For a bill that will not put a dime in this Senior's pocket-in fact will cost me-it sure is spending one hell of a lot of money. Of course, if I get a chronic illness that runs big Drug bills, I will be damn glad to have it.
November 26, 2003, 9:19 a.m.
What Would Kirk Do?
The Medicare bill was inevitable.
By James P. Pinkerton
— James P. Pinkerton is a columnist for Newsday and a Fox News contributor. A veteran of the Reagan and Bush 41 administrations, he is author of What Comes Next: The End of Big Government-And the New Paradigm Ahead.
Most NRO-ers seem angry about the prescription-drug bill on its way to a presidential signature. And maybe they should be. But they shouldn't be surprised.
A prescription-drug benefit is what one should expect when there's so much demand (defined as the elderly and near-elderly dominating the electorate), so much supply (defined as the wealth generated by the U.S. economy growing at a Hong Kong-like 8.2-percent pace), and so little restraint on the American people's social-welfaring appetite (defined as the complete collapse of fiscal conservatism). Add those three factors together, and we get the right-tilting politics of the 21st century, which are far from the conservatism of most of the 20th century. For the conservative view of the world, sub specie aeternitatis, the passage from one century to the next should be small matter. But for the Republican party, the alleged vessel of that conservative worldview, everything has changed.
This free-spendingness is not universally embraced, of course. David Frum worries that "the drug benefit is a very high price to pay." The Cato Institute's Doug Bandow derides the legislation as "the largest expansion of the welfare state in 40 years . . . Republicans are merely Democrats-lite when it comes to using taxpayer monies to buy votes."
Indeed, the Heritage Foundation, as an institution, has gone all-out against the plan, as any visitor to Heritage.org will see immediately. Stuart Butler and Robert Moffit have posted a piece entitled "Time to Rethink the Disastrous Medicare Legislation." Dan Mitchell argues that the bill "undermines" the effort for tax reform, defined, of course, as a flat tax. And speaking of taxes, Rea Hederman calculates that taxpayers would see an immediate $41-billion tax increase if the government were ever to try to run the program on a "pay as you go" approach — which it won't. Heritage further calculates that the program will add an extra $200 billion to annual federal expenditures by 2030.
To be sure, that's a lot of money. But then, we have a lot of money in this country. Indeed, the GDP was just revised upward to $11,063 trillion, up from $9,824 trillion in 2000. In other words, a prescription-drug program, projected to cost $40 billion a year — more if one adds overruns — is a mere drop in the gusher of funds, the additional $1.2 trillion in annual output generated since George W. Bush took office. Indeed, if the economy were to grow at half the current rate of 8.2 percent through 2030, then the GDP of the country would almost triple, to about $31 trillion. And even if the economy were to grow at a far slower rate, the drug benefit looks manageable.
Which, of course, is the approach taken by the Bush administration and most Republicans in Congress: Social-welfare issues are to be managed. They are to be examined through the lens of political costs and benefits. And so a program desired by senior citizens that's affordable is a no-brainer. And if the Democrats are "dished," as the Tory Disraeli dished the Whigs, then all the better.
What's lost in this sort of calculation, to be sure, is the principle. Once upon a time — like, maybe, 40 years ago — conservatives argued according to principle, not according to economistic opportunism. In his 1962 book, Why Not Victory?, Barry Goldwater wrote, "None of us here in Washington knows all or even half of the answers. You people out there in the 50 states had better understand that...If you cherish your freedom, don't leave it all up to big government." Or, as Ed Clark, the Libertarian candidate for president in 1980 argued, "I'm not here to cut the fat out of government; I'm here to cut the muscle out of government."
Now that's principle: Even if we can afford it, you shouldn't have it, and you shouldn't want it. But it's revealing that in the last couple of decades, hard-core libertarian arguments have been made by Libertarians, no longer by Republicans. Why have Republicans given up the Goldwater ghost? The answer might have something to do with the fact that the Arizonan got clobbered in 1964, in no small part because he mused about repealing Social Security and much of the New Deal. Such talk was warming to Buckleyite hearts, but it was no substitute for victory, most conservatives concluded after Goldwater's six-state showing in the '64 presidential election.
Indeed, the next conservative to win the presidency, Ronald Reagan, didn't sound like Goldwater at all in his victorious 1980 campaign. The Gipper said that cutting tax rates was good, not because it would "starve the beast" of big government, but rather because Laffer-magic would give the government more revenue, not less. Meanwhile, Reaganites such as Jack Kemp were even more explicit in saying that Uncle Sam's bulging coffers should be used to help "the truly needy." And it worked: Tax rates went down, growth went up, and so, too, did revenues and expenditures.
Bush, neo-Gipper that he is, liked that fun formula. In 2000, W. campaigned on the biggest expansion of Medicare since 1965, pledging to "ensure that prescription drugs are affordable and available for every senior who needs them." The Bush people figured that their Medicare-message was a vote getter for them in 2000, and they think so again, in 2004. And many on the right agree with that political assessment. John Podhoretz, for example, calls the bill "half-horrific" as a matter of policy. But, he continues, "strictly as an electoral matter, though, the bill is a masterstroke."
To be sure, the Republicans aren't simply copying the Democrats; instead, they've been coming up with their own alternatives, then seeking a compromise. Those alternatives are usually meritorious, insofar as they usually involve more reliance on market forces and less dependence on state money, but they all have one additional central element: They concede the basic idea of the Left, which is that redistribution is a good idea, that money should be taken from Peter to comfort Paul.
Interestingly, no outfit in Washington has done more of this compromise seeking than the very same Heritage Foundation, the outfit that today adamantly opposes the current Medicare-expansion bill. Yet previously, the folks at 214 Massachusetts Avenue, NE were willing to play ball with big government. That is, they have abandoned the old Goldwaterish critique of the Leviathan State in favor of a sophisticated wonkery that seeks out Third-Way-ish approaches to thread the needle between doing nothing and doing everything. That's the art of political compromise, of course, but in so doing, Heritage abandoned black-and-white absolutism — freedom good, bureaucrats bad — for the grayer vocabulary of Benthamism.
Typical of this au courant approach was an "Executive Memorandum" dated July 6, 1999. Four years ago, Heritage was attacking a prescription-drug proposal for seniors put forth by the Clinton administration. That Memorandum, entitled "Bill Clinton's Risky Drug Plan" — interestingly, Bush's plan in 2003 is "disastrous," whereas Clinton's was merely "risky" — offered a comprehensive critique of the Clinton plan for elderly pharmaceuticals. The Clinton proposal, Heritage argued, would both subsidize rich seniors and bust the budget. But then, in the signature Heritage style, the Memorandum recommended smaller government expansion, described as "two simpler, far less expensive steps." Those two recommendations — offering catastrophic coverage and su
bsidizing "Medigap coverage" — make perfect sense if one is trying to craft a lesser alternative to what the Democrats wanted, and want, which is the governmentalization of health care.
No wonder, then, that Bush's 2003 legislation addresses those two concerns of Heritage: It includes catastrophic protection to help the "truly needy" and introduces an element of means-testing to weed out elderly welfare kings and queens.
And yet, as we have seen, Heritage strongly opposes the 2003 bill. Yes, the think tank has its reasons, many of them. But those reasons have had little effect on the debate, because the major bipartisan players have all agreed that "something has to be done" on behalf of drug-needy seniors. And once that agreement sets in, the upward bidding war is set off. And at that point, Heritage's fine points are overwhelmed by the blunt instruments of gross political expedience.
So now we have a truly big-government program that's likely to be shoved along by the momentum of the Kennedyite permanent nomenklatura of Washington, rather than by the "Executive Memoranda" of the conservative counter-establishment.
What to do? Those conservatives who are happy — happy that Bush will be aided in his reelection, at least — need do nothing. But those wingers who wish to stand athwart the train tracks of history yelling "Halt!" — or even "Reverse!" — will need a new worldview.
Or maybe an old worldview. Interestingly, the makings of a true anti-Left conservatism are still on display at Heritage. On the same homepage is a link to a lecture by Lee Edwards, that elder sage of the Right, entitled "The Origins of the Modern American Conservative Movement."
Inside, Edwards recalls Permanent Things, things that have never once been subjected to cost-benefit analysis. For example, he cites Russell Kirk, author of The Conservative Mind (1953), which was so influential to the Goldwater generation. Edwards cites Kirk's six "canons" of conservatism.
A divine intent, as well as personal conscience, rules society;
Traditional life is filled with variety and mystery while most radical systems are characterized by a narrowing uniformity;
Civilized society requires orders and classes;
Property and freedom are inseparably connected;
Man must control his will and his appetite, knowing that he is governed more by emotion than by reason; and
Society must alter slowly.
As one reads those, one searches in vain for any accommodation with modernity, in any of its sophistic or technocratic forms. To Heritage's credit, Kirk is remembered on its site, to be read again, and anew. But at the same time, Heritage and others in the Republican party and the conservative movement put forth distinctly un-Kirkian arguments and alternatives. And in doing so, they compromised with the leftish Zeitgeist. And now, shorn of most argument about First Principles, let alone Six Canons, a far bigger welfare state is growing, and most Americans are perfectly happy to see it grow much larger. Much larger.
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