Certainly telling seniors to buy all their own health care is a complete political (and ethical) non-starter. But telling seniors to pay for more of their own health care — well, it’s hard to see how else we can hope to reduce Medicare’s fiscal burden. Maybe the premium support/voucher model that the Ryan budget proposes isn’t the optimal way to do it. But every other mechanism for serious cost containment leads inexorably to a similar place.
This is obvious when you think seriously about the main Obama administration proposal for Medicare reform — the famous IPAB plan, which would put a board of experts in charge of deciding which treatments Medicare will and won’t cover. If it had any deficit-cutting teeth at all, such a board would constantly end up asking seniors to pay for their own health care (or else go without it), by refusing to pay for treatments that doctors would otherwise prescribe.
From We’re All Rationers
Mr Douthat is right here. There is no form of cost control that is not also a form of rationing. Anyone that is pro-cost-control but anti-rationing doesn’t understand the problem.
What we think of as traditional marriage is not universal. The default family arrangement in many cultures, modern as well as ancient, has been polygamy, not monogamy. The default mode of child-rearing is often communal, rather than two parents nurturing their biological children.
The point of this ideal is not that other relationships have no value, or that only nuclear families can rear children successfully. Rather, its that lifelong heterosexual monogamy at its best can offer something distinctive and remarkable a microcosm of civilization, and an organic connection between human generations that makes it worthy of distinctive recognition and support.
So this is a conservative case against marriage rights is to recognize traditional marriage as social engineering and is worthy of support because of the pretty genealogy diagrams? Huh? I wonder if Mr. Douthat would support asexual reproduction because you can use Venn Diagrams for genealogy. I generally like Mr. Douthat’s column but this is really an awful argument in what is his worst column of the year.
No ideology survives the collision with real-world politics perfectly intact. General principles have to bend to accommodate the complexities of history, and justice is sometimes better served by compromise than by zealous intellectual consistency.
This was all that Rand Paul needed to admit, after his victory in Kentuckys Republican Senate primary, when NPR and Rachel Maddow asked about his views of the 1964 Civil Rights Act.
Like many outside-the-box thinkers, theyre good at applying their principles more consistently than your average partisan, but lousy at knowing when to stop. (Hence the tendency to see civil rights legislation as just another unjustified expansion of federal power.)
Ross Douthat dissects Rand Pauls gaffe and demonstrates why libertarian ideologues do a disservice both to their cause and to open honest policy debate in general.