In yesterday’s column, George Will wrote that
When Mitt Romney selected Paul Ryan, Republicans undertook the perilous but commendable project of forcing voters to face the fact that they fervently hold flatly incompatible beliefs. Twice as many Americans idenify themselves as conservatives as opposed to liberal. On Nov. 6 we will know if they mean it.
Will focuses on “clientalism” as the hallmark of the modern liberalism that conservatives oppose. But he also decries New Deal- and Great Society-era entitlement programs that, he suggests, are policy requisites for that clientalism.
Enter Paul Ryan’s full-throated defense of Medicare in his convention speech yesterday. His commitment to the permanency of this entitlement program could not have been stated more emphatically:
Medicare is a promise, and we will honor it. A Romney-Ryan administration will protect and strengthen Medicare, for my Mom’s generation, for my generation, and for my kids and yours.
To be sure, Ryan’s defense of Medicare is conservative in the sense that it defends a status-quo policy against an even more intrusive and redistributionist policy. But its import for conservatism is more than that. In his speech, Ryan placed himself and Romney squarely on one side of a fault line that divides American conservatism: Ryan is reconciled with the existence of the social-insurance state. He doesn’t just tolerate Medicare as a practical political necessity, he commits to it. Contrary to Will’s intimation, this position can be an authentically conservative position. But it is conservative more in the mold of European-style Christian Democratic conservatism than in the mold of traditional American conservatism.
Ryan’s defense of Medicare is significant. Whatever the practicalities of Washington politics, a good part of modern American conservatism, both at elite and at popular levels, remains intellectually unreconciled to any form of New Deal-type social insurance policies, let alone to redistributive Great Society programs.
Given Ryan’s position as a, if not the, intellectual leader of congressional conservatives, if the Republican presidential ticket wins this election, Ryan’s speech could mark the point at which American conservatism turned definitively from a grudging, politically-expedient tolerance of social insurance to a recognition that it is fully consistent with robust forms of conservatism. By itself, this would represent a dramatic shift in American conservatism, as well as raise a host of additional questions for American conservatism and for American politics and policy. On the other hand, if this line being crossed results in the abstention of more than a very few economic libertarians or Jeffersonians in this year’s election, it could shift one or more swing states, and throw presidential elections to the Democrats.
Whatever the electoral outcome, Ryan’s selection by Romney serves as much to place added stress on fault lines within the GOP coalition as it does to call the bluff of the voting public. And if Romney and Ryan win, we may learn that those Americans who identify themselves as conservatives really ”mean it.” But even if American conservatives prove to George Will that they “mean it,” it may not be exactly the sort of conservatism that he anticipates.
August 30th, 2012 | 2:17 pm
The more important ‘fault line’ in the American body politic is between those who believe that we can continue to provide an ever expanding array of entitlements and somehow pay for it by taxing the 1% versus those who understand that in the next few week’s the nation’s debt will exceed $16 trillion dollars (that does not include the $4 trillion debt owed by the states). This nation is careening toward default, and we cannot tax our way out of it. On that front, conservatives are united.
August 30th, 2012 | 2:51 pm
The question is whether Ryan means what he is saying about Medicare, and whether preserving Medicare for future generations means preserving something that, in the future, will actually resemble the Medicare of today.
I think Romney and Ryan (and Obama) are not leveling with the American people. Turning Medicare into a voucher program, with the vouchers decreasing in purchasing power with every year that passes and medical costs continuing to rise, is not my idea of saving Medicare. And how, I wonder, can conservatives reign in Medicare costs if they restore the $700 billion that Obama and Ryan both saw fit to cut as one of their first acts and also abolish cost-saving initiatives like the Independent Payment Advisory Board?
Romney accusing Obama of “robbing” $700 billion from Medicare and promising to restore it as the true savior of Medicare has certainly got to be one of the most cynical, deceptive political campaign ploys I have ever witnessed. Frankly, it amounts to a lie.
August 30th, 2012 | 2:53 pm
The various permutations of the Ryan budget/reform plan introduce market reforms and a significant amount of privatization to Medicare, which many conservatives believe to be the only realistic path to weaning America off such welfare programs. And, of course, there’s the fiscal situation that where conservatives are also in agreement, as Publius notes. So, there’s little practical difference in near term goals. In the long term, we’ll see.
August 30th, 2012 | 4:40 pm
There’s a book I haven’t read called This Time Is Different: Eight Centuries of Financial Folly
by Kenneth S. Rogoff, Carmen M. Reinhart. Considering the fact that deficits started soaring with the Reagan presidency, kept going up under Bush 41, dropped under Clinton, and started soaring again under Bush 43, how can the Republicans convince us that this time is different? Ronald Reagan is still worshipped, and his economic policies started the whole mess.
Of course, Republicans will no doubt disagree with me when I attribute the rising deficits and debt of the last few years to Bush and not Obama, but prior to that, how can it be denied?
August 30th, 2012 | 6:08 pm
“Republicans will no doubt disagree with me when I attribute the rising deficits and debt of the last few years to Bush and not Obama, but prior to that, how can it be denied?”
I don’t think they would deny it. Republicans have spent like drunken sailors too. The difference is that they now say they won’t, and the Democrats (who increased deficits and debt DRAMATICALLY over Bush) plan to keep right on adding. I don’t see any point in arguing about who poured on more grease when the kitchen is on fire and one of the cooks now has a fire extinguisher and the other has another can of grease.
August 30th, 2012 | 6:50 pm
David N.
Nice chart — very pretty colors, too bad it only shows the debt as a percentage of GDP until the end or thereabouts of FY 2009. Last time I checked it’s nearly Sept. 2012 and Mr. Obama is still President. The selfsame President under whom the deficit has risen from 10.7 trillion dollars to 15.1 trillion (15.6 as of the end of June) in three years! For those of you playing at home the annualized rate of increase during the Bush II administration was an (egregious, I’ll agree) 8.3%. However, the current President makes Bush II look like a pinchpenny as that rate is right at 12.2% on average for his years in office.
And while were at it. At the end of Bush II the debt was at 74.1% of GDP — under President Obama is has risen to 101.7% of GDP — again an increase of over 41% in three and a half years. So yeah, I, and anyone else who can read basic math “will no doubt disagree with [David N.] when [he] attribute[s] the rising deficits and debt of the last few years to Bush and not Obama”.
(All these numbers btw come from the non- partisan PresidentialDebt.org website.)
August 30th, 2012 | 6:54 pm
David Nickol,
It wasn’t Reagan’s policies; it was practical politics. He tried to cut spending, but he was constrained by the fact that the Democrats held the House in his first term and both House and Senate in his second. To be fair, there were also many Republican who objected to cuts, but Reagan might have prevailed on things like eliminating the Department of Education and setting us on a path to smaller government. He thought it was more important to get the economy moving through tax cuts. He succeeded, and we benefited greatly, but the precedent he set with increased spending was very unfortunate. The deficits were reduced under Clinton because of the Republican Congress starting in 1994, aided by a high-growth economy which brought in high revenues (somewhat artificial ones, with the dot-com bubble and all). George W. Bush was very much at fault with his big new programs, though he actually brought down the deficit considerably.
Your comments on vouchers are very much mistaken. One goal of having vouchers is to reduce medical costs through competition. In the few medical areas left where there is competition, such as plastic surgery and laser eye surgery, costs have come down considerably. Just getting the Medicare bureaucracy and the fraud out of the program will save an enormous amount.
August 30th, 2012 | 6:57 pm
I didn’t catch Ryan’s speech last night, but I have just finished reading about it. Anything I say will be disputed as partisan, so I am not going to say anything or even provide any links. I’m just going to ask people to do a Google search for “Ryan speech factcheck” and read a sampling of the articles from whatever sources you find trustworthy. Then come back here and tell me if, although “his commitment to the permanency of this entitlement program could not have been stated more emphatically,” it can actually be believed.
August 30th, 2012 | 7:51 pm
Only one possible excuse exists for the comment posted by David Nickol – that he has been misinformed by persons who do not understand the questions referred to.
Perhaps these persons hold credentials which are of great value in other areas but are of little help when dealing with economic complexities.
Perhaps these advisors do not have access to papers written by respected economists on the subject of the workings of a voucher system.
Perhaps they are not aware of the differences between the Obamacare removal of funds from Medicare and the program proposed by Mitt Romney.
Perhaps they are not aware of the extensive writings and analysis provided by Richard Foster, the distinguished Chief Actuary at CMS, on the consequences of the plan proposed by the president.
To make such an accusation – “Frankly, it amounts to a lie.” – without full and proper knowledge of one’s subject is uncivil and improper and does not advance discussion of this subject.
August 30th, 2012 | 7:56 pm
James Rodgers, you pretty much cover all your bases here. Will’s “real conservatism” is not Ryan’s real conservatism (RC), and if Romney wins then Ryan’s RC will be America’s RC. And it will be the RC of the American people. And so on.
Or, if Romney wins perhaps it will be because no one one the right and enough people on the left don’t like Obama.
Did George W. Bush’s election make “compassionate conservatism” the RC? Did his selection and fight for Harriet Miers redefine judicial RC? Did his open-border stance equate RC with open-borders? Or did all conservatives simply prefer him to Al Gore and Bob Kerry?
Finally, James Rodgers draws the line between Ryan’s RC and libertarians/Jeffersonians. But what do you call us conservatives who believe the imposition is upon us as individuals to care for the poor, rather than the government. What do you call those of us who think we should care for the poor out of our own pockets rather than vote to take most of that money out of someone else’s pockets?
August 30th, 2012 | 11:42 pm
Isn’t Ryancare for seniors essentially Obamacare (go out in the marketplace and buy insurance) + the holy grail of a public option?
August 31st, 2012 | 8:15 am
We could actually afford a more “redistributionist” public healthcare system better than we can afford medicare. Countries with socialized healthcare for all spend less public money per capita on healthcare than we do. Our medicare/medicaid system is more expensive than the NHS or the German system.
Keeping medicare is neither conservative nor progressive, it’s simply stupid. Our system is terrible as a question of social policy – it’s too expensive and doesn’t cover enough people. It’s terrible as a question of fiscal policy – it’s twice as expensive as anyone else’s system, and it doesn’t give us better results. Anyone who doesn’t want to significantly cut public healthcare spending isn’t progressive or conservative. They’re just pandering to aging boomers who stupidly want government to stay away from their medicare.
August 31st, 2012 | 9:26 am
Re: “On the other hand, if this line being crossed results in the abstention of more than a very few economic libertarians or Jeffersonians in this year’s election, it could shift one or more swing states, and throw presidential elections to the Democrats.”
It’s not Medicare that will lose the Libertarians. Because even they recognize that older Americans get sick, they will get taken care and someone has to pay for it. The complexity is in the details.
No, the more dominant animator that drives Libertarians away from normative Conservatism is the Neocon hijacking of foreign policy that is predicated on maintaining an obsolete and unaffordable American Empire Model along with aggressive Militarism abroad and para-Militarism domestically.
Fixing sick people in the States is a social obligation, being World Cop is not…
August 31st, 2012 | 10:09 am
I’ll trade the Department of Energy, the EPA, Homeland Security, EEOC, HHS and the Fed for Medicare.
Deal?
August 31st, 2012 | 10:26 am
david c,
I have no quarrel with the assertion that the debt has skyrocketed under Obama. We could argue until the cows come home as to whether it was foolish or wise to run huge deficits the past few years, but that is a different issue than the one I am raising. I am simply pointing out that the numbers show deficits began to balloon with the presidency of Ronald Reagan, continued under Bush 41, declined under Clinton, and shot up again under Bush 43. We can all read the numbers from objective, nonpartisan sources, and the numbers say that the last three Republican presidents, who have all claimed to be for smaller government, have added dramatically to the federal deficit. The presidency of Ronald Reagan reversed a trend of almost 35 years of falling debt and sent it soaring again. It’s just a fact.
August 31st, 2012 | 10:34 am
Steve M,
Were Bush, Powell, Cheney, and Rumsfeld, part of some neo-con cabal? Or were they “highjacked” by some mysterious clique? And speaking of “highjacking” — you mention America’s alleged “aggressive militarism abroad” — are you referring to attacks against those who killed 3,000 of your fellow citizens?
August 31st, 2012 | 11:07 am
are you referring to attacks against those who killed 3,000 of your fellow citizens?
publius,
Well, that certainly wouldn’t be Iraq. And while I think Afghanistan could not have gone unpunished for harboring al-Qaeda, has invading Afghanistan and fighting the longest war in American history there been the appropriate response to the 9/11 attacks?
August 31st, 2012 | 11:39 am
David,
What was the alternative to invading Afghanistan when the Taliban government refused to hand over Bin Laden and his Al Qaeda cohorts and shut down their training camps? Should we have gone to the U.N. and passed a resolution condemning the Afghan government?
Additionally, the notion propagated by Steve M that a group of “neo-cons” “highjacked” American foreign policy is conspiratorial fiction, frequently accompanied by an anti-semitic undertone. Bush, Cheney, Rumsfeld and Powell were not neo-cons. Nor were Hillary Clinton, Joe Biden, Harry Reid, John Kerry, John Edwards, and the other 20+ Democrats who voted to invade Iraq.
They believed, along with U.N. inspectors and most of the world’s intelligence agencies that Saddam possessed WMDs. Saddam was hardly a force for peace and stability in the Middle East, having invaded Iran, Kuwait, and used poison gas on his own people and defied countless U.N. resolutions. In the context of the immediate post-9/11 world, toppling that rogue regime was hardly an example of America’s “aggressive militarism abroad.”
August 31st, 2012 | 2:00 pm
“I think Romney and Ryan (and Obama) are not leveling with the American people. Turning Medicare into a voucher program, with the vouchers decreasing in purchasing power with every year that passes and medical costs continuing to rise, is not my idea of saving Medicare.”
@DavidNichol,
And niether is it mine. When one looks at the the Three Big Entitlements, and their relative costs, it is Medicaid and not Medicare that is rising the fastest. But, in future years both will race eachother to the top. Our entitlements have been engineered for a nation that can provide an ever growing, large pool of young, educated, high earners. We have the opposite. There is just not enough tax revenue available to all of the public funded good works.
For this nation to afford our entitlements, we would need to have national birthrates of around 3.5-4.5 children per female.Currently our birthrate varies between 1.7 and 2.0 children per female.From 1970-1990 it averaged between 1.5 and 1.8 . We can have a society that practices “good stewardship” as far as family size is concerned. We can have a society that supports a generous social safet net. But we cannot do both.
August 31st, 2012 | 4:17 pm
JP,
Here is the truth nobody is willing to tell (it seems to me).
Medical costs both in Medicaid an Medicare are rising rapidly. As you point out, the ratio of those paying into Medicare is too small to support the medical bills of people collecting Medicare. And of course the people receiving Medicaid are poor, so basically the same workers supporting Medicare are also supporting Medicaid.
In spite of what many people may think, as insurance goes, Medicare and Medicaid are reasonably efficient. As costs continue to increase, giving Medicare recipients vouchers to buy their own insurance—if the vouchers are expected to cover the same thing Medicare covers—cannot be expected to save money. (In my opinion, expecting costs to drop because of increased competition is pretty much a fantasy. Even if they drop some, can they really drop enough to make a significant difference?)
So if payroll taxes on workers are too burdensome to keep supporting Medicare, and vouchers for those on Medicare to buy their own insurance would be just as expensive as Medicare, it means that one way or the other, Medicare recipients are going to have to give up significant benefits and either pay for what they lose themselves, or do without.
So Democrats who are offering no plans at the moment are avoiding talking about an awful truth, and Republicans who are claiming they will “save Medicare” are not telling the awful truth that “saving” Medicare means significantly cutting benefits to the point where only the wealthy will be able to afford to buy additional coverage and not be underinsured.
Medical costs are going up so fast that, if things continue as they are, a great many people will not be able to afford medical coverage if the problem is approached collectively (with government taking a very active role) or individually (with vouchers and the like).
The American health care system is simply way too expensive, and for the average person, even currently, it isn’t very good. Other countries get far more for considerably less.
August 31st, 2012 | 5:34 pm
Or to put it a lot more succinctly, it’s not that—if the current trend continues—the government won’t be able to collect enough in taxes to pay all the medical costs for the poor and the elderly. If the current trend continues, there won’t be enough money to pay all the medical costs for the poor and the elderly.
September 1st, 2012 | 9:50 am
So, we’ve reached a crisis point. In only 5 years Medicare/Medicaid costs combined will approach $1.5 trillion -if current policies continue unabated.
On the one hand we could attempt to attack the problem via the cost levels. Of course, getting the 23 million Americans currently not employed would be a plus. If it comes between funding retirees and a 25 year old, I think most would chose the retiree. On the other hand, I don’t think most people could eye an unemployed 35 year old plumber with cancer, and say “you’re on your own.”
What will most certainly transpire, even with Health Exchanges and all that, is rationing.Of course, it won’t be called that. But, somewhere a bureaucrat will make the cost-benefit analysis. Do we pay $75,000 for granny’s hip replacement? Or do we cover the $150,000 treatment costs for a the unemployed plumber, who if he survives, can still generate another 30 years of tax revenues?
September 3rd, 2012 | 7:05 pm
it is a matter of national survival to adjust the social welfare state to what we can afford. It is also a matter of basic fairness not to pull the rug out from under people who depend on promises made by politicians in the past.
We could have a theoretical discussion of why social insurance should be trimmed way back and while we tried to convince people, the entitlement tsunami would drown us all. The best we can hope for is to avoid catastrophe through something like the Ryan plan.
I think the Social Security system is doing grave damage to America but this idea is not in political play for the foreseeable future.
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