1. I just got back from the meeting of the President’s Council on Bioethics. The main topic was healthcare. Here’s one big issue: The present system, where most people get the insurance from their employer, is collapsing. It’s incompatible with a dynamic economy and unaffordable over the long term. And when key "intermediary" groups can no longer do a job, it’s inevitable that some responsibilities devolve to individuals, and others to the government. We need a system that fosters competition among private insurers, gets everyone covered (maybe through individual mandates)--incuding the so-called uninsurable, eliminates the present tax breaks for employer-based insurance (which are very regressive), and replaces those breaks with tax credits and subsidies to make insurance affordable for all. The result should be as much individual responsibility or choice as is reasonable. But that responsibility isn’t really for "abstract individuals" alone. The new system--to be sustainable--has to encourage voluntary caregiving by families, communities, and churches. We have to think more consciously in terms of SUBSIDIARITY in our increasingly individualistic time. Otherwise, we’ll end up with more government than is good for us. Republicans have to show they really understand the imperatives of this new situation, and not merely rail against new rights, socialized medicine, and so forth. More on this later.
That leads us to the "Sam’s Club Republicans," who have to be cultivated for the GOP to have a future. For them, the SOCIAL ISSUES concerning the disintegration of the family and elite contempt for ordinary virtue remain more real than ever. But so too are the issues flowing from their economic anxiety--like health care. They don’t experience their lives as on the road to some "soft despotism." For them, the individual--surrounded by collapsing "safety nets"--seems more on his or her own than ever. Sam’s Club Republicans don’t want "socialized medicine," but they also don’t want to constantly worry about access to affordable health care for themselves and their children.
The main reason for the "enthusiasm gap" in the presidential campaign so far is that McCain doesn’t yet seem to feel the pain of the "Sam’s Club Republican"--either morally or economically. Mac has to appeal to independents (one honorable maverick appealing to others), given how discredited the Republican "brand" is right now. But he also has to energize the base that reelected the president in 2004.