April 15, 2011--Darwinian Republicans

Congressman Paul Ryan's budget plan, which I gave two cheers to when it was first announced, on closer reading is worth just one. And that one is more because he offered a reasonably comprehensive plan while others, including at the time President Obama, were silent about what they would do about our long-term deficit.

Now from Obama we have an outline of his thinking, which offers a trenchant critique of the Ryan plan. The critique leads to a comparison between what Ryan proposes and Obama's thinking. Both are short on specifics--these will come during the next few months as a necessary vote looms on increasing the nation's debt ceiling (look for Tea Party fireworks that will make their recent ranting look like intelligent discourse)--but in the two conceptual frameworks we have Ryan's classic GOP vision that individuals, not governments, need to solve their most basic problems, while Obama contends that when citizens fall into difficult circumstances there is a responsibility for government, for all of us, to be helpful.

Their differing views on health care symbolize these differences. Both agree that projected spending on Medicare and to a lesser extent Medicaid is growing so fast as to be unsustainable. Both agree that costs have to be contained. But that is where the agreement ends.

Ryan would begin to phase Medicare out as solely taxpayer funded entitlement and over time turn it into a program where those over 65 would be given vouchers to purchase private medical insurance. If for 65+ year-olds polices cost more than the value of the vouchers--as they surely will--they would need to make up the difference.

Obama would retain the current single, government-payer system but require the cost of providing medical care to be slashed. Reimbursements fees for doctors, tests, hospitalizations, and medications would be contained. Serious efforts would be made to cut fraud and abuse. All difficult things to achieve, but the burden to do so would not be borne sorely on the backs of our most vulnerable fellow Americans.

Actually, neither plan will be easy to implement, either because of political resistance (seniors will not sit still and watch the Ryan plan enacted--they vote and vote) while the cost containment strategy of the Obama plan will face fierce opposition by all parts of the medical business establishment, from doctors to hospitals to pharmaceutical companies.

But, cruelly, at the heart of the Ryan plan is a form of biological Darwinism that sees life as a struggle for existence in which the fittest survive. He and Republicans who share his views in effect say that if you do not have the means to take care of yourself, if you lose out in the game of unfettered capitalism (or weren't lucky enough to be born to wealthy parents) don't look for much help from others who are doing better because this is nature's way of sorting out winners from losers.

Literally, in the case of health care, with their lives, as in the jungles and forests.

Ironically or hypocritically, they may not want Darwin to be taught in the schools, but when it comes to how they actually view life they see it to be an evolutionary struggle.