May 1, 2012

FIRST THINGS FIRST:

Why Reform Conservatism deserves a chance (Michael Gerson, 4/30/12, Washington Post)

Rejectionist Conservatism, which comes in tea party and libertarian variants, would use current political controversies to fundamentally reorder the role of the federal government. At least in theory, it would repeal not just Obamaism but also the Great Society, the New Deal and much else in pursuit of a minimal state.

Reform Conservatism, in contrast, would seek to achieve federal goals in modern, market-oriented ways. It is less concerned about re-founding the country than making Medicare work. Its chief practitioner is Rep. Paul Ryan (R-Wis.), supported by a few policy experts of disproportionate creativity and influence. [...]

Ryan's expression of Reform Conservatism has both virtues and vulnerabilities. It deals seriously with the fiscal crisis -- which, driven by demographics and cost increases, is a health entitlement crisis. For 40 years, federal, non-health-related spending has been relatively stable as a percentage of the economy. During the same period, federal health spending has increased as a share of the economy by more than five times and will double again by 2050. No realistic amount of tax increases or discretionary spending cuts can cover this expanding national commitment. Either health entitlements, particularly Medicare, are substantially reformed, or their cost will consume every other purpose of government.

Ryan proposes moving toward a premium support system in Medicare in which seniors could choose a private plan or current Medicare. Competition would put downward pressure on costs. Poorer and sicker seniors would get extra help. Middle- and upper-income seniors, over time, would pay more out-of-pocket. It would be a difficult but orderly transition to a more market-oriented, means-tested system.

Ryan's Reform Conservatism is more vulnerable to criticism on the way it deals with long-term economic growth. It would lift some tax burdens on the economy, but it probably underestimates the challenge of globalization and does not specify the measures necessary to increase American competitiveness.

And Ryan's approach is least impressive in confronting America's main social problem -- a lack of social capital and economic mobility at the bottom of the income scale. There are a variety of good conservative ideas to encourage teacher quality, savings and wealth building, financial literacy, good parenting skills, and high school and college completion. They are not even a peripheral part of the Ryan agenda, which is dominated by addressing the fiscal crisis.

While Democrats are going to fight making medicine more market based, the infusions of cash that will go to children in things like O'Neill accounts should appeal to them, just as W bought vouchers with NCLB cash and HSAs with prescription drug money.

Posted by at May 1, 2012 8:43 AM
  

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