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There He Goes Again

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In his most recent New York Times column, David Brooks extolled the "courage" of Paul Ryan's latest budget plan and noted with great satisfaction that the Ryan plan put Democrats on the defensive (notwithstanding that no other leading Republicans appear to want to embrace the plan openly). And Brooks did what he does best -- attempted to dress up extremism in the guise of respectable, measured language. Yes, Brooks provided a few obligatory comments about the deficiencies of the plan. But don't be fooled by his weak attempt at even-handedness. Ryan's plan clearly fills Brooks with delight. It's a "bold step" that could be the first step in a "great journey" and has moved us off "Unreality Island," because Ryan is "forcing Americans to confront the implications of their choices."

Brooks, of course, is part of the class of Americans that never has to confront the implications of its own choices. And since Brooks will never experience the reality -- reduced wages and benefits and joblessness -- that a growing share of Americans already face, he can wring his hands with glee that Ryan is warning those of modest means that they haven't sacrificed enough for the present and future enrichment of Brooks and his kind.

Three points in Brooks' column are especially noteworthy:

1) Brooks said of the Ryan plan that it "relies on a premium support model that would allow individuals to exercise greater control over what sorts of procedures they would not be covered for." As Dean Baker and others have made clear, the value of the vouchers Ryan has proposed for future seniors will be woefully inadequate to cover their likely medical costs. But beyond that basic, straightforward fact, is the monstrous implication of Brooks' argument: That humans can and should anticipate, in advance, what is likely to make them sick in old age and to plan accordingly. The conservative nostrum of "personal responsibility" is, thus, being taken to a whole new extreme. As I approach Medicare age, I can presumably decide, just as if I were planning to buy any other consumer product, which diseases to purchase protection from. Except that, of course, I cannot possibly anticipate what might or might not happen to me, health-wise, in old age. Since Brooks knows other human beings, he knows this. But still he tries to slip past the reader the premise of ordinary consumption to argue that Ryan's plan represents "control" in any sense that people would find meaningful. In reality, the fundamental premise of insurance in general, and health insurance in particular, is that we cannot fully plan for or control when calamity might strike. That's really the whole point.

2) Brooks juxtaposed the "premium support model" to the President's plan, which "relies on a centralized board of technocrats to restrict choices." As Baker points out, this is simply false. Nothing in the bill would restrict an individual's ability to get a certain procedure. What it would do is prevent the government from paying for certain procedures through Medicare. Brooks would never use such an uncouth and Palineseque term as "death panels." But seriously, isn't he just about saying the same thing, but for a respectable New York Times audience? Unless you oppose any effort to allow the government to review the effectiveness of certain procedures before you decide to pay for them (there are, of course, those who do), you are going to have to set up some kind of review board or committee to do so. And those "technocrats" would be people with real medical and scientific expertise. So what meaningful information is Brooks conveying by reducing the process of determining what medical procedures are effective and what aren't for purposes of Medicare reimbursement to a "centralized board of technocrats?" Maybe a little dog-whistle to those who see health care reform as a Stalinist plot to destroy our freedoms?

And my God, does it have to be pointed out that we already have large, near-monopolistic entities where technocrats determine, every minute of every day, what treatments will be paid for, and what won't? They're called private insurance companies and those entities constantly deny coverage. And of course, insurance companies do this in service of one goal -- their bottom line. Since Brooks knows other human beings, specifically Americans in this case, he must know this.

3) Ryan has been criticized, among other things, for having proposed a plan that, on the question of reducing deficits over the long run is, in essence, a fraud. Brooks acknowledges some deficiencies in Ryan's purported attempts at reducing deficits. For example, he acknowledges that the plan doesn't have an answer to "rising health care costs." Since that's by far the biggest long-term source of deficits -- something Brooks doesn't acknowledge -- that alone should be enough to question whether Ryan has really done "a great service to the country," as Brooks says. Brooks also says it's wrong for Ryan to exempt those 55 and older from his voucher scheme and describes as an "immoral imposition on future generations" these near-retirees' overly generous benefits.

But for Brooks none of this adds up to what is staring him in the face -- the Ryan plan is not a deficit reduction plan. It's not a call to a day of reckoning. Instead, it's a massive transfer-of-wealth plan. Though Brooks admits that inequality is a growing problem, he has not one word of criticism for one of the most outrageous features of Ryan's plan -- the large shift in tax burden from the wealthy to everybody else. In fact, Brooks pooh-poohs raising taxes on the rich because "there aren't enough rich people to generate the tens of trillions of dollars required to pay for Medicare, let alone all the other programs."

Well, no, raising taxes on the rich won't do it alone. But Ryan's not merely saying that we cannot generate enough taxes on the wealthy to cover all of our costs. He's proposing to reduce taxes on the wealthy. As it stands, the extension of the Bush tax cuts for those making over $250,000 a year would cost the government perhaps seven hundred billion in revenue in the next decade. By some estimates, the entire 75-year shortfall for social security, about $4.5 trillion, is the equivalent of the foregone revenue from that lowered tax rate on the very well off. So, restoring the Clinton-era tax rate on high earners helps a lot, even if it doesn't solve all of our problems. But since no one is saying it is, Brooks' point is irrelevant, or worse.

Whether Ryan's plan will make it into law in anything like its current form is a separate question. Brooks himself acknowledges that it won't. But it's worth asking, what about this plan is bold, courageous and a "bold step" for starting us on a "great journey?" The Ryan plan fails to reduce deficits; it shifts wealth further up the income scale; it will make future seniors dramatically more vulnerable to medically-induced financial catastrophe and will, ultimately, make them less likely to be able to treat adequately their illnesses. And this is a cause for celebration, indeed for barely concealed joy, from our esteemed New York Times columnist.

Heaven help us.

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