Published for www.washingtonpost.com, April 30, 2012

In a recent column, I described two forms of conservatism that coalesced in opposition to President Obama’s polarizing expansion in the size and role of government.

Rejectionist Conservatism, which comes in tea party and libertarian variants, would use current political controversies to fundamentally reorder the role of the federal government. At least in theory, it would repeal not just Obamaism but also the Great Society, the New Deal and much else in pursuit of a minimal state.

Reform Conservatism, in contrast, would seek to achieve federal goals in modern, market-oriented ways. It is less concerned about re-founding the country than making Medicare work. Its chief practitioner is Rep. Paul Ryan (R-Wis.), supported by a few policy experts of disproportionate creativity and influence.

In my initial description, I called Rejectionist Conservatism more “ambitious” — which is true only in the abstract. Some tea party rejectionists have opposed the Ryan budgets because they would not achieve quick balance — a symbolic display of ideological ambition. Yet during the recent presidential primaries, Rep. Michele Bachmann (R-Minn.) distanced herself from Ryan’s Medicare proposal. Ron Paul was weaker on entitlement reform than anyone else in the Republican field. It is far easier to endorse the theoretical abolition of government programs than to embrace specific reforms involving actual political risk.

Ryan’s seriousness has attracted support from both House Speaker John Boehner (R-Ohio) and presidential candidate Mitt Romney. It has also made Ryan the main target of unreconstructed liberalism, which is determined to deny any distinction between the House budget and a tea party manifesto.

Ryan’s expression of Reform Conservatism has both virtues and vulnerabilities. It deals seriously with the fiscal crisis — which, driven by demographics and cost increases, is a health entitlement crisis. For 40 years, federal, non-health-related spending has been relatively stable as a percentage of the economy. During the same period, federal health spending has increased as a share of the economy by more than five times and will double again by 2050. No realistic amount of tax increases or discretionary spending cuts can cover this expanding national commitment. Either health entitlements, particularly Medicare, are substantially reformed, or their cost will consume every other purpose of government.

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