pet projects

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.

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18 thoughts on “pet projects

  1. “because part of what conservatism stands for is organic, market-driven growth and individual choice”

    Part of the problem is these words, which are all good, become simplistic platitudes when uttered to much. It’s fine to believe in them, even I as an evil librul, think they are good. The assumption that they are always the most salient and only issues is rarely answered. I can’t even begin to count how often all markets are considered to have the same dynamics in conservative talk. Conservatives often come off as dogmatists for simply insisting on the same handful of buzzwords in every case. Now it might be possible to show how those concepts have a solid logical basis, but it takes a wonk to do that. To many conservative plans read as:
    1 apply conservative principles
    2 things work perfectly
    3 the end

    So I agree, bring on the conservative wonks who can dig into the details.

    I don’t think Medicare is seen to easily scale up to include more people. There needs to be a solution for small business which the health care exchanges are aimed at. The liberal view, as much as I can represent it, is that markets have severe limitations in health care and have failed in a major way.

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  2. I’m sorry, but I don’t buy this whole premise offered by Miller. It almost sounds as if there is awe at what the liberals have accomplished, when in fact there should be horror, and the conservatives are complicit — the Republicans should feel guilt for helping, not shame for not out-wonking them.

    The conservatives had their shot, with Reagan and with Bush, and they blew it. The conservatives had a nation ready and willing to have government give power and responsibility back to them and the conservatives misread it. The conservatives thought if they didn’t play the liberal game, they would scare people and lose power, wouldn’t be accepted by the power elites in Washington, so they grew government and they hid like cowards when the liberals barked and called them reactionaries or made them look like monsters. Then people saw it was all a game and said — “If you’re giving, then we’ll take” — or they just said — “Fuck it”.

    The covervatives didn’t, and don’t, have the courage of their convictions, not in politics — the politicians are politicans and they can’t win now by out-tinkering and out-wonkering, trying to guide the process gently back to sanity. Every move they make to try to stem the tide of statism by offering alternatives will be shouted down as anti-progressive, mean-spiritied and uncaring. The conservatives helped create the statist monster and they don’t have what it takes to slay it. There are only two things that can stop the statist behemoth now — citizens saying enough is enough and resisting statism with revolutionary zeal, which is not not likely to happen, because there is no party in politics to back them, or government collapse, which is very likely to happen.

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  3. One of the things I have argued frequently is that liberalism is not always bad as a generator of ideas. The problem is that there’s often a heavy overreach. Conservatism checks that. Ideally they work together to move the country forward at a safe and responsible pace.

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  4. I think you’re right that what needs to be done is intra-coalitional. A good analogy might be the intra-left fight over single payer health care. It took a lot of argument and discussion amongst lefties to get people to accept that a pure single-payer plan wasn’t a viable option (in fact, you’ll still occasionally see splits over this, as in the highly public fight waged by the California Nurses Association). It took years to get everyone on the same page as to what the bare minimum we’d be willing to accept was. But now, the groundwork has been laid, and basically the entire progressive movement can work on pushing what they see as a politically viable yet acceptable bill.

    Similarly, conservatives are going to have to figure out a compromise between their movement and reality, both in the form of physical/fiscal reality (global warming, health care) and public opinion. It’ll probably have to include some form of cost controls for health care (because our fiscal structure goes *crunch* if it doesn’t); it’ll also have to include Social Security, although there are changes that could be made within that structure like means testing, raising the retirement age etc. But this process will have to take place before it’s possible for conservative government to really work.

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  5. As for your question about Medicare expansion–I believe “Medicare for All” would be logistically equivalent to a single payer (or so indicates this old Ezra Klein post). We’d love it if we could get it, but no way does that pass the Senate (probably not even the House). No way would it be “more palatable to conservatives”, at least not the kind who actually get elected.

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    • Yeah, it’s a little odd to ask that question, as much as E.D. says he’d give the idea a listen. I have a suspicion he’d give a listen and say, ‘No thanks.’

      Obviously, if the leftern half of Democracia as it exists today was located smack-dab in the middle of the center-right of American politics (where anything needs to be to pass), we’d have Medicare for all, as many Europeans do. The reason we don’t is that the center-right in this country (as measured in global political terms) actually occupies the center-left of our politics (Ben Nelson, Mary Landrieu, etc.). And so we don’t.

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      • And E.D., if you really are for Medicare for all, all I can say is that’s fantastic. Can I interest you in an intermediate step that could very well lead us there if it turns out to be popular enough, and there is enough political support for then going the full monty?

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        • For all? I think that would be a disaster (sort of like Social Security for all but worse). However, I would not oppose, at this time (for lack of any real alternatives) expanding Medicare to cover more of the uninsured. I would like that to come with an overall deregulating of the system, though. I think any expansion of the safety net should include a retreat of the government from the markets.

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  6. Medicare for all would chip away at the profits being made by private insurance companies and their lobbyists (K Street) don’t like that idea.

    Despite my being a strong Democratic supporter, I believe members both parties are equally susceptible to the allure of large campaign donations. That is why Medicare for all (a single payer concept) has so little traction.

    General revenue funded basic Medicare for all (as a floor) with private insurance available for those who wish to buy supplements is my preferred solution. Tweaking is probably necessary, of course.

    I also believe that the essence of our health care crisis is that too large a slice of every dollar spent goes to middle-folk (managers, accountants, MBAs and MFAs) and too little goes to care givers (MDs & RNs and so forth).

    Big Business and Big Government are working hand-in-hand to preserve these profit centers. Adam Smith would be appalled by both parties (Dem & GOP).

    IMHO, as always.

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  7. As has been said elsewhere by I-don’t-remember-who, conservatives seem to have confused their means with ends. “Organic, market-driven growth and individual choice” is not a goal worth standing for. It’s a means worth advocating as the best option for promoting a free and prosperous society that people want to live in and raise their families in.

    Since the conservative movement swallowed the Reagan message whole hog 30 years ago, they’ve uttered “small government” and “no more taxes” and “strong defense” so often that they’ve forgotten the point of those things and come to believe they are themselves the point. But most families don’t care about small government. They care about feeling safe, and having the means to support themselves, and being able to do what they want without people interfering. There may in fact be more options for how to achieve that than “small government” and whatever the Democrats come up with. It would be nice if more conservatives bothered to think about those, and put them on the table for public consideration.

    But conservatives would have to see their responsibility as greater than merely laying out principles in order for that to happen. I’m really grateful that some here are trying to do just that. In the end, it’s going to take a willingness among conservatives to learn to *design policy*. Anti-planning has to turn into acceptance that there is better and worse planning, and conservatives will need to develop not just ideas but methods that lead to better planning along with examples of what better (more limited, more conservative) plans look like.

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  8. PS — Single payer is not politically viable, I agree. To fight for it today would be futile and President Obama should not choose that hill to make an Alamo like stand.

    That said, I also believe that anything less than single payer will leave us with a highly dysfunctional and unsatisfactory system.

    That is why I like a Medicare for all system offering basic coverage with folks being free to buy whatever private supplemental coverage they desire.

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  9. My fear in conservatives touting any moderate big-government health care proposal is that it will have the same effect as lame-duck Bush starting the whole bail out cycle even before Obama took office. It would have been nice if conservatives could point to some kind of break between conservative and progressive ideologies. But we can’t do that now, because in many ways Bush was no conservative.

    Thus, conservatives ought not worry excessively about putting together some fantastic hybrid plan that is somehow at once pragmatic and principled. For one thing, I highly doubt such a thing exists. And for another thing, the paramount endeavor is to hold the line on principles of limits on government dictated by the Constitution and first principles. That position may continue to take a beating, but someone has to keep the fire burning until the grand experimenters run back screaming from the monster they’ve created.

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    • Tim, I think you’re way off if you believe that slashing the safety net is going to win you votes. There’s a reason it’s never been done, and it’s not just political cowardice–it’s a realization that it would never pass, would look bad while failing to pass, and would fail both politically and policy-wise. Your movement is going to have to realize that we can’t get rid of Medicare, just like I can’t get rid of guns or publicly finance all campaigns.

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      • Dan,
        You’re probably right that it would not win any votes. Though I’m not talking so much about slashing the safety net, as I am talking about being extremely cautious about expanding it. In fact, you just identified another reason to be wary about expanding it: it could never be repealed. Entitlements are a one-way ratchet. See, e.g., Goldberg v. Kelly.

        However, I think we may be talking past each other. Proffering solutions while wearing an elephant lapel pin does not make those solutions conservative. Realpolitik should be anathema to true conservatives. Although it is clear that people right now want immediate relief, and they are looking to government to provide it, there will again come a time where people want government to shrink again. In that sense, there is a lot of political capital that conservatives can collect right now in the form of something like bonds with a mature date still several years off.

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