial cuts to benefits and no one even dared to suggest them. Then came the Contract With America and the first Republican majority in Congress in decades. Within months, the new Speaker of the House Newt Gingrich was revealing that the GOP’s animosity toward a public health care plan for seniors hadn’t disappeared. They’d just gotten better at hiding it. “Now we don’t get rid of it in round one because we don’t think that that’s politically smart, and we don’t think that’s the right way to go through a transition,” Gingrich said, in a now-famous statement replayed thousands of times during the 1996 presidential campaign. “But we believe it’s going to wither on the vine because we think people are voluntarily going to leave it — voluntarily.” People would leave Medicare voluntarily? Who would believe such science fiction? Probably someone who reads Ayn Rand.

Photo credit: AP Photo/The Wilmington News-Journal, Robert Craig

Medicare Part D: The Trojan Horse


Why would you add a prescription drug benefit to Medicare that will cost trillions and trillions without adding any mechanism to pay for it? How else would you get George W. Bush re-elected? Besides that? Have you ever heard of “Starve the Beast”? In 1985, an unnamed Reagan staffer described the philosophy of cutting taxes as a means of guaranteeing that spending will have to be cut. How else can you guarantee spending will have to be cut? How about adding unfunded benefits that make the programs unsustainable? Maybe that’s how you got “small government conservatives” like Rep. Paul Ryan (R-WI) to vote for an expansion of the federal government.

The Ryan Plan: Privatize And Destroy


After Republicans took the House in large part by running against the Medicare savings that were included in Obamacare, Paul Ryan decided that he had a mandate to completely end Medicare as it has existed for more than 40 years. His “Path to Prosperity” completely privatized the program in a way that would have cost seniors $6,500 more a year. When critics savaged his program as “Social Darwinism,” he revamped his proposal a year later, adding a public option for people who wanted to keep Medicare but pay more for it. However you slice it, by cutting private insurers into the Medicare pie, you’re destroying the efficiencies in the program. Insurers will cherry-pick the healthiest seniors and make the public program more costly, which would lead Republicans to call for—wait for it—more cuts. Republicans’ problem with Medicare is that it works and reassures people that government can actually do something right. Paul Ryan’s plan would fix that.

The Fiscal Cliff: A Thousand (Or $600 Billon) Cuts


Remarkably, Mitt Romney adopted nearly all of Paul Ryan’s Medicare plan and then put Ryan on his ticket. After finding that the congressman who had proposed maiming Medicare wasn’t exactly helping him with swing voters, Romney basically hid Ryan during the closing weeks of the campaign. Once Romney was soundly defeated, Republicans were faced with a president who was re-elected with a higher share of the popular vote than any president since Reagan. With the Bush tax cuts set to expire, Republicans who had religiously opposed raising taxes for 30 years decided that they might be willing to raise taxes on the rich if Democrats would agree to Medicare “reforms.” Americans oppose cutting Medicare, by a margin of 70 to 25 percent. The GOP’s $600 billion in proposed cuts have nothing to do with eliminating the biggest bloat in Medicare—corporate profiteering, unnecessary care and the exorbitant costs incurred during the last months of a patient’s life. All their cuts revolve around making the program available to fewer people, and more inefficient. Why would they propose such a thing? Because it’s harder to kill a program that’s efficient and available to all Americans 65 or older. So make it weaker and available to only those 67 or older. It’ll be easier to kill next time around. Oops, I mean easier to “reform.”

Photo credit: AP Photo/Susan Walsh

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