Philp Klein has been engaging my long-time friend Jim Pinkerton over the issue of conservative governance. Undoubtedly anyone seeking to change public policy must accommodate ideology with political reality on occasion. But the Medicare drug benefit, which Jim defends, is a perfect example of the worst sort of irresponsible politics divorced from serious governance.
First, the GOP continued the illusion of a government free lunch. Congress promised benefits without figuring out how to pay for them. This once was supposed to be the Democrats’ modus operandi. Now it has become a hallmark of Republican “governance.”
Second, with both Social Security and Medicare running huge unfunded liabilities, Congress made the fiscal bomb even bigger. Today the total unfunded liability for these two programs is $107 trillion. The unfunded liability of the drug benefit alone exceeds that of Social Security.
Third, the program was badly designed. The so-called “donut hole” is nonsensical, confounds the purpose of insurance, and invites future Congresses to spend even more by filling in the hole. Almost certainly “realistic” Republicans will help lead that charge.
Fourth, the drug benefit makes Medicare harder to fix, since Congress added a new program rather than integrating drug coverage into normal health care coverage. It’s a policy mess that has become almost impossible to sort out.
The tendency of Republicans to use libertarian rhetoric while imposing statist policies–big spending, federalizing education, expanding Medicare, and much more–has another dangerous impact. It undercuts the limited government message and reduces the credibility of anyone claiming to represent freedom values. It’s why voters became convinced that the Democrats were better on spending. Who can blame them? Under Republican government the GOP was spending money as fast as Lyndon Johnson and vastly expanding his social programs.
Conservatives have to ask: if the price of staying in power is making the largest addition to the welfare state in forty years, then what is the purpose of staying in power? If it is to simply to allow one rather than another set of political activists to exercise power, then anyone who believes in limited government should find other work To be fair to Bobby Jindal, his proposal is nothing akin the Medicare drug benefit. But the latter truly was both a philosophical and practical disaster. It is a good example of how giving in on essential principles is essentially the same as surrender..