So Dan Miller critiqued me and conservatives in general for not talking about health policy enough, and he’s right. We haven’t. Part of this is because when it comes to government planning there is just so much to talk about. If I were a progressive blogger I could talk about how we could plan this or that development, or structure this or that plan around our education system, or shape this or that policy to use the government to at once cover more people and save money doing etc. etc. etc..
Lots of charts and numbers and predictions would be at my fingertips. Conservatives scorn social planning and therefore dismiss a lot of this wonkishness. So you don’t have the elaborate plans that liberals do when it comes to something like health care. (Ironically the most effective rebuttal to Waxman-Markey was via Jim Manzi who used lots of charts and other wonkish communication tools…)
Now, this is okay up to a point – conservatives shouldn’t want to map out everything as much as liberals do, because part of what conservatism stands for is organic, market-driven growth and individual choice. But the problem with leaving it at that is that we are in fact stuck with a pretty massive state and we do need to have an exit strategy if we want to deregulate or have a shot at changing entitlements to better fit a conservative model – because, quite frankly, entitlements are popular. They can be better managed then they are. They can make better use of market solutions. But they’re more than likely not going away, and maybe they shouldn’t. We need safety nets.
Things like vouchers, and direct-payment rather than relying on lots of red-tape-adorned bureaucracies are good ideas that need to be more fleshed out. Viable alternatives that don’t leave people thinking their health care or their social security would be left as vulnerable to a crash as their 401k’s were are important to articulate.
Conservatives need more wonks, plain and simple. But the job of conservative wonks should be to plan out the gradual dismantling of big government without falling prey to all sorts of pitfalls that we’ve seen in the past – like hiring private contractors to do government work, both domestically and increasingly overseas. Deregulatory capture is something I’m interested in but don’t know much about – though I think I know enough to believe that it’s a very real threat.
In any case, not to ramble, but I think a lot of things – from conservative takes on community-building and new urbanism to health care and better schools – all have a need of more in-depth, critical thought from the right of the aisle. Blaming those damned liberals for everything will simply not do. I think this is what I was touching on a bit in my post on distrust of government. Sure, we should distrust it for its inefficiency and the ease with which it is manipulated by special interests, but we should also work to figure out how the bloody clock ticks. If you can’t figure that out, then any attempt at dismantling it will fail.
Exit question: Why didn’t the Democrats just push Medicare expansion instead of a brand new program? Wouldn’t that have been a lot safer and cheaper? This has been raised in the comments and elsewhere. I’m curious to know if this sort of thing would have been acceptable for progressives. Certainly it would have been (I imagine) more palatable for conservatives. It’s more palatable to me – just expand existing programs to cover essentially everyone who isn’t covered now, and then maybe start scaling toward more market-oriented solutions. Try to get those benefits taxed to help pay for it, etc.