Understanding the Single-Issue Voter, by Anne Chamberlin

Reformation21

by Anne Chamberlin

Moving around often as a child and as an adult, I had the privilege of joining or regularly attending many different American churches in different regions. I've been a member of small (40-80 people), medium (200 members), and large (multi-service) churches. All of these churches have been non-urban, except one (in China). They are demographically just what you'd expect from the suburbs: mostly white communities where lower-middle class to upper-middle class families live. Congregations like these can be very diverse when it comes to livelihood and educational level. Members typically commute into the nearby city; are local service and care workers such as nurses, first responders, and teachers; or run small businesses (everything from storefront business owners to contractors to hairstylists). Some of these suburban areas abut rural areas.

As evidence of the liveliness of their faith, the particular churches I have attended (all in conservative denominations) have embraced multiple local and international outreaches to those in need. After all, a robust commitment to reaching those in need - the poor, the widow, the orphan -- is surely one of the clearest evidences of a true and living Christian faith. A quick survey I conducted of these yields a rich and prolific list of justice-and-mercy ministries. These believers have been busy with the following:

Partnerships with urban ministries and crisis pregnancy centers, support for single mothers, support for homeless ministries, divorce recovery, marriage and family and addiction counseling, ministries to people facing disabilities, prison ministry, deacon's funds, clothing collection or food pantry or service, refugee support, local and international student ministries and meals, ESL classes or Spanish language services, ministries and services for those who are homebound, ill, the elderly, and grief response and caring programs like Stephen Ministry. (And this list does not touch upon a deep-pocketed commitment to multiple overseas missionaries and programs.)

The vibrant outreach of these Christians is a living picture of James' teaching that a personal faith in Jesus Christ necessarily works out through the hands, feet, and wallets of real believers. But for me, all of this is more than a list on a website or a line on a graph. I know these people as friends. My family has worked alongside them and learned from them. I haven't told you the individual stories of people I know who whose personal ministries nurture their communities (in addition to the work they do during their regular work week, of course). If I shared some of their stories, you'd be encouraged and challenged. I can say with the psalmist in Psalm 16, "As for the saints who are in the land, they are the excellent ones, in whom is my delight."

Many of these evangelical saints -- with their sleeves rolled up in ministry and partnerships that cross local, international, and demographic lines -- voted for Donald Trump. Yet there seems to be a growing notion among some evangelical leaders that white Christians who voted for Trump may not love the least of these as well as Christians who voted otherwise. There seems to be a distancing from and disdain for faithful brothers and sisters who also voted for Donald Trump.

This disdain, despite the fact that these suburban churches believe that salvation is found in repentance and faith in Christ alone, hold Scripture as the final authority, and show it by loving the least and the lost, both in their neighborhoods and out of them.

So -- why the dismissal of the good works of white suburban evangelicals? Perhaps some of these religious leaders are leaning too heavily on their own notion of political purity as an indicator of true Christian faith. Perhaps they struggle with true openness towards "the other," politically speaking (more on this, below). Perhaps they simply have lost sight of the biblical example set by God's people since ancient times. Or perhaps something else.

But the biblical example is that, in a fallen world and as citizens of nations and regions ruled over and populated by pagans, the people of God are often obligated to labor and partner with pagan rulers for the saving of lives and the benefit of His people. Across time, God's people have partnered with pagan kings whose beliefs, rhetoric, and practices might make Presidents Trump, Clinton, and Kennedy collectively blush. Abraham partnered with the kings of the plain. Joseph supported the pharaoh of Egypt (in a powerful position). David allied himself with foreign kings and worked for a Philistine. Daniel worked (apparently with aplomb) on behalf of Nebuchadnezzar. Isaiah refers to the future pagan king, Cyrus, as "anointed." In so doing, they saved innocent lives and the people of God were delivered.

This article is in no way whatsoever a defense of Trump's entire set of values and behavior or, in saying that, of Hillary Clinton and her values and behavior. (And as an aside, have I missed the many hand-wringing articles and interviews from these same evangelicals over the blocks of believers who voted for Hillary Clinton or for President Obama in past years?) This is an explanation of and defense of the faith of the Christians I know who labor for the least and lost, and who also voted for Trump

Of all of the appalling policies in our nation, many Christians have strong convictions that the most appalling is abortion. Minorities rank high in the ledgers listing those killed by abortion, and these Trump-voting believers care about their neighbors. Abortion's victims are hidden, not seen ("undocumented). The oppressor is the only one to see their faces. His acts are valorized as "choice" and "services" in our culture, and his grisly work flourishes behind a glossy storefront or in a clinical building.

In The Screwtape Letters preface, C.S Lewis described the modern age and its evils like this:

"But it [evil] is conceived and ordered (moved, seconded, carried, and minuted) in clean, carpeted, warmed and well-lighted offices, by quiet men with white collars and cut fingernails and smooth-shaven cheeks who do not need to raise their voice. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the offices of a thoroughly nasty business concern."

Evil does a very good job at looking nice, and, well, clinical. And since it is easy to forget victims when they are hidden, it is easy to marginalize them. To make the systematic killing of millions a secondary policy issue.



And so, by and large, when I speak to my suburban friends, their vote for Trump came down to abortion. And while they disagree with much or most of his rhetoric, they already see his administration enacting pro-life policies which will work for the saving of international lives as well as those of American children of all races. (And, oddly, Trump's pro-life policy moves are relatively unheralded and uncelebrated by the some evangelicals.)

Christians may disagree with a vote for Trump, just as they may for Hillary Clinton or any of the list of 2016 third-party candidates: Bernie Sanders, Jill Stein, Gary Johnson, Evan McMullin, Darrell Castle, etc. As a matter of fact, conservatives in general can understand that disagreement. Why? Two possibilities.

First of all, it may be a matter of mindset. In The Righteous Mind, social psychologist and "partisan liberal" Jonathan Haidt concluded that conservatives in general (of which white evangelicals are often a subset) are more broadminded than liberals, and appear to be better able to understand various perspectives.

Second of all, it is a matter of experience. Within these churches during the election, there was frank debate and discussion. I sat around coffee tables and at dinner tables in intense conversations with people who were coming at this election from all angles.

These saints are used to disagreeing politically with the very same brothers and sisters they love, admire, and work alongside in ministry. And they have found they can disagree during a difficult election without dismissing the other's faith. Perhaps this nuanced way of understanding each other may be eluding influential evangelical leaders. But people in "flyover churches" confront serious, thoughtful, differing opinions from serious, thoughtful people all the time.

And so I make an appeal for my friends, to my friends. People may assess the political situation differently, but surely canny Christians can understand that many of their brothers and sisters who voted for Trump are also fully Christian, are sacrificially serving the least and the lost, and may even have a legitimate, thoughtful reason for their vote.

Anne Chamberlin is a wife, mother of three living in Pittsburgh, Pennsylvania. She is a freelance journalist who has written for the Gospel Coalition.

3 REASONS YOU SHOULD CARE ABOUT ELECTION DAY

http://www.thegospelcoalition.org/article/three-reasons-you-should-care-about-election-day

It's the last Tuesday in October, just one week away from Election Day. I've noticed in some (not all) American Christian corners a silence about issues in the political realm. This may have to do with a few possibilities: the rejection of old-school Moral Majority hypocrisy and overreach, the rejection of Obama-as-Messiah liberalism, a distaste for corrupt government and flawed candidates, some kind of notion that secular nations like ours aren't our Christian business, or ignorance about self-rule in our country. As believers, we know that the purpose of government is not to save souls, but to "punish those who do evil and praise those who do good" (1 Pet. 2:14).

Whatever the cause of the silence, here are three reasons American Christians should be politically principled, informed, opinionated, and involved.

1. You are a ruler, and God calls kings to rule well.

There is no one king in America. You and I are kings, for we hire and fire our elected representatives. While you may not have asked for this burden, when you are an American citizen you live in country that has given its people self-rule. It follows that, as kings, Christians would seek the advice given to rulers in Scripture.

Some guidance in Scripture for rulers is direct. God has direct guidance for King Lemuel in Proverbs (Prov. 31:1–9). Lemuel is to rule soberly, justly, and fairly, looking out for those who are oppressed and those whose rights are being stolen. The proverbs have many statements about kings: they take pleasure in honesty, they appreciate skilled labor, they mete out justice.



Some guidance in Scripture is by example. The king of Ninevah (a non-Jewish king of a non-Jewish people) was a king who did well. He repents of his moral sins, and he legislates that his people repent as well, thereby saving them from destruction. Again, these were not Israelites (Jonah 3:7–10). For another example, in the New Testament Paul calls on believers to pray for rulers, that they would help us live peaceful and quiet lives, that we might be "godly and dignified in every way" (1 Tim. 2:1–4). It would follow that Christians would wish to rule in such a way that those prayers are answered.

2. You are a Christian, and God calls you to love well.

Christ calls us to love our neighbor. It is the second half of his summation of all the law and the prophets (Matt. 22:34–40). Christian, do you love your neighbor? If you do, you will care about the types of laws he lives under. You will care about the just, merciful, and sensible implementation of such laws, too, for these things affect your neighbor. You will keenly study and deduce the things your elected officials wish to reward and encourage, and that which they wish to punish or discourage, and you will vote accordingly. These things affect your neighbor.

You will keenly study and deduce which policies work, and which are well-intentioned yet bound to fail. They affect your neighbor, and you love her. You will weigh a flawed candidate with sensible policies that achieve good things for your country and culture—against another flawed candidate with well-intentioned but foolish or destructive policies.

You will need to think philosophically about the human condition, and weigh the two parties and their approach to legislation, and you will decide which party has more sensible and upright policies. You will need to be shrewd about propaganda, false narratives, cover-ups, and the like, and you will need to learn from history. Because you love your neighbor.

You will do this because in your city, county, state, and country the crime rate, education, educational freedom, corruption, defense, and how the international community treats your countrymen—to name a few issues—matter to your neighbors. And you love them.

Christian, you love your neighbor, even—especially—the tiniest ones. I am speaking of our neighbors in utero who deserve the right to live. May I submit that you consider these—your smallest, weakest neighbors—when you weigh candidates and legislation?

3. You have the Word, and you already know 'it's complicated.'

As a child of God, you hold in your hands the book that thoroughly explains the human condition. Again, whether you like it or not, to whom much is given much shall be required. By describing life, humanity, family, community, and kingdoms, the Bible is relevant to people living in every possible "-archy" and "-ism." Its message is eminently applicable to image-bearers living in monarchies, oligarchies, aristocracies, kleptocracies, and democracies, and under fascism, communism, and socialism. It's relevant because government is about people, and the Bible is the definitive, inerrant story of God and humanity.

And it's yours. It's in your hands.

The Bible teaches us about human nature and experience, how we thrive, and what brings out the best and the worst in us. It describes how true oppression looks and what true human rights and duties we ought to pursue. Of course human candidates, parties, and platforms are not perfect. Far be it from any believer to be surprised by sin, corruption, or imperfection. But somehow we still scorn and turn away from a system made up of flawed people. What did we expect? As Americans, we can turn away from brokenness in our culture, government, and systems. We can reject "those people and their government" and God's call on us as rulers and Christians, because we cannot find the flawless candidate or party or legislation. We can hunker down in our "Christian ghetto.”

As Christians, however, we are called to turn toward our neighbors. We are called to live in this world and engage our communities and love those around us. We can do this by exercising the gift of self-rule wisely, shrewdly. As Christ's regents, we can support sensible candidates and policies to help bring about freedom and quiet living rather than oppression, here in our little 21st-century kingdom called America.

Anne Chamberlin lives in Allen, Texas, and blogs at Tales from Shangri-La.

Full Text - Mitch Daniels CPAC speech

Indiana Governor Mitch Daniels
February 11, 2011 Remarks
Ronald Reagan Centennial Dinner
Conservative Political Action Conference
Washington, D.C.

Video

Phyllis Schlafly, David Keene, George Will, good friends, thank you for the enormous privilege of this podium. Even a casual observer of American public life knows how many great ideas have been born here, how many important debates joined here, how many giants of our democracy appeared on this platform. When David broached the invitation, my first reaction was one I often have: “Who cancelled?” But first choice or fifteenth, the honor, and the responsibility to do the occasion justice, is the same. I am seized with the sentiment best expressed by Hizzoner, the original Mayor Richard Daley, who once proclaimed a similar honor the “pinochle of success.”

We are all grateful to our co-sponsors, the Reagan Foundation and the Reagan Ranch. How fitting that we convene under their auspices, as we close this first week of the centennial. Those of us who served President Reagan were taught to show constant respect for the presidency and whoever occupies it. But, among us alums, the term “the President” tends to connote just one of those forty-four men, that great man with whom God blessed America one hundred years ago this week.

The prefix in “co-sponsor” is meaningful tonight. It is no state secret that the two foundations have not always been co-operative, or co-llaborative, or co-llegial. So it is a tribute to the stature and diplomacy of David Keene that they have come together to produce so warm a moment as this. I am now converted to the view that yes, the Israeli-Palestinian conflict will be solved. Well done, David; Nobel Peace Prizes have been awarded for far less.

I bring greetings from a place called Indiana. The coastal types present may think of it as a “flyover” state, or one of those “I” states. Perhaps a quick anthropological summary would help.

We Hoosiers hold to some quaint notions. Some might say we “cling” to them, though not out of fear or ignorance. We believe in paying our bills. We have kept our state in the black throughout the recent unpleasantness, while cutting rather than raising taxes, by practicing an old tribal ritual – we spend less money than we take in.

We believe it wrong ever to take a dollar from a free citizen without a very necessary public purpose, because each such taking diminishes the freedom to spend that dollar as its owner would prefer. When we do find it necessary, we feel a profound duty to use that dollar as carefully and effectively as possible, else we should never have taken it at all.

Before our General Assembly now is my proposal for an automatic refund of tax dollars beyond a specified level of state reserves. We say that anytime budgets are balanced and an ample savings account has been set aside, government should just stop collecting taxes. Better to leave that money in the pockets of those who earned it, than to let it burn a hole, as it always does, in the pockets of government.

We believe that government works for the benefit of private life, and not the other way around. We see government’s mission as fostering and enabling the important realms – our businesses, service clubs, Little Leagues, churches – to flourish. Our first thought is always for those on life’s first rung, and how we might increase their chances of climbing.

Every day, we work to lower the costs and barriers to free men and women creating wealth for each other. We build roads, and bridges, and new sources of homegrown energy at record rates, in order to have the strongest possible backbone to which people of enterprise can attach their investments and build their dreams. When business leaders ask me what they can do for Indiana, I always reply: “Make money. Go make money. That’s the first act of ‘corporate citizenship.’ If you do that, you’ll have to hire someone else, and you’ll have enough profit to help one of those non-profits we’re so proud of.”

We place our trust in average people. We are confident in their ability to decide wisely for themselves, on the important matters of their lives. So when we cut property taxes, to the lowest level in America, we left flexibility for localities to raise them, but only by securing the permission of their taxpayers, voting in referendum. We designed both our state employee health plans and the one we created for low-income Hoosiers as Health Savings Accounts, and now in the tens of thousands these citizens are proving that they are fully capable of making smart, consumerist choices about their own health care.

We have broadened the right of parents to select the best place for their children’s education to include every public school, traditional or charter, regardless of geography, tuition-free. And before our current legislature adjourns, we intend to become the first state of full and true choice by saying to every low and middle-income Hoosier family, if you think a non-government school is the right one for your child, you’re as entitled to that option as any wealthy family; here’s a voucher, go sign up.

Lastly, speaking now for my administration colleagues, we believe in government that is limited but active. Within that narrow sphere of legitimate collective action, we choose to be the initiators of new ideas or, as we have labeled ourselves, the Party of Purpose. In President Reagan’s phrase, “We are the change.” On election nights, we remind each other that victory is not a vindication, it is an instruction, not an endorsement, but an assignment.

The national elections of 2010 carried an instruction. In our nation, in our time, the friends of freedom have an assignment, as great as those of the 1860s, or the 1940s, or the long twilight of the Cold War. As in those days, the American project is menaced by a survival-level threat. We face an enemy, lethal to liberty, and even more implacable than those America has defeated before. We cannot deter it; there is no countervailing danger we can pose. We cannot negotiate with it, any more than with an iceberg or a Great White.

I refer, of course, to the debts our nation has amassed for itself over decades of indulgence. It is the new Red Menace, this time consisting of ink. We can debate its origins endlessly and search for villains on ideological grounds, but the reality is pure arithmetic. No enterprise, small or large, public or private, can remain self-governing, let alone successful, so deeply in hock to others as we are about to be.

Need I illustrate? Surely the consequences, to prosperity, world influence, and personal freedom itself are as clear to this audience as to any one could appear before.

Do I exaggerate? I’d love to be shown that I do. Any who think so please see me in the hallway afterward, and bring your third grade math books.

If a foreign power advanced an army to the border of our land, everyone in this room would drop everything and look for a way to help. We would set aside all other agendas and disputes as secondary, and go to the ramparts until the threat was repelled. That is what those of us here, and every possible ally we can persuade to join us, are now called to do. It is our generational assignment. It is the mission of our era. Forgive the pun when I call it our “raison debt.”

Every conflict has its draft dodgers. There are those who will not enlist with us. Some who can accept, or even welcome, the ballooning of the state, regardless of the cost in dollars, opportunity, or liberty, and the slippage of the United States into a gray parity with the other nations of this earth. Some who sincerely believe that history has devised a leftward ratchet, moving in fits and starts but always in the direction of a more powerful state. The people who coined the smug and infuriating term – have you heard it? – “the Reagan Interruption.”

The task of such people is now a simple one. They need only play good defense. The federal spending commitments now in place will bring about the leviathan state they have always sought. The health care travesty now on the books will engulf private markets and produce a single-payer system or its equivalent, and it won’t take long to happen. Our fiscal ruin and resulting loss of world leadership will, in their eyes, be not a tragic event but a desirable one, delivering the multilateral world of which they’ve dreamed so long.

Fortunately, these folks remain few. They are vastly outnumbered by Americans who sense the presence of the enemy, but are awaiting the call for volunteers, and a credible battle plan for saving our Republic. That call must come from this room, and rooms like it.

But we, too, are relatively few in number, in a nation of 300 million. If freedom’s best friends cannot unify around a realistic, actionable program of fundamental change, one that attracts and persuades a broad majority of our fellow citizens, big change will not come. Or rather, big change will come, of the kind that the skeptics of all centuries have predicted for those naïve societies that believed that government of and by the people could long endure.

We know what the basic elements must be. An affectionate thank you to the major social welfare programs of the last century, but their sunsetting when those currently or soon to be enrolled have passed off the scene. The creation of new Social Security and Medicare compacts with the young people who will pay for their elders and who deserve to have a backstop available to them in their own retirement.

These programs should reserve their funds for those most in need of them. They should be updated to catch up to Americans’ increasing longevity and good health. They should protect benefits against inflation but not overprotect them. Medicare 2.0 should restore to the next generation the dignity of making their own decisions, by delivering its dollars directly to the individual, based on financial and medical need, entrusting and empowering citizens to choose their own insurance and, inevitably, pay for more of their routine care like the discerning, autonomous consumers we know them to be.

Our morbidly obese federal government needs not just behavior modification but bariatric surgery. The perverse presumption that places the burden of proof on the challenger of spending must be inverted, back to the rule that applies elsewhere in life: “Prove to me why we should.”

Lost to history is the fact that, in my OMB assignment, I was the first loud critic of Congressional earmarks. I was also the first to get absolutely nowhere in reducing them: first to rail and first to fail. They are a pernicious practice and should be stopped. But, in the cause of national solvency, they are a trifle. Talking much more about them, or “waste, fraud, and abuse,” trivializes what needs to be done, and misleads our fellow citizens to believe that easy answers are available to us. In this room, we all know how hard the answers are, how much change is required.

And that means nothing, not even the first and most important mission of government, our national defense, can get a free pass. I served in two administrations that practiced and validated the policy of peace through strength. It has served America and the world with irrefutable success. But if our nation goes over a financial Niagara, we won’t have much strength and, eventually, we won’t have peace. We are currently borrowing the entire defense budget from foreign investors. Within a few years, we will be spending more on interest payments than on national security. That is not, as our military friends say, a “robust strategy.”

I personally favor restoring impoundment power to the presidency, at least on an emergency basis. Having had this authority the last six years, and used it shall we say with vigor, I can testify to its effectiveness, and to this finding: You’d be amazed how much government you’ll never miss.

The nation must be summoned to General Quarters in the cause of economic growth. The friends of freedom always favor a growing economy as the wellspring of individual opportunity and a bulwark against a domineering state. But here, doctrinal debates are unnecessary; the arithmetic tells it all. We don’t have a prayer of defeating the Red Threat of our generation without a long boom of almost unprecedented duration. Every other goal, however worthy, must be tested against and often subordinated to actions that spur the faster expansion of the private sector on which all else depends.

A friend of mine attended a recent meeting of the NBA leadership, at which a small-market owner, whom I won’t name but will mention is also a member of the U.S. Senate, made an impassioned plea for more sharing of revenue by the more successful teams. At a coffee break, Mr. Prokhorov, the new Russian owner of the New Jersey Nets, murmured to my friend, “We tried that, you know. It doesn’t work.”

Americans have seen these last two years what doesn’t work. The failure of national economic policy is costing us more than jobs; it has begun to weaken that uniquely American spirit of risk-taking, large ambition, and optimism about the future. We must rally them now to bold departures that rebuild our national morale as well as our material prosperity.

Here, too, the room abounds with experts and good ideas, and the nation will need every one. Just to name three: it’s time we had, in Bill Simon’s words “a tax system that looks like someone designed it on purpose.” And the purpose should be private growth. So lower and flatter, and completely flat is best. Tax compensation but not the savings and investment without which the economy cannot boom.

Second, untie Gulliver. The regulatory rainforest through which our enterprises must hack their way is blighting the future of millions of Americans. Today’s EPA should be renamed the “Employment Prevention Agency.” After a two-year orgy of new regulation, President Obama’s recent executive order was a wonderment, as though the number one producer of rap music had suddenly expressed alarm about obscenity.

In Indiana, where our privatization of a toll road generated billions for reinvestment in infrastructure, we can build in half the time at two-thirds the cost when we use our own money only and are free from the federal rulebook. A moratorium on new regulation is a minimal suggestion; better yet, move at least temporarily to a self-certification regime that lets America build, and expand, and explore now and settle up later in those few instances where someone colors outside the lines.

Finally, treat domestic energy production as the economic necessity it is and the job creator it can be. Drill, and frack, and lease, and license, unleash in every way the jobs potential in the enormous energy resources we have been denying ourselves. And help our fellow citizens to understand that a poorer country will not be a greener country, but its opposite. It is freedom and its fruits that enable the steady progress we have made in preserving and protecting God’s kingdom.

If this strikes you as a project of unusual ambition, given the state of modern politics, you are right. If it strikes you as too bold for our fellow Americans to embrace, I believe you are wrong. Seven years as a practitioner in elective politics tells me that history’s skeptics are wrong. That Americans, in a vast majority, are still a people born for self-governance. They are ready to summon the discipline to pay down our collective debts as they are now paying down their own; to put the future before the present, their children’s interest before their own.

Our proposals will be labeled radical, but this is easy to rebut. Starting a new retirement plan for those below a certain age is something tens of millions of Americans have already been through at work.

Opponents will expect us to be defensive, but they have it backwards. When they call the slightest spending reductions “painful”, we will say “If government spending prevents pain, why are we suffering so much of it?” And “If you want to experience real pain, just stay on the track we are on.” When they attack us for our social welfare reforms, we will say that the true enemies of Social Security and Medicare are those who defend an imploding status quo, and the arithmetic backs us up.

They will attack our program as the way of despair, but we will say no, America’s way forward is brilliant with hope, as soon as we have dealt decisively with the manageable problems before us.

2010 showed that the spirit of liberty and independence is stirring anew, that a growing number of Americans still hear Lincoln’s mystic chords of memory. But their number will have to grow, and do so swiftly. Change of the dimension we need requires a coalition of a dimension no one has recently assembled. And, unless you disbelieve what the arithmetic of disaster is telling us, time is very short.

Here I wish to be very plainspoken: It is up to us to show, specifically, the best way back to greatness, and to argue for it with all the passion of our patriotism. But, should the best way be blocked, while the enemy draws nearer, then someone will need to find the second best way. Or the third, because the nation’s survival requires it.

Purity in martyrdom is for suicide bombers. King Pyrrhus is remembered, but his nation disappeared. Winston Churchill set aside his lifetime loathing of Communism in order to fight World War II. Challenged as a hypocrite, he said that when the safety of Britain was at stake, his “conscience became a good girl.” We are at such a moment. I for one have no interest in standing in the wreckage of our Republic saying “I told you so” or “You should’ve done it my way.”

We must be the vanguard of recovery, but we cannot do it alone. We have learned in Indiana, big change requires big majorities. We will need people who never tune in to Rush or Glenn or Laura or Sean. Who surf past C-SPAN to get to SportsCenter. Who, if they’d ever heard of CPAC, would assume it was a cruise ship accessory.

The second worst outcome I can imagine for next year would be to lose to the current president and subject the nation to what might be a fatal last dose of statism. The worst would be to win the election and then prove ourselves incapable of turning the ship of state before it went on the rocks, with us at the helm.

So we must unify America, or enough of it, to demand and sustain the Big Change we propose. Here are a few suggestions:

We must display a heart for every American, and a special passion for those still on the first rung of life’s ladder. Upward mobility from the bottom is the crux of the American promise, and the stagnation of the middle class is in fact becoming a problem, on any fair reading of the facts. Our main task is not to see that people of great wealth add to it, but that those without much money have a greater chance to earn some.

We should address ourselves to young America at every opportunity. It is their futures that today’s policies endanger, and in their direct interest that we propose a new direction.

We should distinguish carefully skepticism about Big Government from contempt for all government. After all, it is a new government we hope to form, a government we will ask our fellow citizens to trust to make huge changes.

I urge a similar thoughtfulness about the rhetoric we deploy in the great debate ahead. I suspect everyone here regrets and laments the sad, crude coarsening of our popular culture. It has a counterpart in the venomous, petty, often ad hominem political discourse of the day.
When one of us – I confess sometimes it was yours truly – got a little hotheaded, President Reagan would admonish us, “Remember, we have no enemies, only opponents.” Good advice, then and now.

And besides, our opponents are better at nastiness than we will ever be. It comes naturally. Power to them is everything, so there’s nothing they won’t say to get it. The public is increasingly disgusted with a steady diet of defamation, and prepared to reward those who refrain from it. Am I alone in observing that one of conservatism’s best moments this past year was a massive rally that came and went from Washington without leaving any trash, physical or rhetorical, behind?

A more affirmative, “better angels” approach to voters is really less an aesthetic than a practical one: with apologies for the banality, I submit that, as we ask Americans to join us on such a boldly different course, it would help if they liked us, just a bit.

Lastly, critically, I urge great care not to drift into a loss of faith in the American people. In speech after speech, article upon article, we remind each other how many are dependent on government, or how few pay taxes, or how much essential virtues like family formation or civic education have withered. All true. All worrisome. But we must never yield to the self-fulfilling despair that these problems are immutable, or insurmountable.

All great enterprises have a pearl of faith at their core, and this must be ours: that Americans are still a people born to liberty. That they retain the capacity for self-government. That, addressed as free-born, autonomous men and women of God-given dignity, they will rise yet again to drive back a mortal enemy.

History’s assignment to this generation of freedom fighters is in one way even more profound than the tests of our proud past. We are tasked to rebuild not just a damaged economy, and a debt-ridden balance sheet, but to do so by drawing forth the best that is in our fellow citizens. If we would summon the best from Americans, we must assume the best about them. If we don’t believe in Americans, who will?

I do believe. I’ve seen it in the people of our very typical corner of the nation. I’ve seen it in the hundred Indiana homes in which I have stayed overnight. I’ve seen it in Hoosiers’ resolute support of limited government, their willingness, even insistence, that government keep within the boundaries our constitutional surveyors mapped out for it.

I’ve always loved John Adams’ diary entry, written en route to Philadelphia, there to put his life, liberty, and sacred honor all at risk. He wrote that it was all well worth it because, he said, “Great things are wanted to be done.”

When he and his colleagues arrived, and over the years ahead, they practiced the art of the possible. They made compacts and concessions and, yes, compromises. They made deep sectional and other differences secondary in pursuit of the grand prize of freedom. They each argued passionately for the best answers as they saw them, but they never permitted the perfect to be the enemy of the historic good they did for us, and all mankind. They gave us a Republic, citizen Franklin said, if we can keep it.

Keeping the Republic is the great thing that is wanted to be done, now, in our time, by us. In this room are convened freedom’s best friends but, to keep our Republic, freedom needs every friend it can get. Let’s go find them, and befriend them, and welcome them to the great thing that is wanted to be done in our day.

God bless this meeting and the liberty which makes it possible.

Blair: Bono “could have been a president or prime minister”

Former UK Prime Minister Tony Blair has some strong praise for Bono in Blair’s just-released memoir, A Journey. He says Bono “could have been a president or prime minister standing on his head.” Here’s a snapshot of the full paragraph sent in by @U2 reader Neil W.

Extreme?

"Those Voices Don't Speak for the Rest of Us"

Obama, the Thin-Skinned President

In their book "The Battle for America 2008," Haynes Johnson and Dan Balz wrote this:

[Chief political aide David] Axelrod also warned that Obama's confessions of youthful drug use, described in his memoir, Dreams From My Father, would be used against him. "This is more than an unpleasant inconvenience," he wrote. "It goes to your willingness and ability to put up with something you have never experienced on a sustained basis: criticism. At the risk of triggering the very reaction that concerns me, I don't know if you are Muhammad Ali or Floyd Patterson when it comes to taking a punch. You care far too much what is written and said about you. You don't relish combat when it becomes personal and nasty. When the largely irrelevant Alan Keyes attacked you, you flinched," he said of Obama's 2004 U.S. Senate opponent.

I thought of this memo after reading the comment by Sen. Pat Roberts after he and other Senate Republicans had a contentious 80-minute meeting with the president on Tuesday. "He needs to take a Valium before he comes in and talks to Republicans," Roberts said. "He's pretty thin-skinned."

Sen. Roberts is being too generous. Obama is among the most thin-skinned presidents we have had, and we see evidence of it in every possible venue imaginable, from one-on-one interviews to press conferences, from extemporaneous remarks to set speeches.

The president is constantly complaining about what others are saying about him. He is upset at Fox News, and conservative talk radio, and Republicans, and people carrying unflattering posters of him. He gets upset when his avalanche of faulty facts are challenged, like on health care. He gets upset when he is called on his hypocrisy, on everything from breaking his promise not to hire lobbyists in the White House to broadcasting health care meetings on C-SPAN to not curtailing earmarks to failing in his promises of transparency and bipartisanship.

In Obama's eyes, he is always the aggrieved, always the violated, always the victim of some injustice. He is America's virtuous and valorous hero, a man of unusually pure motives and uncommon wisdom, under assault by the forces of darkness.

It is all so darn unfair.

Not surprisingly, Obama's thin skin leads to self pity. As Daniel Halper of The Weekly Standard pointed out, in a fundraising event for Sen. Barbara Boxer, Obama said,

Let's face it: this has been the toughest year and a half since any year and a half since the 1930s.

Really, now? Worse than the period surrounding December 7, 1941 and September 11, 2001? Worse than what Gerald Ford faced after the resignation of Richard Nixon and Watergate, which constituted the worse constitutional scandal in our history and tore the country apart? Worse than what Ronald Reagan faced after Jimmy Carter (when interest rates were 22 percent, inflation was more than 13 percent, and Reagan faced something entirely new under the sun, "stagflation")? Worse than 1968, when Bobby Kennedy and Martin Luther King, Jr. were assassinated and there was rioting in our streets? Worse than what LBJ faced during Vietnam -- a war which eventually claimed more than 58,000 lives? Worse than what John Kennedy faced in the Bay of Pigs and in the Cuban Missile Crisis, when we and the Soviet Union edged up to the brink of nuclear war? Worse than what Franklin Roosevelt faced on the eve of the Normandy invasion? Worse than what Bush faced in Iraq in 2006, when that nation was on the edge of civil war, or when the financial system collapsed in the last months of his presidency? Worse than what Truman faced in defeating imperial Japan, in reconstructing post-war Europe, and in responding to North Korea's invasion of South Korea?

In his autobiography "Present at the Creation," Dean Acheson wrote about the immensity of the task the Truman administration faced after war ended in 1945, which "only slowly revealed itself. As it did so, it began to appear as just a bit less formidable than that described in the first chapter of Genesis. That was to create a world out of chaos; ours, to create half a world, a free half, out of the same material without blowing the whole to pieces in the process."

For Obama to complain that the problems he faces are so much worse than any other president in the last 80 years is stunningly self-indulgent, to say nothing of ahistorical.

With Obama there is also the compulsive need to admonish others, to point fingers, to say that the problems he faces are not of his doing. Oh, sure; on occasions there are the grudging concessions, like in Thursday's press conference devoted to the oil spill in the Gulf of Mexico, where Obama says, "In case you're wondering who's responsible, I take responsibility" to ensure that "everything is done to shut this down." But those words are always pro forma, done reluctantly and for tactical political reasons, a rhetorical trick that is meant to get him off the hook. As recently as last week, Obama, in the Rose Garden, was implicitly blaming the previous occupant of the White House for the explosion of the offshore rig Deepwater Horizon [Obama remarks linked here].

The president's instincts are by now obvious to all: deflect blame, point fingers, and lash out at others, most especially his predecessor. We know from press reports (see here and here) that the strategy for the Democrats in 2010, two years after Obama was elected president, is to – you guessed it – blame George W. Bush.

What explains all this is hard to know. But it's clear he has adopted an image of himself as something rare and remarkable, a historic figure of almost super-human abilities. "I am absolutely certain that generations from now," Obama said during the summer of his presidential run, "we will be able to look back and tell our children that this was the moment when we began to provide care for the sick and good jobs to the jobless; this was the moment when the rise of the oceans began to slow and our planet began to heal; this was the moment when we ended a war and secured our nation and restored our image as the last, best hope on earth."

"We are the ones we have been waiting for," Obama and his aides said constantly during the campaign.

President Obama's more unattractive personal qualities probably won't wear well with the electorate. Americans tend to tire of those who are look back rather than ahead and are always blaming others for the problems they face.

Barack Obama -- a man who was as unprepared to be president as any man in our lifetime -- has over the last 16 months shown that he is overmatched by events. His poll numbers continue to drop, his health care proposal is becoming less rather than more popular, the oil spill in the Gulf is badly eroding his image for leadership and competence, and his party has been battered in election after election since November. We have now reached the point where Democrats are running against Obama and his agenda in order to survive (witness Mark Critz in Pennsylvania).

We can hope that Obama, an intelligent man, learns from the errors of his ways. But the great danger in all of this is that in the face of his troubles Obama and his aides become increasingly defensive, display a greater sense of entitlement and even a touch of paranoia. When arrogant men lose control of events it can easily lead to feelings of isolation, to striking out at critics, to bullying opponents, and to straying across lines that should not be crossed.

And so the president needs to surround himself with people who can tamp down on the uglier impulses within his administration, who are willing to tell Obama that the lore created by him, Axelrod, Plouffe, and Gibbs during the campaign has given way to reality, that cockiness is not the same as wisdom, and that spin is no substitute for substantive achievements. And Obama needs someone who has standing in his life to tell him that the presidency is a revered institution that should not be treated as if it were a ward in Chicago.

The ingredients are in place for some serious problems down the road. Those who care for the president need to recognize the warning signs now, sooner rather later, before it becomes too late, for him and for the nation.

The Purposes of Political Combat

O my America, how partisan you have become! How difficult you have made it for visionary politicians who want nothing more than to improve you!

You have been paralyzed into stasis by the status quo, which has injected its subtle toxins into your bloodstream by means of radio frequencies between 530 and 1700 kilohertz and a lone television cable-news channel, whose incomprehensible power overruns the combined effect of two others like it; nightly newscasts on three broadcast channels; and the vast majority of newspapers and magazines in the United States. Rallies of surly citizens claiming the mantle of Revolutionary War Bostonians in the spring of 2009 and rude questioners at political gatherings with elected officials home from Washington in the summer of 2009 were harbingers of the inexplicable political reversal that has since been made flesh by electoral defeats in Virginia, New Jersey, and Massachusetts, and polling numbers suggesting a catastrophe in the offing for President Barack Obama’s party come November, when elections for all 435 House seats and 33 Senate seats take place.

How can this be, my America? You had given Obama and the Democrats a nearly free hand; not since 1977 had the political balance in Washington been tilted so completely to the advantage of one of the two parties. Seventy million cast their ballots for Obama, and on that same night, Democrats won a 78-seat majority in the House of Representatives and (after much recounting) the 60 seats in the Senate they needed to enact legislation almost at will. Under such circumstances, partisanship should no longer have had any meaning or held any sway, for, O my America, you asked for change, and you gave the change agents the power they needed to enact change; but after only a few months, the works got all gummed up. It will now require procedural tricks and sleights of hand to effect the very change you sought—and in effecting it, and thereby following your will, Democrats may seal their own fate in this election year. Thus has partisanship worked its ugly dark magic, turning the political system upon itself when the verdict of the electorate in November 2008 should have been final.

_____________


The preceding paragraphs re-present a distillation of liberal thought about the political circumstances of the present moment. The degree of bafflement liberals express at the surprisingly perilous position in which Barack Obama and the Democrats find themselves is understandable; after all, such peril was nearly unimaginable to everyone just a year ago. The results of the 2008 election had been so decisive, the condition of the post-Bush Republican party so parlous, and the double wound to the Right caused by the difficulties of the Iraq war and the financial meltdown so infected that Obama and his party appeared to have an all but free hand.

Indeed, the combined effects of a war gone sour and the capitalist system’s apparent self-immolation seemed to Obama and his team to have brought a decisive end to one ideological era and inaugurated a new period in which the American people were now consciously and explicitly seeking liberal activism from their politicians.

It was by no means an unreasonable presumption. The 2008 election, with its 53-46 margin in favor of Obama, and his victory in the unlikely states of Virginia, North Carolina, and Indiana, followed on the 2006 midterms, in which Democrats crushed Republicans and regained control of both chambers for the first time in 12 years. Both elections were cast as, and indeed seemed to be, referenda on the failures of the Right—not just standard political failures, but failures on a grand scale that invalidated the modern conservative governing project.

Those failures were considered moral ones, expressed in the political and personal corruption in which Republican politicians had engaged and around which much of the 2006 elections seemed to revolve. They were seen as economic, with Republicans shouldering the blame for the economic meltdown of 2008. And they were thought managerial, in the decision to go to war partly on the basis of nonexistent weapons of mass destruction and then the failure to do what was necessary to win that war. Liberals and leftists were tireless in arguing that these failures were not coincidental but linked, that they shared a common root—the essential heartlessness and soullessness of the Republican party and the conservative movement. And the electorate appeared to respond exactly as they had hoped it would.

It therefore seemed only logical that the thoroughgoing rejection of the Right was pretty much the same thing as an endorsement of the ideas and policies of the anti-Right. After all, liberals had had to concede as much when things had gone against them, hadn’t they? For years following the 1994 congressional election, a common presumption in political circles was that the United States had proved itself to be a “Center-Right nation,” at least as far as the voting public was concerned. Leftist thinkers like Thomas Frank found themselves compelled to devise a theory to explain why Americans chose to vote in ways injurious to their own supposed best interests. “The matter with Kansas,” Frank said in his bestselling 2004 analysis, was that its people had been conditioned to respond to hot-button cultural stimuli on matters like abortion rather than to support redistributionist economic policies designed to improve their own well-being. The same line of argument had been offered a decade earlier about Southern and urban ethnic voters by the reporters Thomas and Mary Edsall in their 1992 book, Chain Reaction—only in that case, the Edsalls said, the stimuli had been primarily racial.

It had further become axiomatic in liberal circles from the 1970s onward that the Right had secured the superior political posture on matters of security, regarding both crime at home and America’s position abroad, by ginning up (knowingly in a state of cynicism, or desperately due to personal neurosis, or innocently as a result of stupidity) a state of peril in relation to supposed threats that were little or no threat at all—Cuba, Nicaragua, the Soviet Union. The terrorist attacks on the United States in 2001 came as an almost undisguised blessing for the Right, according to one version of this theory popularized in Michael Moore’s Fahrenheit 9/11; they became a means of generating new security fears, most especially fear of Iraq, which made possible the engagement in an unnecessary war whose purpose was to rally people ’round the flag and the Republican president—until things went horribly wrong.

Bombarded by these various catalysts, the argument ran, the American people had entered into a period of unreason in which they reacted to averse changes in their lives and communities by embracing symbols of power and authority rather than insisting on concrete and specific political changes that would make their lives better and easier. The most telling statement of this theme came from Barack Obama during his run for the Democratic nomination in early 2008, when he said of rural voters that

our challenge is to get people persuaded that we can make progress when there’s not evidence of that in their daily lives. You go into some of these small towns in Pennsylvania, and like a lot of small towns in the Midwest, the jobs have been gone now for 25 years and nothing’s replaced them. And they fell through the Clinton administration, and the Bush administration, and each successive administration has said that somehow these communities are gonna regenerate and they have not. So it’s not surprising then that they get bitter, they cling to guns or religion or antipathy to people who aren’t like them or anti-immigrant sentiment or anti-trade sentiment as a way to explain their frustrations.

These words were revealing not only in the condescension he displayed toward the very people he insisted his campaign was designed to help but also in the way they expressed Obama’s—and, by extension, the specific Left-liberal attitude he both embodies and exemplifies—distrust of and contempt for politics itself.

I am using the word politics to describe the arena of public policy, in which matters involving the direction of the United States are hashed out. Players in the arena range in size and import from the president to an individual voter, from the Senate majority leader to a school-board member in his home state of Nevada, from Charles Krauthammer to a commenter on a blog or a caller to a radio show. The arena is host to conflicts over matters large (weapons systems) and small (the food pyramid), bitterly disputed (abortion) and barely discussed (depreciation schedules), of historical import (war) and entirely evanescent (a la carte cable pricing). But conflicts are what they are, and politics is how they are adjudicated.

The great military strategist Clausewitz once said that “war is the continuation of politics by other means,” but the opposite is true as well. In a stable republic like the United States, in the 145 years since the end of the Civil War, Americans have managed not to war with each other because we have come to accept implicitly that we handle our disagreements in the arena of politics.

And that has led to another implicit acceptance, which is that the system cannot afford to have us arguing, as Henry Kissinger described North Vietnamese negotiating tactics, over the shape of the table. So with very few exceptions, we operate by consensus on the legitimacy of the essential architecture of the government. And because time is finite and there are limits even to the natural human drive to disagree, our politics actually function with a great deal of overall consensus, a consensus driven by the overall stability of the body politic. Among elected politicians, even the pacifistically inclined find it necessary to vote for increases in the defense budget, while those inclined toward libertarianism will support Social Security increases and extensions of unemployment insurance. That may not be their inclination, but they are compelled to it by the logic of a stable political system.

When a stable political system finds itself in imbalance, however, something more complicated and unpredictable begins to happen. Principled differences will tend to crystallize every now and then around one or two events or issues or pieces of proposed legislation. The crystallization almost always occurs when one party or ideological tendency attempts, or is thought by the other party or ideological tendency to be attempting, to extend the bounds of the consensus in such a way that it shifts into something else. Once the conflict crystallizes, all bets are off, and the games in the arena begin.

This is what politics is at its core. Now, elections are the primary vehicle for the conduct of politics, because they are adjudicated at a given time and place and feature a winner and a loser. The methods used to win elections and defeat rivals are always in low odor in a democracy, because they are confrontational and impolite and lack nuance. But those methods work, and so they are used. The odd part is that the people who use them successfully, politicians and their staffs and consultants, often want to limit these methods exclusively to election seasons; they want to believe that there is a time to run for office and a time to govern, and the time for governing ought to function under different rules. According to this way of thinking, “politics” is something low, while governing is something high; you engage in politics because you have to in order to secure the power to engage in governing, which is your sworn and devoted duty.

Thus it was that Barack Obama could invite his 2008 rival, John McCain, to a health-care summit in February 2010 and greet McCain’s criticisms of the president’s health-care bill by saying, “Let me just make this point, John. Because we’re not campaigning anymore. The election is over. We can spend the remainder of the time with our respective talking points going back and forth. We were supposed to be talking about insurance.”

McCain wanted to discuss the particulars of the health-care legislation passed by the House and Senate. The purpose of the health-care event was to create some form of momentum that would help Obama and his vision for health-care reform carry the day. Nonetheless, Obama had determined that the conversation at that point was to be about “insurance.” He was annoyed at McCain’s effort to introduce political considerations into the discussion. Such a thing was lowering, the stuff of campaigning. “The election is over,” said the president. Two weeks later, speaking heatedly before a crowd in Pennsylvania, he insisted that “the time for talk is over.”

Talk is politics. Governing is action.

By saying “the time for talk is over,” Obama was echoing his own words a year earlier about the $787 billion economic-stimulus proposal he was then trying to work through the legislative process: “The time for talk is over, the time for action is now.” At every step of the way in the course of pushing his relentlessly ambitious domestic agenda, Obama has invoked this duality: His opponents want to fight; he wants to do. They are playing politics; he is above politics.

The obvious objection to my argument here is that Obama doesn’t mean this; in belittling his opponents and their propensity to talk, he is playing politics himself, attempting to throw them on the defensive. But the habitual nature of his response, and the response of those who support him, to the populist uprisings against his agenda over the past year suggests he is not the least bit disingenuous.

Obama really does seem to believe that the opposition to his core policies—the creeping nationalization of health care, the effective nationalization of the American automotive industry, the imposition of onerous regulations on energy production, and the expiry of tax cuts that will lead to gigantic effective increases—is not principled. Rather, such opposition deserves to be dismissed as bad faith—the efforts of the status quo, big business, and the politicians in their pockets. Or it is to be explained away as evidence of psychological or spiritual impairment created by the wounds inflicted upon sorry and ignorant souls who are being manipulated by forces beyond their control.

How is it that Obama can fail to see that changes of the magnitude he is seeking would compel those who believe that those changes are dangerous—who honestly believe that they are bad for the country and whose belief is grounded in powerful ideas about how society should be ordered—to marshal their forces to do whatever is in their power to prevent them from taking place? And that it would be wise not to dismiss or belittle the energy and resolve of the opposition, but rather to take their full measure and plan accordingly?

Obama’s failure may reside in his contempt for politics. For the national counter-assault against Obama is a manifestation of democratic politics as they ought to work. A rather vague promise of change during his presidential campaign morphed afterward into an agenda of astonishing size with an astonishing price tag. The passage of a $700 billion bank bailout supported by Obama before the election was followed by his $787 billion stimulus package. No sooner had that $1.5 trillion been committed than the president began advocating cap-and-trade legislation that would cost $800 billion through the election in 2012. And then came health care, with a cost of, at the barest minimum, $900 billion over 10 years, and very likely double that or more.

Americans did not take this grandiose and ruinously destructive plan on faith, nor should they have. A majority of them may have voted for change, but that change was change from something, from George W. Bush primarily, and not necessarily change toward something, toward a wholesale revision of the relation between the state and the economy. In response to Obama’s call for an end to talk and a time for action, an engaged and concerned citizenry used whatever political means were at hand—from spontaneous rallies following a financial consultant’s call on a little-watched cable-TV show for a revival of the Boston Tea Party, to a Senate victory in Massachusetts for a candidate promising to be the 41st vote to block health care.

In using politics to slow down and thwart him, Obama’s rivals are not simply talking. They are acting as citizens in a democratic republic. When challenged by their president, they, too, decided that the time for talk was over and the time for action had begun.

A Way Out of Soviet-Style Health Care

Editor's note: The following is excerpted from an article with the same headline by Nobel Prize winning economist Milton Friedman that was published in the Wall Street Journal on April 17, 1996. Friedman died in 2006. A related editorial appears nearby:

In a chapter in his novel "The Cancer Ward" titled "The Old Doctor," Alexander Solzhenitsyn compares "private medical practice" with "universal, free, public health service" through the words of an elderly physician whose practice predated 1918. . .

Mr. Solzhenitsyn himself had no personal experience on which to base his account and yet, in what I have long regarded as a striking example of creative imagination, his character presents an accurate and moving vision. The essence of that vision is the consensual relation between the patient and the physician. The patient was free to choose his physician, and the physician free to accept or reject the patient.

In Mr. Solzhenitsyn's words, "among all these persecutions [of the old doctor] the most persistent and stringent had been directed against the fact that Doctor Oreschenkov clung stubbornly to his right to conduct a private medical practice, although this was forbidden."

In the words of Dr. Oreschenkov in conversation with Lyudmila Afanasyevna, a longtime patient and herself a physician in the cancer ward: "In general, the family doctor is the most comforting figure in our lives. But he has been cut down and foreshortened. . . . Sometimes it's easier to find a wife than to find a doctor nowadays who is prepared to give you as much time as you need and understands you completely, all of you."

Lyudmila Afanasyevna: "All right, but how many of these family doctors would be needed? They just can't be fitted into our system of universal, free, public health services."

Dr. Oreschenkov: "Universal and public—yes, they could. Free, no."

Lyudmila Afanasyevna: "But the fact that it is free is our greatest achievement."

Dr. Oreschenkov: "Is it such a great achievement? What do you mean by 'free'? The doctors don't work without pay. It's just that the patient doesn't pay them, they're paid out of the public budget. The public budget comes from these same patients. Treatment isn't free, it's just depersonalized. If the cost of it were left with the patient, he'd turn the ten rubles over and over in his hands. But when he really needed help he'd come to the doctor five times over. . . .

"Is it better the way it is now? You'd pay anything for careful and sympathetic attention from the doctor, but everywhere there's a schedule, a quota the doctors have to meet; next! . . . And what do patients come for? For a certificate to be absent from work, for sick leave, for certification for invalids' pensions: and the doctor's job is to catch the frauds. Doctor and patient as enemies—is that medicine?"

"Depersonalized," "doctor and patient as enemies"—those are the key phrases in the growing body of complaints about health maintenance organizations and other forms of managed care. In many managed care situations, the patient no longer regards the physician who serves him as "his" or "her" physician responsible primarily to the patient; and the physician no longer regards himself as primarily responsible to the patient. His first responsibility is to the managed care entity that hires him. He is not engaged in the kind of private medical practice that Dr. Oreschenkov valued so highly.

For the first 30 years of my life, until World War II, that kind of practice was the norm. Individuals were responsible for their own medical care. They could pay for it out-of-pocket or they could buy insurance. "Sliding scale" fees plus professional ethics assured that the poor got care. On entry to a hospital, the first question was "What's wrong?" not "What is your insurance?" It may be that some firms provided health care as a benefit to their workers, but if so it was the exception not the rule.

The first major change in those arrangements was a byproduct of wage and price controls during World War II. Employers, pressed to find more workers under wartime boom conditions but forbidden to offer higher money wages, started adding benefits in kind to the money wage. Employer-provided medical care proved particularly popular. As something new, it was not covered by existing tax regulations, so employers treated it as exempt from withholding tax.

It took a few years before the Internal Revenue Service got around to issuing regulations requiring the cost of employer-provided medical care to be included in taxable wages. That aroused a howl of protest from employees who had come to take tax exemption for granted, and Congress responded by exempting employer- provided medical care from both the personal and the corporate income tax.

Because private expenditures on health care are not exempt from income tax, almost all employees now receive health care coverage from their employers, leading to problems of portability, third party payment and rising costs that have become increasingly serious. Of course, the cost of medical care comes out of wages, but out of before-tax rather than after-tax wages, so that the employee receives what he or she regards as a higher real wage for the same cost to the employer.

A second major change was the enactment of Medicare and Medicaid in 1965. These added another large slice of the population to those for whom medical care, though not completely "free," thanks to deductibles and co-payments, was mostly paid by a third party, providing little incentive to economize on medical care. The resulting dramatic rise in expenditures on medical care led to the imposition of controls on both patients and suppliers of medical care in a futile attempt to hold down costs, further undermining the kind of private practice that Dr. Oreschenkov "cherished most in his work."

The best way to restore freedom of choice to both patient and physician and to control costs would be to eliminate the tax exemption of employer-provided medical care. However, that is clearly not feasible politically. The best alternative available is to extend the tax exemption to all expenditures on medical care, whether made by the patient directly or by employers, to establish a level playing field, in terms of the currently popular cliche.

Many individuals would then find it attractive to negotiate with their employer for a higher cash wage in place of employer-financed medical care. With part or all of the higher cash wage, they could purchase an insurance policy with a very high deductible, i.e., a policy for medical catastrophes, which would be decidedly cheaper than the low-deductible policy their employer had been providing to them, and deposit all or part of the difference in a special "medical savings account" that could be drawn on only for medical purposes. Any amounts unused in a particular year could be allowed to accumulate without being subject to tax, or could be withdrawn with a tax penalty or for special purposes, as with current Individual Retirement Accounts—in effect, a medical IRA. Many employers would find it attractive to offer such an arrangement to their employees as an option. . . .

War & History with Victor Davis Hanson

FRIDAY, MARCH 19, 2010
War & History with Victor Davis Hanson: Chapter 5 of 5
Victor Davis Hanson offers some insight into his life as a war historian — and more.
PERMALINK

THURSDAY, MARCH 18, 2010 War & History with Victor Davis Hanson: Chapter 4 of 5 Victor Davis Hanson talks about the study of war. PERMALINK

WEDNESDAY, MARCH 17, 2010 War & History with Victor Davis Hanson: Chapter 3 of 5 Victor Davis Hanson discusses error and war, including the errors made in the War in Iraq. PERMALINK

TUESDAY, MARCH 16, 2010 War & History with Victor Davis Hanson: Chapter 2 of 5 Victor Davis Hanson describes the several ways in which the American way of war is distinctive. PERMALINK

MONDAY, MARCH 15, 2010
War & History with Victor Davis Hanson: Chapter 1 of 5
Victor Davis Hanson explains why war is inseparable from the human condition.
PERMALINK

About Victor Davis Hanson
Victor Davis Hanson is the Hoover Institution’s Martin and Illie Anderson Senior Fellow. He is the author of many books, including The Father of Us All: War and History, Ancient and Modern. A contributor to National Review Online, Hanson has written hundreds of articles for major American periodicals. He was one of ten recipients of the National Humanities Medal in 2007.