The Challenges Of Reforming Health Care In A Partisan Era

interview with Avik Roy, John Podhoretz
via Uncommon Knowledge
Tuesday, April 11, 2017
Avik Roy and John Podhoretz discuss health care

Recorded on March 22, 2017

In a lively debate Avik Roy and John Podhoretz discuss health care coverage and whether the American Health Care Act (AHCA), created to replace Obamacare/Affordable Care Act (ACA), will solve our health care problems. They both agree that if we could begin again we would never design a health care system like ours, but, since we cannot start over, how can we make things better.

They debate whether universal health care coverage is a good idea, how to provide health care coverage to the most needy, and allow the wealthy and more capable citizens to choose and pay for their own coverage. Roy thinks the system the Affordable Care Act put in place caters too much to the wealthy and that the AHCA will just exacerbate health care inequality.

Podhoretz and Roy’s debate ranges from health care to race, inequality, history, and the election of 2016. They note that the Republicans and Democrats are split/disagree on many issues and ideas. Trump voters watch different TV shows and movies, read different newspapers, and have different cultural experiences than the Clinton supporters; therefore the two parties see the world through very different lenses. They examine the changes in the Republican and Democratic Parties over time, including their involvement in the Civil Rights movement and the rise of identity politics and racism.

The interview ends with a question on fatherhood and how it shapes both Podhoretz's and Roy's thinking as journalists and public intellectuals. Podhoretz does not want to foist his feelings and views on his children but notes that the media no longer make it possible for children to keep their innocence. Roy dreads sending his children to public schools and discusses some of the problems facing parents and children today. Roy says that parents can choose the environment in which they will raise their children and that there is no need to turn their children over to popular culture.

Peter Robinson: The American Healthcare Act, the Republican replacement act for Obamacare, represents a triumph of principle and good sense. Either that or it's a complete catastrophe. With us today, guests who see it both ways, John Podhoretz and Avik Roy on Uncommon Knowledge now.


Peter Robinson: Welcome to Uncommon Knowledge, I'm Peter Robinson. Having received an undergraduate degree from MIT and an MD from Yale, Avik Roy decided to become a journalist. Dr. Roy is the Opinion Editor at Forbes online and the founder and director of a new think tank in Austin, Texas. The foundation for research on equal opportunity. A graduate of the University of Chicago, John Podhoretz has been a journalist for an unbroken three and a half decades. Nearly unbroken the break occurring when he spent a year as a speechwriter in the Reagan White House. Mr. Podhoretz is now the film reviewer for The Weekly Standard, a cohost of the GLoP podcast, you heard that correctly, the GLoP podcast, and the editor in chief of Commentary Magazine. Avik and John welcome.

John Podhoretz: Thank you.

Avik Roy: Great to be with you, a lifelong dream.

Peter Robinson: Well happy to make dreams come true Avik.

Avik Roy: I was watching Uncommon Knowledge in my dorm room in the 90's and I thought if I really make it big then I'll know I made it big if I made it on Peter Robinson's show and here I am.

Peter Robinson: You're here, baby.

Avik Roy: I love it.

Peter Robinson: Downhill from this moment. Writing about the American Healthcare Act in The New York Post, John Podhoretz. This is a question directed to you, John's words. "Barack Obama and the Democrats may have lost the house in 2010, the senate in 2014, and the presidency in 2016, but they may be winning the most important argument they've ever made." Before we get to your rebuttal, explain what you're talking about there.

John Podhoretz: I think that the release of the American Healthcare Act, the Republican effort to start taking on Obamacare showed the way Republicans talked about it both positively and negatively, showed that a rubicon may have been crossed since the passage of Obamacare in 2010. And the rubicon is, a kind of common unspoken, almost unspoken acceptance of the idea that there should be universal coverage for healthcare in the United States. That was never a Conservative or Republican goal. It's not the right goal but in conceding it, or in seeming to accept it implicitly, not necessarily in the drafting of this law but in the way congressman went on TV to talk about the law and to defend it or attack it. That concession means that in the largest picture, Obama might have won the larger argument about where healthcare is going in the United States. Which is to say if Republicans cannot defend the idea that what is important is the freedom of the individual to make choices about how to live his life as opposed to the notion that we are all in this together and must all participate in healthcare to ballast each other's healthcare outcomes. Then we have accepted an essential social Democratic principle and that's a huge concession.

Peter Robinson: Barack Obama argued that it is the responsibility of the government to provide every American with healthcare. And the American Healthcare Act, the Republican proposal to replace Obamacare ratifies that decision and everything else is details. Avik.

Avik Roy: So what John just articulated is the conventional Conservative view, that universal coverage is a great defeat for conservatism and a victory for progressivism. I take a different view-

Peter Robinson: Avik, can I just say that's the first time I've ever heard John called a conventional Conservative. But go ahead.

Avik Roy: I think he would agree that, that's a conventional Conservative view. I think that conventional view is wrong and represents a failure of imagination of Conservatism. I know Peter that you keep Friedrich Hayek close to your heart? I do as well actually quite literally because here on my iPhone I've got The Constitution of Liberty and The Road to Serfdom on my Kindle app. And if you read The Constitution of Liberty or The Road to Serfdom, you'll see that Friedrich Hayek actually supported universal coverage. He actually talked about how in wealthy societies like he was referring to post-war Britain at the time, there is actually an affirmative case to be made that the economic security that comes from basic health insurance for everyone is actually a worthy goal. And if it's done in a market oriented way it can actually be done with very low cost, but a great deal of economic security and adequate healthcare leads to a better society. So he supported universal coverage. In fact, the United States doesn't have a free market healthcare system, didn't before Obamacare. The thing that we've done, and this has not raised the hackle so much of Conservatives, is we heavily subsidize healthcare for the wealthy through the tax break for employer based coverage, which is regressive tax break that helps the upper middle class. You and I, Peter and John, we pay taxes so that Mitt Romney and Warren Buffet and Hillary Clinton can get government subsidized healthcare called Medicare. You don't see Rand Paul and Ted Cruz raising a lot of objections to that. Instead, they're raising objections to health insurance for low income uninsured people and I wish we in the Conservative movement would say "You know what"-

Peter Robinson: Hold on let me get one point very explicitly here. You're granting John’s argument. You're saying yes, yes, yes, it's over. Everybody now agrees that it's the responsibility of the government to provide universal health care but that's not such a bad thing. But you are granting the premise aren't you?

Avik Roy: I wrote a cover story for The Washington Examiner a few years ago called "The Conservative Case for Universal Coverage" and my argument was ... and this is based on data. We could spend one seventh of what we spend on healthcare in America in terms of government spending, in terms of overall public and private health spending and cover everybody in this country or provide the right kind of safety net that provides a level of financial assistance that lower income people really need, if we just stop subsidizing health insurance for upper income people. If we just did that, we'd spend a fraction what we spend. We wouldn't have a budget deficit. We wouldn't have an entitlement crisis. We've done it all wrong. The reason why all these problems exist is because we've spent all of our resources subsidizing health insurance for upper income people.

Peter Robinson: I'm going to ask this question one more time. I'm not even disagreeing with anything you say but I just want to get to the premise here. So I think John will argue ... John is more than capable of amending or correcting my statement of his position. But John would argue, that Obamacare changed the relationship of the state to the citizen in a fundamental way.

Avik Roy: And I would totally disagree with that.

Peter Robinson: Never before ... Let me state it though. Never before had the federal government claimed the right to use its coercive powers to force citizens to do something just because they were breathing. And you are saying ...

Avik Roy: I agree that the individual mandate was a constitutional injury and I totally disagree with the supreme court decision by John Roberts-

Peter Robinson: There is no root to universal healthcare absent coercion is that not correct?

John Podhoretz: I would actually argue that Avik is right and that sure there's-

Peter Robinson: I'm trying to stick up for you and you're kicking me out at knees here John.

John Podhoretz: But there is a way. There is way and the way is single payer health insurance. Government provided health insurance and the creation of a government system of healthcare in which largely speaking, the medical profession works for the government and supplies its services to the individual. 

Peter Robinson: Canadian System, National Health service in Britain, it exists.

John Podhoretz: Pretty much. By the way it's constitutionally sound. It's something that would be passed by legislation. There's no constitutional issue with single payer it's just that its inimical as I understand it. It's inimical, the nationalization of the health care system. It's inimical to the American political experiment but I think that this is where we're going inevitably and part ... Let me just follow up on this in this sense, which is Avik is absolutely right that the original sin of our healthcare system was the decision to create the employer tax break in 1946. Just as you could say that the original sin of our real estate market was the decision to make deductibility of home mortgages. Which again is a regressive break that helps the richer you are the larger a mortgage you get, the better a break you get from the government. The problem we have is that this is where we are. If would could go back in time and start from zero and redesign from the ground up we know all these things about the moral hazards of using the tax system in this terrible way. But we can't so we have to build from where we are. And that's part of the American Healthcare Act obviously is that Paul Ryan, and the president, and Tom Price, the health, and human service secretary looked at this and said "What can we do that is practicable in 2017? What adjustments can we make that can get through the senate with 51 votes instead of 60? What can we do here and there?" Because that's the reality that they face. But I think in overarching terms, if we are looking at this and saying "What must be satisfied is that American's get healthcare." We get to Avik's point and the only way we get there eventually is not through the ways that he would want it. It's through single payer.

Avik Roy: Okay I would like to respond by asking you, John, a hypothetical question. And it's a very hypothetical question.

John Podhoretz: Yeah.

Avik Roy: Let's say in 2010, hypothetically, we passed a law that reduced federal spending by 10 trillion dollars over three decades. Reduce taxes by two trillion dollars over three decades. Had no individual mandate but ended up resulting in 20 million more people having health insurance because health insurance premiums went down by 25%. This is, admittedly, a hypothetical scenario. But if that combination reforms less spending, less taxes, fewer regulations, led to more people having health insurance, would that have been a defeat for conservatism?

John Podhoretz: No, but you're missing ... but-

Avik Roy: So I'm glad you said that because this is the problem with the failure of imagination of conservatism. Is that we've conflated a policy outcome, more people having health insurance, with the process by which we achieve that outcome. And the point I'm trying to make is that we Conservatives, we have always known that less government leads to more abundance, more wealth, more prosperity. We would never say we need more government so that every American can have a smartphone. We would never say we need government so that every American can have a job and yet we've accepted the left wing narrative that the only way to make sure that more people have the economic security of health insurance is through more statism. Why do we accept that narrative in healthcare when we accept it nowhere else in the economy? And this has been the failure of imagination of conservatism.

Peter Robinson: Hold on. Again a simple question. So here's the simple question. You believe then that if American Health Care Act, the Republican replacement for Obamacare, is enacted largely as it being talked about as we sit here today, that will lead to an increase in liberty?

Avik Roy: No, I'm not saying that. I'm not saying the American Healthcare Act is the hypothetical example. I'm saying that there are policies. So my think tank, the Foundation for Research on Equal Opportunity has published a proposal that is called transcending Obamacare you, can download through our website that actually based on our estimates, which are of course estimates would do exactly what I described. They would deregulate the insurance market, reduce federal spending, reduce federal taxes, but increase the number of people with health insurance because we dedicate our scarce resource to the people who need the help and not to the people who don't need the help.

Peter Robinson: So the two of you, as best I can tell, agree on the Conservative principle that the government ought not to use coercion to achieve universal healthcare. You're suspicious that we can survive that there's any way of acting on that. You disagree by saying "No, no there are ways we can increase liberty and healthcare at the same time." Right?

Avik Roy: Exactly.

Peter Robinson: Okay hold that thought we'll come back to it. But as we sit here today, tomorrow a vote is scheduled in the House of Representatives. The American Healthcare Act, you're in the House, do you vote for it or not?

John Podhoretz: I would not vote for it as a matter of general principle. If I am a Republican congressman, I'm gonna vote for it for political reasons.

Peter Robinson: Okay fair answer. Fair answer. Avik?

Avik Roy: I would vote for it with deep misgivings about certain aspects of the bill.

Peter Robinson: Let me ask again another couple of questions about the very nature of healthcare. I talked to someone whom I better not quote because he didn't know I was intending to but this is someone whose close to Democratic members of the senate. And here's the calculation the Democrats are making right now. Stand back, have nothing to do with this bill, let the Republicans push it through and let it be theirs. Let them own it because this is gonna be so unpopular. Premiums will rise it's going to cause so much trouble that we the Democrats will have a chance to come back in the mid-terms, take seats in the house, recapture the senate. Which, is roughly speaking just what the Republicans were thinking when the Democrats enacted Obamacare. Back then the Democrats were wrong. They thought in time Obamacare would become popular. It didn't become popular. So we have this strange situation in which professional politicians, the Democrats are making one calculation, the Republicans are making the opposite calculation and furthermore, they've changed places since Obamacare was enacted. Can I just ask, is it the case that it is the very nature of healthcare, that it is always going to prove so complicated and so disappointing because we will all get sick and we will all die, and the ultimate outcome is always going to be a failure. That whatever political party most associates itself with healthcare is making a big mistake. They should push it out to the private sector for political reasons. John?

John Podhoretz: In 2011 in Commentary Magazine, Tevi Troy published an article about how healthcare had been a 20-year disaster for Democrats. Democrats had essentially invented the healthcare issue as a national issue really around 1990 or 91. That's what's interesting about how it's become one of the predominate domestic political issues of our time. It's not as though people didn't get sick and die before 1991. There was a senate race in 1991. Harris Wofford was running against Richard Thornburgh in a special election in Pennsylvania and a newly minted consultant named James Carville suggested to Wofford that they should run this race on healthcare. Wofford won the race in a surprise upset victory talking about the disastrous healthcare system. And in 92 Bill Clinton took on healthcare as a major issue, became a national issue. And if you look at what happened over the course of those 20 years Clintoncare, Hillarycare was a disaster for Democrats. It lost them the house and senate in 1994. Then Obamacare did terrible things to the ... It passed in March of 2010 and that's what I said that you quote at the beginning, they lost the house in 2010, they lost the senate in 2014, they lost the presidency in 2016. All of which Obamacare was materially involved in. Now it's a dynamic process now. That's what's interesting is that you said, Obamacare is not popular. You're right, it was very unpopular. When it started to be apparent that the healthcare system was going to change with a Republican congress and a Republican president and people started saying "Oh what are you gonna replace it with?" And voters started getting nervous, It's numbers have climbed. Now it's not wildly popular, but it is not the toxic stew that it was at the beginning. So I think there is great merit in that if you touch it although you're in trouble. Although in 2003 the heated objection of Conservative Republicans who were very upset about it, the White House and the Republican leadership in congress, muscled through Medicare part D, the prescription drug benefit for the elderly, which has proved to be a wildly popular piece of legislation that kinda fits Avik's model. Which is to say, that it's basis is universal coverage. That is to say if you are 65 or older you get Medicare part D if you want it. And nonetheless, it does what it was supposed to do. It hasn't led to wild increases in drug prices. It's actually helped to moderate the market and all that. So, in theory, the thing Medicare drug benefit is, that it was ab initio. It was its own thing. It was a new thing. It was designed based on knowledge of a lot of the previous mistakes that had been made to make sure that it wasn't a monstrous jalopy constructed out of horrible things. The problem with where we are now is, anything you do to the healthcare system in theory it would be fantastic to literally expunge where we are and start from zero but it cannot happen.

Peter Robinson: Which, is the spirit. That's what people felt. You could argue that's what people felt Trump meant when he said "Repeal and replace" and maybe what Trump thought he meant. And now it turns out wait a minute, you can't touch this, you can't do that because of the reconciliation process. You can't do that. Avik they could still do better than they're doing. So back to you Avik. Is it the case that whoever becomes associated with healthcare ... You've already argued in effect that people could do a good job with healthcare. That it could be a political winner. Is the Republican party, supposing this bill actually gets enacted, is the Republican party going to regret it in 2018?

Avik Roy: If this bill is, they will. You know going back to the question you just asked, I think there's certain things worth losing elections for. Real entitlement reform, real reform of the system that maybe unpopular in certain quarters but over the long term, results in a better system that's more affordable for the country, for the tax payer, for the individual struggling with his health insurance bills. That would be worth it. That's worth losing elections for. Is this bill worth losing elections for? I'm not sure about that.

Peter Robinson: Rearranging the chairs in the Titanic is not worthwhile.

John Podhoretz: However, it's a complicated issue cause you have the issue of the bill and then you have the politics of the bill. So, put aside and be cynical and put aside the qualities both positive and negative about the bill. For whatever reason and for whatever reason it happened. Donald Trump and Paul Ryan decided that this was going to be the first thing that they were going to do. Right? So Trump said I wanna repeal and repress on the first day. Ryan said okay we're gonna go for this first. They designed this bill, they're in the House of Representatives and yet they design a bill that's designed to pass muster in the Senate, which was I think-

Avik Roy: I don't know about that.

John Podhoretz: But you know what I mean. It was designed to be a bill that in theory could go right to the Senate and would have these features that made it possible for it to be passed with 51 votes and not 60, right? So they decided to go first. Once they decided to go first and Trump said this is my bill, his presidency hinges on the passage of this bill. I don't think it's too much to say that even though it's so early. When has a president that we can think of lost his first major ask? You know when? Never.

Peter Robinson: Well, Jimmy Carter.

John Podhoretz: Jimmy Carter. I'm trying to think of what his first-

Peter Robinson: It took them a couple years to turn against him. You're right.

John Podhoretz: Right. I'm just saying there is Trump, he says "I'm coming to Washington to change things. I'm a winner, they're all losers. I know how to do things. I know how to make deals." He comes in, he's got a Republican House and a Republican Senate and he cannot get his first piece of legislation through. His throat is cut. 

Peter Robinson: Two quotations. All right boys, this leads us to the state of the Republican party. Avik Roy in an interview with Fox this past summer "The Republican coalition has inherited the people who opposed the Civil Rights Act of 1964. The Southern Democrats who are now Republicans have not come to terms with that." Now Avik, history, whereas in 1964 only about 70% of Democrats in the house and senate supported the 64 act, 80% little over 80% of Republicans supported the act. So, how is it the case that the Republican party gets tarnished with this accusation that they oppose the 1964 act? And how is it that the Republican party becomes the new home over four decades for ... I think you're saying really the Republican party now has the support of Southern racist.

Avik Roy: Well I think it's factually true that people who are racist in terms of white racism tend to find more of a home in the Republican party than the Democrat party. I think that's true. I think that political science, public survey, public opinion polls show that. That's not to say the Republican party is racist today, or that it was then. It's just the fact that, and actually racism isn't even really the problem, the real problem is white identity politics.-

Peter Robinson: You're leaving out Barry Goldwater. I raised a historical point and you haven't answered because I've seen you write the answer. That the reason the Republican party gets associated with opposing civil rights is because Barry Goldwater did oppose them. But go ahead.

Avik Roy: Right and Barry Goldwater had concrete constitutional and philosophical reasons for opposing the Civil Rights Act but it cannot be avoided. I think if you really study the political science, if you study the political Conservative, how parties have realigned and ideologically adjusted over time, that the Republican party did inherit those Southern Democrats. And the Democratic party, there were people on the progressive left who actually actively tried to drive them out because they felt that this was going to be an obstacle-

Peter Robinson: Drive them out of the Democratic party.

Avik Roy: Out of the Democratic party because they saw this an obstacle to a more left wing Democratic party. So these are things that have happened and again this is not to say that conservatism is bad or the Republican party is bad or anything like that. But that I think we have failed to see that I think the concede among Conservatives has been that we don't believe in identity politics. We're about the individual. It's only the left that engages in identity politics. And I think we fail to see that we Conservatives often engage in identity politics too, for the America that we look back favorably and nostalgically towards from the 40's and 50's and 60's.

Peter Robinson: John Podhoretz. Donald Trump won the votes of 58% of white voters, 8% of African Americans and only 29% of Hispanics. You will grant that Dr. Roy has a point?

John Podhoretz: I do grant it and I think that one of the things that this election revealed was that 40 years of a culture and a political culture on the left, but a culture in general that has been balkanizing and asserting that we are not all Americans, but that we are black first, Asian first, Hispanic first, gay first, that our identities are not a common thing but that our most important coloration is our either tribal or sexual identity turned into a giant case of blow back when the majority in the United States decided that if this was the way things were constituted then they constituted an interest group in themselves. Nobody expected this to happen in that way precisely because whites are a majority in the United States. They make up, what, 72%, 73% of the population. And so the idea was that this was all fine, you could this forever because of course it was their country it was a country of white people and so minority pleading was totally fine. What's more, we were told beginning in 2012 and onward, that this was inevitably in decline. That we were seeing that the demographic changes in the United States meant that at some point in the relatively near future, the white's domination of American demographics was going to end. And that in 2050 or something like that whites would be a plurality, but not a majority and so the inevitability was that the Democratic, what David Dinkins the former mayor of New York called the gorgeous mosaic of America, would be the reality. Well it turns out that if that's true ... And it may not be true but if it is true, that the majority isn't gonna go down without a fight. That they've been attacked, they feel abused. They feel like the country is running away from them, they feel like that all these minority groups are getting special benefits and that they do special pleading and it's not fair and now it's their turn. I think it's a horrifying development, but I think A) it's understandable and B) this is one of those unintended consequences of the notion that if you play the victim, that the strength of any minority group's position is enhanced by playing the victim and going and demanding restitution in some fashion or other. That if you do too much and you spend too much time at it and you change the cultural norms in that fashion, that there are going to be terrible consequences from it. We all thought there were gonna be terrible consequences from it, but I don't think that we knew that they would come in the form of a billionaire living on fifth avenue who was pretending to be a member of the white underclass.

Peter Robinson: Steve Bannon, now senior counselor to the president, in an interview that he gave shortly after the election. "If we", by we he means Trump and Trump's movement, "If we deliver, we'll get 60% of the white vote and 40% of the black and Hispanic vote, and we'll govern for 50 years." In other words, the way to expand the GOP is to make America great again. Create jobs, control the borders, forget all the nonsense about playing a role in the globe and put American interests first. And you appeal not just to white America ... What's striking here is Steve Bannon is saying, we're not trying to appeal just to white America. You appeal not just to white America, but to African Americans, Hispanics as well and you can put together a new governing coalition. Surprisingly enough the way out of the problem that Avik Roy identified is being shown to us by Donald Trump.

Avik Roy: Look, I hope that's true. I hope that Steve Bannon is right and I hope that Donald Trump is right. By the way we have to give President Trump credit for one thing. He actually slightly according to exit polls, outperformed Mitt Romney in 2012 in terms of his performance with minorities. I think he outperformed Mitt Romney by about one percent or two percent with blacks, Asians and even Hispanics. So all that to his credit. You know I want to say going back to what John was saying. I agree with about 90% or 80% of what John was saying. I think there are excesses-

Peter Robinson: That's a good day.

Avik Roy: I tremble to disagree with John-

John Podhoretz: I don't agree with most of what I say.

Avik Roy: At all but I will make this one additional point perhaps to what John was saying, which is, it's true that there are excesses on the left in terms of identity politics and things like that and I think we all as Conservatives rebel against that or recoil from it. But I find that sometimes we've kind of taken the opposite view. That because the left gets so annoying with political correctness that say gratuitously inflammatory things that don't recognize the real struggles that blacks in particular have had in America is okay. That we should diminish and ignore the history and the real struggle that particularly southern blacks experience in this country. Not just during the era of slavery, but during the 20th century as well. And I really wish that we as Conservatives, while we reject the left wing approach to identity politics ... If we invested as much time rejecting that and be annoyed by it and being put upon by it to study actually what happened to blacks in places like Texas and Alabama and Mississippi let alone in New York and Michigan we'd have a perhaps more balanced perspective why a lot of minority people in minority communities align with the Democratic party the way they do. Because I feel like the Republican party and the Conservative movement have not sufficiently and frequently enough recognized the dignity and the challenge that it's been to be black in America in the way that we really ought to.

Peter Robinson: I don't feel that.

John Podhoretz: You and I are in an interesting position here because you're a member of minority and so am I. I'm Jewish, you're of Indian descent so we-

Peter Robinson: I'm just gonna sit here and watch the two of you figure this out.

John Podhoretz: I left you out of this. So I mean that point is that it may not feel to people as though someone who looks like me ... And therefore you know a cop isn't gonna pull me over let's say or something like that, is that much minority. My group is 2% of the population of the United States and I feel as it may well be that Republicans particularly over the last maybe 10 or 15 years have gotten fed up with the idea that they're being called racist and that they're racist. And they feel like they've spent 30, 40 years supporting or promulgating or advocating for policies that would be of great help to the poor and to minorities and those policies have been rejected by the poor and minorities and by their representatives even though they would help people emerge from their immiseration. I think that something's happened over the last 10 years but I think that our experience of Jews in the United States certainly and Jews of course are not Republicans by any means or Conservatives by any means is an example that when it comes to minorities in this country as opposed to every other country on earth minorities are paid enormous respect. Public policy centers to an extraordinary degree on helping the people who are less fortunate achieve a better aim. I don't think it works. Mostly it doesn't work at all and sometimes it has a terrible consequence but the notion that both the Conservative movement and the United States in general doesn't care enough about minorities. That notion is completely undone by the history of the last 50 years. In the way the education system works-

Avik Roy: I'll disagree with you in a couple of ways again and I tremble to do it. I think there's a distinction between immigrants to the United States who I agree have had a lot of success and that's one of the great things that we should celebrate about America and the experience of people who are brought here in chains who I think have had a very different experience. I think the Conservative movement has not done enough to confront that history in ways that would allow us to again recognize the dignity of the experience that they've had. And that's not say that we-

John Podhoretz: You’re talking about the African Americans but that does not explain let's say the rise in minority consciousness of Latinos and Hispanics who were not brought here in chains and who don't have that experience and yet also have interest groups and demand affirmative action, demand special rights in education-

Avik Roy: And I'm agreeing with you there but I do think the black experience is a special case.

Peter Robinson: I want to make one point because I do actually after all have a seat at the table. I want to make one point and then move on to another question. The specific figures have escaped me now, which is unfortunate because I like to be as specific as possible. But during the Reagan economic expansion, there was a period of about five years when the ethnic group, which was most benefited, which was moving up the most quickly economically was African Americans. The Policies of this Conservative disproportionately benefited African Americans. All right final item here. Americans have ... You pointed this out. I saw this in a tweet of yours. Americans have sorted themselves out geographically to a remarkable extent. Liberals on the coasts, Conservatives in Texas and in the center and according to an article in 538 to which John brought my attention the other day. "More than 61% of voters cast ballots in counties that gave either Clinton or Trump at least 60% of the majority party vote. That's up from 39% of such voters in 1992 an accelerating trend that confirms that America's political fabric, geographically, is tearing apart." Republicans and Democrats now hold different values. Read different newspapers and live in different places. John has used the word balkanization. Article 538 talks about the political fabric ripping apart. This is something new in the post-war experience for this nation. Does it compromise the American experiment? How can you govern when half the country loathes Barack Obama and now half the country loathes Donald Trump? And really feels it viscerally.

Avik Roy: Well especially when you have a federal government that's trying to impose a one size fits all solution that's central then, that creates even more polarization because people feel their fates are not determined locally they're determined by a central government. So, that's a big problem. But one thing I want to point out about those statistics that you just cited. We're sitting here taping this show on the campus of Stanford University within 20 miles of where we're sitting, is the most dynamic entrepreneurial place in the world. Where the freest economy is generating enormous innovation but yet within 20 mile radius if you pulled what percentage of the people voting here were Republican it'd probably be five, 10%. Right? So whatever the number is I think that we over simplify when we describe Conservative and liberal and assign those to these voting categories of the people who are voting Democratic and Republican. In fact there are new schisms in both the Republican party and the Democratic party. In the Democratic party it's between the progressive left and the managerial elite represented by places like Silicon Valley and on the right-

Peter Robinson: Say that again. Repeat that, that's interesting.

Avik Roy: Progressive left and the managerial elite.

Peter Robinson: Okay.

Avik Roy: So people like-

John Podhoretz: So Bernie versus Hillary.

Avik Roy: Yeah Bernie versus Hillary exactly and on the right between what we might call the K street, Wall Street Acela corridor Conservatives and a more populist right that isn't actually that oriented towards free markets. They're against free trade, they're against entitlement reform, they're for protection of themselves and using the power of the state to do that in ways that conventional Conservatives have not been. So while we've seen this partisan soaring that you've described I'm not as convinced that we've seen an ideological sorting. I think we have perhaps not looked under the surface of who are the Republican coalition and who the Democratic coalition are and I think there are fissures in both.

John Podhoretz: I think you're right that the ideological sorting is much more complicated. That the Bernie Sanders voter has more in common with the hard Trump voter when it comes to say ideas about trade and banking and the like then we imagine. And that fissure within those parties may create new alliances over the course of the next 25 years if there not evanescent. We do have a cultural sorting, culture in the broadest sense. What you're describing is not necessarily Republicans and Democrats, or Liberals and Conservatives. You're describing, I think you might say secular versus religious, or what people used to call the new class versus sort of like the old line Americans or something like that, that they watch different TV shows, they're interested in different movies. The Trump voter made American Sniper. The Trump voter is responsible for American Sniper. The Obama voter or the Hillary voter is responsible for I don't know, I'm trying to think of-

Avik Roy: Avatar.

John Podhoretz: Maybe Avatar I don't know, La La Land. So they watch different programs, they have different cultural experiences. We're not in this situation in the 1970's where everybody watched The Mary Tyler Moore show and indeed getting to the atomization point, black people watch different programs from white people. Black Liberals watch different programs from white Liberals and so there are these real cultural separations whereas 40 years ago there weren't cause we all lived in a common culture. However, just to balance that out there was real regional culture in the United States that is itself now mostly gone. Like real genuine ... You know 1960 or something like that, it meant something much different to be a Texan then it does now. A Texan was a different type of-

Avik Roy: Oh it still means-

John Podhoretz: I know you Texans think so but it's not real because your mall has the same 200 stores as the Stanford mall does. That's what I'm talking about the retail is the same. The food is the same most all of that stuff. The way that we live is not all that dissimilar except for church. 

Peter Robinson: In 1960 Texas was a different country.

Avik Roy: The barbecue is much better in Texas.

John Podhoretz: Okay and the deli's better in New York but you still have deli's and we still have barbecue but the way that we perceive how we should live is now entirely different.

Peter Robinson: Kevin Baker, his fascinating piece in the New Republic. Angry piece about red America. And he wrote, "It's time for blue states and cities" ... Democratic Liberal. "It's time for blue states and cities to abandon the American national enterprise. Call it the new federalism or virtual secession or maybe blue exit." Now Republicans have argued for states’ rights and federalism for decades and it is one of the miracles of our national history that on election day Democrats woke up opposed to states’ rights and in favor of other greater concentrations of power in Washington, and went to bed that night with a new respect for states’ rights.

Avik Roy: Oh yeah, not just states’ rights, judicial activism.

Peter Robinson: So the question I have here is whether all of this balkanization which I have to say-

John Podhoretz: Oh and the perfection of the constitution, that's the other thing.

Peter Robinson: Yes exactly.

John Podhoretz: Suddenly they're all yes, they're all Neil Gorsuch.

Avik Roy: And now Russia is the number one geopolitical threat in the world.

John Podhoretz: Exactly.

Peter Robinson: So is this actually in some way good news? Republicans don't want that much federal government and now Democrats are having second thoughts about the federal government. Can we get some reinvigoration of regional power? Of states’ rights? Of federal ... You don't buy it.

John Podhoretz: Nah because the whole point of this-

Peter Robinson: I'm trying to give you a cheerful note here.

John Podhoretz: No, because the whole point of this is the de-legitimation of Donald Trump. Now I'm no Trump fan and I have great problems with him but you win an election fair and square and you get to be president and that's how it works. And I didn't like Obama and Obama got to be president and I wasn't one of the people standing around saying that he wasn't legitimate or he wasn't American or anything like that and I didn't like when my side does it and I don't like when their side does it and that's all part of this atomization. That they cannot except a result that they do not like. I mean if somebody said I do not accept the results of the super bowl everybody would laugh at them. You know? You can't do it in sports so why can you do it in the most important thing in life?

Peter Robinson:I'm looking at the Texan at the table. Are we gonna get a reassertion?

Avik Roy: Well you know what I would say is one fundamental difference between the hard left and the hard right or ideological progressives and ideological Conservatives, his ideological progressives are very results and outcome oriented. They'll adopt whatever argument is necessary to achieve the policy outcome that they want. Whereas Conservatives will say things like "Well the constitution forbids this and therefore it doesn't matter what the policy outcome is, the constitution forbids it." And that fundamental difference results in the kinda discussion we're just having. So oh, its great progressives care about federalism so maybe we'll have some allies now, but no because at the end of the day-

Peter Robinson: Only until they get what they want.

Avik Roy: Conservatives are willing to say if federalism leads to bad policy outcomes in California we're okay with that because we believe in federalism. Whereas, progressives would say, "No it's the policy outcomes that we want to avoid so we won't devolve things to the states because we don't want to allow bad policy outcomes in Texas."

Peter Robinson: So they're both pretty pessimistic basically?

Avik Roy: Yeah about that anyway. About making the left and seeing the error of their ways yeah.

Peter Robinson: Last question. We're talking about the nature of the country, we're talking about the future of the country I have a question for you. John is the father of three children. Six months ago you became the father of your son. If the answer to this is no, just say so. But do you find that fatherhood, fatherhood this ancient experience that fatherhood affects the way you do your job as a journalist? As an intellectual? Does it affect the way you think about the country? Does it affect the way you feel about this country? John?

John Podhoretz: Yes but in odd ways. The oddest way is that I have spent ... My oldest is 12 1/2 and I've spent most of her life shielding her from politics and the news and my children who are younger because having on-

Peter Robinson: You're like a mafia don you don't want the kids to know what you do for a living.

John Podhoretz: Having on a television that has on a newscast will compel them to ask me questions about the nature of evolving politics and morality that I have not wanted to have to bring up with them. I as it happens did not want to discuss transgenderism with my daughter when she was seven and there was a picture of a transgendered person on the cover of the New York Times magazine. I have very strong feelings about it, I don't want to go into it here but I did not want to exert my feelings on her about this issue one way or the other I just did not want to have it addressed. So as a journalist and a parent, one of the things that I am most unhappy with about the development of my business is the fact that it no longer views itself as having a responsibility to help parents keep their children's innocence as long as possible. Which, was indeed a very important part of the general sense in media responsibility in this country when we were children and not only is it gone, some of this is actually defiantly on purpose. You need to have these conversations that you don't want to have so we will force them upon you. And that to me is how my children are in a state of greater innocence and lack of knowledge about what is going on in the world then I was certainly at their age, and that I would've expected them to be.

Avik Roy: I'm too new as a father to have the insights and reflections that John has. I do dread sending my child to schools in this country for the reasons that you've described. I have no idea how I'm gonna have ... If it was hard to have these conversations today or even 10 years ago, how am I gonna have them in 2027? I have absolutely no idea. But I will say this Peter, that fatherhood, parenthood in general is an incredible joy. It's a responsibility but it's an incredible joy and I think the thing it has done more than anything else in terms of changing anything about me is it's made me happier. I was always a pretty happy guy. I'm a temperamentally happy guy I like to think as Conservatives go but there really is an incredible joy to parenthood and I worry that we're living in a country where not as many people realize that parenthood is a joy. If you look at the number of people particularly in married families who are having children in that conventional nuclear way it's declining. In Europe, we're seeing the rates of childbirth are going down. It's happening in the United States as well because a lot of people don't see that. They don't see the joy of parenthood and childhood the way that many of us do. And I feel sad for them cause certainly for myself it's brought a lot of joy to my life.

John Podhoretz: Can I add to this cause I think there's also another part of this odd cultural message that has come down in the last 15 to 20 years is quite the opposite of what you say that parenthood is a horrible experience. You get no sleep and your children are this and they're annoying and they get ADD and you have to give them Ritalin and your marriage blows up and you never have time for each other and you're both working and it's all so horrible and if you are sort of a culturally literate person around the age of 19 or 20 or 21 I think you look at the advance into adulthood. You may look. Your children are that age so you may know better than I, you might look at this with a certain level of horror. That the thing that people wanted to be throughout most of history was older. They didn't want to be kids, they wanted to become adults. They wanted to get out of their parents’ house, have their own, have a wife, have children, have a husband, have children, have a home, have a family and now much of the cultural messaging of the sort of liberal elite is about how they don't tell you the truth about it, which is that it's a hard, hard and terrible things-

Peter Robinson: So John you're talking about the hostility of American popular culture to family formation and to the innocence of children.

John Podhoretz: Yeah.

Peter Robinson: Which, sounds a lot like ... We have a friend called Rod Dreher who has a book out now called The Benedict option in which he argues that Christians ... This part of the argument won't apply to you my elder brother in the faith but that Christians should withdraw. That politics is lost in this country. But you don't feel any impulse to withdraw?

John Podhoretz: None at all. Everybody feels the impulse to withdraw from things that annoy them and you say I shouldn't have to, have to deal with this but withdrawal is not an option. We need to be in there fighting the good fight and not allowing-

Peter Robinson: You don't feel like a roman senator in about the year 400.  Say yeah you know Junius and Pluto it's all over we've done the best we could and it's over. We had a lovely run but it's done.

John Podhoretz: My major thought experiment is this, there's an unborn child up in heaven it's 2017 and God says to the unborn child "Okay you can pick ... There are 204 countries in the world you can now pick which one you're born in." What country would that unborn child pick? Child wouldn't pick China he would still pick the United States and so the notion of seeding the country to the people who are arguing things and fighting for things that I don't believe in, that I think are inimical, I think we're the opposite of a lost cause.

Avik Roy: I want to pick up a phrase that you mentioned-

Peter Robinson: This is my friend John. You say to John, "John do you feel defeatist?" And John says in very sophisticated ways what he's really saying is "Hell no, I feel like fighting even harder." That's John. Avik.

Avik Roy: You used a phrase that I think is very important, popular culture. It's popular for a reason and I think sometimes we don't confront that. There is no law preventing me from reading Plato's Republic as a bedtime story to my six-month-old, there no law preventing me from playing Bach over my stereo system rather than Beyoncé. People can and have the choices in terms of what culture they raise their children with. Yes schooling and other influences are there but we still have a lot of agency in how we raise our children and I think too often we surrender that agency and say "Well Hollywood is this and CBS said that" instead of saying "You know what I'm gonna expose my children to the things I want them to encounter in this world."

Peter Robinson: John Podhoretz, Editor of Commentary. Avik Roy of The Foundation for Research on Equal opportunity. Thank you.

John Podhoretz: Thanks very much.

Peter Robinson: For Uncommon Knowledge and the Hoover Institution I'm Peter Robinson.