Adam Serwer reports from Charles Murray’s “State of White America” address. Long story short, though, folks have gotten kind of soft:

Yesterday I went to Charles Murray’s AEI lecture on the State of White America which was actually far more interesting than I expected. I won’t say much about it here because I’m writing a piece about it for the magazine, but after Murray was finished going over some of his empirical findings he retreated into the basic platitudes of conservative moral theology.

Murray’s basic conclusion was that something went deeply wrong in the mid-1960s, an idea that caused everyone in the room to nod their heads solemnly. And the basic thing that went wrong was that President Lyndon Johnson’s extension of the American welfare state, undermined the essential virtue of the American people by making them soft, weak and lazy where once they were hard, strong and industrious. America’s decline can be traced to this moment. Liberals laugh at that old Ronald Reagan speech declaring the end of freedom with the advent of Medicare but conservatives actually think that on some level he was actually right.

This put me in mind of Monica Potts’ review of Kay Hymowitz:

“Before [today], the fact is that primarily, a 20-year-old woman would have been a wife and a mother,” author Kay Hymowitz told the crowd of about 100 at the Manhattan Institute in New York City. Men would have been mowing lawns and changing the oil in their family sedans instead of playing video games and watching television. In previous decades, adults in their 20s and 30s were too busy with real life for such empty entertainment, Hymowitz says. “They didn’t live with roommates in Williamsburg in Brooklyn and Dupont Circle in D.C.”

Hymowitz’s argument, essentially, is that not only has feminism opened up new doors of opportunity to women, but it’s helped contribute to the growth of a society in which young men are less crushed down with family and household obligations and are spending more time enjoying themselves. Except she means this as a bad thing! In both cases the conservative conceit seems to be that a decline in human suffering is a bad thing because it leads to a corresponding decline in admirable anti-suffering effort. John Holbo memorably dubbed this Donner Party Conservatism.

Given that the bulk of Paul Ryan’s spending reductions over the long term come from promising to eliminate Medicare ten years in the future, I was wondering how he achieved any meaningful debt reduction within the normal ten-year baseline. The answer, according to the initial CBO analysis (PDF) is that he doesn’t:

All the various cuts that take place before the Great Medicare Phaseout don’t compensate for the tax cuts that Ryan proposes, so relative to current law debt goes up. Then further out in the future if we implement the Medicare elimination plan, debt starts to decline.

Via Suzy Khimm, evidence from the Kaiser Family Foundation that public support for Medicaid is pretty robust:

Fifty-nine percent of the American people said Medicaid was either “very important” to them or their families (39%) or “somewhat important” (20%).

Paul Ryan is trying to define Medicaid beneficiaries as the new welfare queens, but the essence of the “welfare” debate is persuading most people that a program doesn’t benefit them.

Kevin Drum wonders if these predictions of ever-growing health care costs might not be groundless: “I can think of lots of technological revolutions that were pretty costly at first but eventually reached a point where they leveled out and then became cheaper. In fact, pretty much all of them. But perhaps healthcare is different in some ways from previous technological revolutions?”

I think health care is different in a pretty serious way. With normal consumer goods there’s lots of incentives for producers to come up with ways of making something that’s “worse but cheaper.” You don’t need to be making the best car to have a successful car company. You don’t even need to be tricking people into thinking that you’re making the best car. There’s a “luxury” car market, but there’s also a larger and more robust market for cars that are aiming to be good values.

But a whole lot of different factors militate against this in the health care realm. Medicare promises senior citizens all the health care a doctor can talk them into buying, but it doesn’t give them much of an option of consuming less health care and more fancy dinners or fun vacations if they’d prefer that. Nobody wants to encourage their spouse to get a discount health treatment option so that the family can afford to get the kitchen redone. Nobody brags to their friends “with the money I saved taking Johnny to the half-price pediatrician I was able to get him a XBox and me a new pair of shoes—everyone’s happier!” Even when people are paying for their own health care (rather than a family member’s) out of pocket (rather than via insurance) it’s still a weird marketplace. I was in this position myself recently, but at the very time I was (in conservaland) supposed to be driving a hard bargain over my dental surgery I was also in agonizing pain—hence the dental surgery—and psychologically desperate to believe that I was in good hands. Then on top of that you have all these provider-side regulatory restrictions that impede competition. All in all, it’s a mess.

I don’t think it’s plausible to imagine health care becoming a totally “normal” marketplace, since the dichotomy between health and care seems built into the human mind. But it is important to take some kind steps to shift out of this dynamic. And on some level, Paul Ryan’s Medicare ideas are meant to achieve this, though I have no idea why he thinks inserting an extra layer of profit-seeking interests will accomplish the task.