PART D…. At a recent town-hall event, President Obama was asked about how to pay for health care reform without adding to the debt. “It’s a great question,” the presidents said. “First of all, I said I won’t sign a bill that adds to the deficit or the national debt. Okay? So this will have to be paid for.”

Obama then proceeded to take a stroll down memory lane. “That, by the way, is in contrast to the prescription drug bill that was passed that cost hundreds of billions of dollars, by the previous administration and previous Congress, that was not paid for at all, and that was a major contributor to our current national debt. That’s why you will forgive me if sometimes I chuckle a little bit when I hear all these folks saying, ‘oh, big-spending Obama’ — when I’m proposing something that will be paid for and they signed into law something that wasn’t, and they had no problem with it. Same people, same folks. And they say with a straight face how we’ve got to be fiscally responsible.”

It’s a point that’s gone largely overlooked of late. Just six years ago, Karl Rove thought he could lock up that “permanent Republican majority” by adding a prescription drug benefit to Medicare. Seniors — at least the one who didn’t get caught in the dreaded “donut hole” — would be so impressed they’d vote GOP forever. All Republican policymakers had to do was approve a poorly-written bill that expanded government involvement in health care while adding trillions of dollars to long-term debt.

It has a certain relevance to the ongoing policy debate of the day.

Matt Yglesias does good service by reminding us of the 2003 Senate vote on Medicare Part D, the budget-busting prescription drugs for seniors bill that passed the Senate 54-44, even though it wasn’t paid for (it adds trillions to the deficit over time). Here’s the vote: it is interesting to note that the two Gang of Six members who are the most prominent naysayers and budget hawks on the Senate Finance Committee now, Chuck Grassley and Mike Enzi, voted for the bill. As did assorted other noisy conservatives like Sam Brownback, John Cornyn and John Kyl. What irresponsible spendthrifts!

Republicans who actually are deficit hawks — John McCain (usually) and Lindsey Graham, for example — voted against it. Many Democrats — Ted Kennedy, Russ Feingold, Hillary Clinton — also voted against it, mostly because they didn’t think it provided sufficient coverage (and let the drug companies off the hook).

But the headline remain grousers like Grassley, who oppose the alleged expense of the Obama plan now (even though the President has vowed not to sign a bill that isn’t, more or less, paid for). It should be noted that Max Baucus — who has also made non-stop noises about fiscal responsibility — voted for it, too.

The bill even included a provision on end-of-life counseling — hey, look, GOP-approved “death panels” — that the Tea Baggers of the day didn’t seem to notice or care about. Indeed, at the time, conservative activists had nothing but good things to say about expanding an entitlement program by hundreds of billions of dollars, expanding the government’s role in health care, and handing the tab to future generations. Where were the angry patriots comparing Bush to Hitler, and accusing Republican lawmakers of trying to turn the United States into Soviet Russia?

For that matter, somehow, Baucus and Grassley were on board with Bush’s Medicare boondoggle, which included nothing to “bend the curve” and only added heavily to the debt. It’s funny how standards change when there’s a Democratic president.

Steve Benen

Follow Steve on Twitter @stevebenen. Steve Benen is a producer at MSNBC's The Rachel Maddow Show. He was the principal contributor to the Washington Monthly's Political Animal blog from August 2008 until January 2012.