IT'S UNDERSTANDABLE IF MR. BARTLETT RESENTS W FOR CLEANING UP THE MESS REAGANAUTS LEFT BEHIND (via Pepys):

What Is a Bush Republican? (Daniel Casse, March 2006, Commentary)

[Bruce] Bartlett’s analysis is altogether reminiscent of the sky-is-falling tenor of Stockman’s 1986 memoir, The Triumph of Politics, written after he resigned as White House budget director and bearing the subtitle, “How the Reagan Revolution Failed.” Stockman believed that Reagan’s unwillingness to cut spending doomed future generations to fiscal peril. In Impostor, Bartlett makes a similar argument. His own agent of impending calamity is the Medicare Modernization Act of 2003, passed by Republicans at the insistence of the President and, by Bartlett’s lights, the “worst legislation in history.”

The 2003 bill created, for the first time, a prescription-drug benefit as part of the Medicare entitlement program, which until then had provided reimbursement only for hospital care and doctors’ visits. As a matter of public policy, analysts had long decried the anomaly of a program that paid for expensive bypass surgery but not for the far less costly statin medicines that can help prevent heart attacks in the first place. As a political matter, many also believed that this was an opportunity Republicans could not pass up; Democrats had been successfully exploiting the issue for partisan gain since Reagan’s time.

Dismissing the claims of a political upside to Bush’s move, Bartlett focuses instead on how the initial projections for prescription-drug coverage had vastly underestimated the program’s long-term costs. Since then, the Medicare Trustees, an independent group, has raised its own long-term estimates still further, projecting, over the next 75 years, more than $8 trillion in drug entitlements with no funding source in sight. Hence Bartlett’s view that, absent drastic reductions in benefits, only higher taxes can avert fiscal disaster.

It is certainly true that, so far, the legislation has brought Bush little political benefit. Moreover, implementation of the plan beginning this past January has been so rocky, leaving some of the most financially vulnerable seniors without their prescription medicine, as to overshadow all else. Nor do most health-care actuaries and budget experts disagree with Bartlett that longer-term costs are the real problem.

The same goes for the many conservative activists who have echoed Bartlett’s arguments. Stephen Moore, until recently the head of the Club for Growth, a fundraising organization for free-market political candidates, said that his group could not “in good conscience support [this] largest entitlement expansion in decades.” Former House majority leader Dick Armey declared that “the conservative, free-market base in America is rightly in revolt over” the plan. The Wall Street Journal described the legislation as a “Medicare fiasco.”

And yet it must be said that there is something peculiar about these cries of alarm from veteran Washington observers. The unfunded liability of the entire Medicare program has not exactly been a secret. Although the addition of a drug benefit certainly compounds the problem, it has hardly created a substantially new one.

The liability of the drug benefit over the next 75 years is estimated at $8.7 trillion; the liability of the hospital and doctor-visit components of the Medicare program already in place is nearly three times that figure. In the words of Gail Wilensky, a former head of the federal Medicare and Medicaid programs, “this is not a fundamentally different problem.” The real debate concerns how Congress should eventually contain the costs: through regulation and price controls, or through market mechanisms and means testing. It is long past time for that desperately needed debate to begin, and the addition of a prescription-drug benefit—which was bound to occur at some point or other—will surely hasten it.

There is, besides, good news in the drug bill itself. Among its provisions are three significant reforms that conservatives have been advocating for years but that have received scant attention from Bush’s critics. The first is the creation of health savings accounts for seniors, which give individuals far greater control over their spending decisions. The second allows private-sector insurance companies to compete in offering seniors their choice of drug-coverage plans. This has already shown more impressive results than predicted: in late January, the Wall Street Journal reported that the new Medicare benefit had sparked “a competitive scramble in the health-insurance industry,” with companies vying to lower costs.

The third reform is both the most overlooked and the most important. Starting in 2007, high-income seniors will see their Medicare subsidies for doctor visits drop from 75 percent to 20 percent of the bill. That the federal government should have been providing any Medicare subsidy at all to wealthy retirees is a puzzle unto itself, but the short answer is that Democrats in Congress have fiercely resisted any significant reform of the benefit structure of Medicare that might change its status as a universal entitlement. Therein lies precisely the value of this reduction. It advances a long-sought conservative goal—beginning to wean the wealthiest seniors from taxpayer-funded coverage—and sets a precedent for battles yet to come.

If, indeed, conservatives are ever to achieve a fundamental reform of Medicare through means testing and market competition, they will inevitably have to build on the changes introduced in this bill. That many of Bush’s conservative critics have failed to grasp this simple truth is a telling comment on the degree to which their narrow focus on the raw dollar amounts of government spending has blinded them to their own ideological interests.

Introducing incremental conservative reforms into big-government programs has become, in fact, something of a hallmark of George W. Bush’s brand of governance. Two years ago in these pages, I argued that he was, in piecemeal fashion, offering up what amounted to a new version of conservatism.2 Rather than focusing on the sheer size of the federal government, he was focusing on outcomes and how to produce them.

Thus, in education, he supported a costly spending bill in exchange for establishing a hitherto unheard-of emphasis on testing at the state level. To alleviate poverty, he set out to harness the work of the faith community as a complement to, if not a substitute for, the work of welfare bureaucracies. To reform Social Security, he proposed a gradual—and again costly—transition to private retirement-savings accounts. To reform Medicare by encouraging more Americans to choose individual health-savings accounts with high deductibles will likewise be costly, requiring deficit-ballooning tax incentives that, according to the latest budget, are projected to deprive the government of $60 billion in revenue over the next five years.

To be sure, Bush has still not succeeded in delivering on many of his proposals. Nor, despite the use of inadequate slogans like “compassionate conservatism” or “the ownership society,” has he ever presented them as constituent elements of a coherent philosophy. To the contrary, his advocacy of import restrictions on steel, and the Department of Energy spending initiatives announced in his latest State of the Union address, smack more of liberal industrial policy than of any conservative aim. In that sense, it is hardly surprising that some conservatives are as bewildered as they are angry.

In a welcome new book, Fred Barnes of the Weekly Standard has set out to remedy the lack of a consistent thread to Bush’s proposals while countering the “bickering and grousing” of discontented conservatives. According to Barnes, Bush has achieved something for everyone in the Republican coalition: supply-side tax cuts, an idealistic foreign policy, the concept of private accounts for Social Security, the appointment of strict constructionists to the federal bench, staunch opposition to abortion and gay marriage. Is there a philosophy in this smorgasbord of policies? Barnes argues that there is: “coherence rests with the three words and one institution that sum up Bush conservatism. The words are choice, accountability, and freedom. The institution is a strong national government.”

Barnes’s pithy formulation is unlikely to satisfy the angry conservatives, or to silence calls for small government. But it does convey accurately enough the direction of “Bush conservatism”—and it does undeniably comport with political reality. As unpalatable as it may be for some conservatives, the fact of the matter is that reducing the size of government no longer resonates with Americans as it once did. In 1996, when a Washington Post survey asked respondents if they favored smaller government providing fewer services, 63 percent said yes; by mid-2004, the proportion had fallen to 50 percent.

Does this mean, as Bush’s critics contend, that thanks to him the Reagan revolution really has failed? Hardly: the declining place of “small government” in the list of public priorities needs to be seen in the twin context of conservative triumphs over the past 25 years and the arrival of new anxieties—terrorism, homeland security, retirement, health care—that are unavoidably the province of “strong national government.” Advising Republicans to raise again the fallen banner of small government is thus no recipe for success, ideological or political. “Just as socialism [is] no longer the guiding goal for the Left,” wrote the New York Times columnist David Brooks on the eve of the Republican national convention in 2004, “reducing the size of government cannot be the governing philosophy for the next generation of conservatives.”

There are other pitfalls as well in concentrating on the ways in which Bush falls short of the Reaganite ideal of conservatism. In the first place, it overlooks the many other ways in which he is more conservative than Reagan. Take, for instance, gay marriage, stem-cell research, and cloning—contentious moral issues that never confronted Reagan, that are fraught with political risk, and on which Bush has adopted clear and consistently conservative positions. He has also been arguably more active than Reagan when it comes to proposing and defending conservative nominees to the federal bench. Although they have not yet met with success, his proposals for private accounts in Social Security, a permanent end to the estate tax, and market-oriented health-care reforms as outlined in this year’s State of the Union address bring conservative ideas into policy realms never explored during the Reagan era. In the area of national security, he has expanded the homeland-security apparatus and been unhesitant about using executive-branch powers to track suspected domestic terrorist activities. In foreign policy, his uncompromising determination to defeat global terrorism has led him to be much less sparing in the use of force than Reagan ever was.

Nor, speaking of pitfalls, should one forget that Reagan’s two terms in office were full of contradictions of their own. Reagan’s speeches may have excoriated Congress for its failure to send him balanced budgets, but his (admirable) build-up of defense expenditures made such a balanced budget impossible. His embrace of supply-side tax cuts was countered by the tax increases he signed in 1982—at the time, the largest in American history. Reagan also did not hesitate to spend more to help favored industries like agriculture and timber.

In fact, there is no issue on which Ronald Reagan was more conservative in practice than George W. Bush and not many where he was more conservative than Bill Clinton.

MORE:
Betraying the Reagan Legacy (Bruce Bartlett, 2/28/06, Real Clear Politics)

Ronald Reagan was almost as great a president as his times allowed for, but the simple political reality is that he ran up huge deficits, signed several tax increases, negotiated auto import quotas, traded arms to Iran, negotiated with the Soviets, saved SS and did not reform a single entitlement program, took few steps to reduce abortion, and not only never took the House but turned a GOP majority in the Senate into a ten seat advantage for the Democrats.

Posted by Orrin Judd at March 1, 2006 10:24 PM