Is the Conservative Establishment Against Entitlement Reform?

One of the oddest aspects of the last six months has been the degree to which the Republican base has embraced symbolic (9-9-9) over substantive (Paul Ryan) positions on entitlement reform from the GOP Presidential field. Why is this happening? Over at Redstate.com, bastion of populist conservatism, Dan McLaughlin thinks he has the answer. But in fact, his essay answers a different question: why it is that conservative voters remain woefully unprepared to tackle the fiscal challenges ahead.

“There’s been a lot of talk,” Dan opens, “about the struggle between the GOP ‘Establishment’ and ‘Outsiders,’ sometimes—but sometimes not—meaning the Tea Party…it’s time to clarify the core issue that has people…scratching their heads at their own constituents.” So what is it that divides conservatives? Is it social issues? Knowledge of French? “The answer is a simple one: it’s almost entirely about spending.”

According to Dan, the divide between the Establishment and the Outsiders is their commitment to reducing government spending. “There is general philosophical agreement among both Republicans and conservatives about [the need to reduce spending]. Where the fault line lies is in exactly how far we are willing to go to do something about it.” According to Dan, the establishmentarian candidates are “the two Northeasterners,” Mitt Romney and Rick Santorum, with Rick Perry and Ron Paul as the outsiders and Newt Gingrich “in the middle.”

But Dan’s formulation is problematic on many levels. First: insofar as Dan considers himself an “outsider,” conservatives who think Mitt Romney is too moderate are throwing the weight of their support behind…Rick Santorum and Newt Gingrich, not Ron Paul or Rick Perry. Ron Paul’s support comes largely from libertarians and non-Republicans, and Perry is in the single digits in most polls. So…people who support Romney, Santorum, or Gingrich (halfway) are establishmentarian, and only those who support Paul or Perry are outsiders? It lacks plausibility.

Which candidates have proposed substantive reforms?

And then there’s the substance. By Dan’s formulation, it’s Perry and Paul who are the most committed to spending reductions, and Romney, Santorum, and Gingrich who have made their accommodations to the welfare state. But the truth is in fact the opposite. Perry and Paul may supply the most bombastic rhetoric against entitlements (by, for example, calling Medicare unconstitutional), but it’s actually Mitt Romney and Rick Santorum—Dan’s establishmentarians—who have put forth the most serious proposals for Medicare reform. Dan demands that “the GOP [have] a more sustainable long-term answer to fixing entitlements,” but opposes the candidates who have proposed one, and supports the ones who have not.

Dan goes on to criticize Romney and Santorum, because they are concerned that Newt Gingrich’s market-oriented reforms to Social Security will cause a temporary, but huge, ballooning of the deficit. This is odd—because Romney and Santorum are right. We simply can’t afford, right now, to increase the debt to fix a program that is not as threatening to our fiscal survival as are Medicare and Medicaid. Indeed, Dan doesn’t even discuss Medicare reform in an article ostensibly dedicated to reducing spending.

Which commentators have proposed substantive reforms?

Dan also divides the “commentariat” into the establishment (National Review) and the outsiders (Redstate.com). National Reviewniks, he says, “no longer [provide] a sustained and serious voice of resistance to an Establishment that is unsustainable,” whereas RedState does, “which may say a good deal about why RedState’s following has grown apace these last few years.”

This, again, makes little sense. National Review has been the leading source of detailed conservative proposals and thoughtful conservative opinion on entitlement reform. People like Yuval Levin and Jim Capretta, who write regularly for NR, have effectively dedicated their careers to the cause of entitlement reform. Andrew McCarthy regularly denounces the Paul Ryan plan in NR’s pages because it “leaves the [entitlement] cancer in place” instead of abolishing it.

Now, I’m a great admirer of Redstate.com. Ben Domenech, one of its founders, is one of the best conservative writers on health care issues. But outside of Ben’s work, I haven’t seen any serious proposals for entitlement reform on Redstate.com. Maybe I just haven’t seen them, and if so, that’s my fault.

Of course, it’s not just about the candidate’s proposals, but also their records. Romney is saddled, as we know, with Romneycare. Santorum and Gingrich are responsible for the Republican expansion of government in the late 1990s and 2000s. Rick Perry has the most conservative track record as an elected official, but has persuaded few that he can serve as an agent of change in Washington. Ron Paul votes against everything, knowing that he can, because his votes are inconsequential. Indeed, Paul actively detracts from true entitlement reform by claiming that we can balance the budget solely by slashing defense.

The importance of tone

My sense is that the division between the conservative “establishment” and the “outsiders,” to the degree that this is even a real phenomenon, is one of tone and of identity politics. Conservatives have a well-earned suspicion of anything that comes out of the Northeast, and of Ivy League-educated coastal elites in general. The thinking goes that, since most Northeasterners and Ivy Leaguers are liberals, the so-called conservatives who come out of these places must be liberals also. Conversely, conservatives who come out of red states must be true conservatives.

In addition, the self-styled conservative outsiders rally around strong rhetoric, even if it is devoid of substance. When Ron Paul says that Medicare is unconstitutional, he comes across as the rock-ribbed “outsider” conservative willing to take on the spending Establishment. The rhetoric of Mitt Romney and Rick Santorum may be less inflammatory, but it is backed up with real proposals that stand a chance of getting passed by an actual Congress.

Ross Douthat of the New York Times wrote a piece last year, that I can’t find, in which he talked about how the Left and the Right keep campaigning for total electoral victory: blocking all initiatives from the other side, biding their time until their side controls 60 votes in the Senate. But the reality is that total control almost never happens.

Hence, lasting entitlement reform will require both Republicans and centrist Democrats to come together. That involves—yes—compromise with the dastardly forces of statism. Because we don’t have 40 years to fix Medicare. We have to fix it now. From where I sit, it’s what Dan describes as the “establishment” that is doing the most to make that happen.

Avik Roy is a health care analyst at Monness, Crespi, Hardt & Co., and writes on health care policy for Forbes at his blog, The Apothecary where this post first appeared. You can follow him on Twitter at @aviksaroy.