Poland’s ruling Law and Justice party is one of the most popular right-leaning parties in the West. It is also one of the most innovative. In recent weeks, it has promised a massive increase of healthcare spending – a proposal that is popular with voters and unpopular with libertarian ideologues.
“There must be a health service that is universally available and at the same time, which I want to stress forcefully, public,” said the party’s leader, Jarosław Kaczyński. “The private sector will play a supplementary role … above all we must ensure every citizen of our country, every compatriot, has medical services and support for free.”
The party intends to raise public healthcare spending to 6 per cent of GDP by 2024. The change would put Poland on a par with the healthcare spending of other developed countries (the OECD average is 6.6 per cent).
The proposal is only the latest violation of free-market orthodoxy by Poland’s governing party. Law and Justice has enacted a generous child allowance, which has reduced poverty and may be helping to increase Polish birth rates. It has pledged an extra “13th month” pension payment for retirees and the elimination of income tax for those under 26.
Support for Law and Justice is concentrated in poorer areas. Unlike its counterpart in America, the party has decided to support policies that please its base rather than a narrow group of economists and donors. It has also defied liberals, who lament the party’s preference for cash handouts over increased funding for state-run bureaucracies. Its healthcare proposal is a notable – and perhaps necessary – exception to this strategy. Defending universal access to healthcare is essential to the party’s electoral success.
Given how much ink has been spilled over East European populist parties, it is striking how little has been said about those parties’ innovative economic policy. But the electoral success of Law and Justice and of Hungary’s Fidesz depends on their ability to deliver economic growth and social spending along with conservative cultural
Western pundits often describe these parties as far-right, but they are in fact centre-right parties that have adjusted to a populist political moment. Their pragmatism has allowed them to fend off challenges from both left and right – the latter illustrated by the nationalist movement that summoned hundreds of thousands of marchers to the streets of Warsaw last year.
Centre-right parties in the West should learn from the success of their Eastern European counterparts. It is not enough to sound populist economic themes. Given the changing nature of their electoral base, centre-right parties need to deliver economic policies that benefit the working class. Only by doing so can they fend off the Elizabeth Warrens and Bernie Sanderses, along with far-right insurgents.
In 2018, the richest congressional districts in 12 different US states flipped from the Republicans to the Democrats. Meanwhile, five heavily Republican states voted by referendum to expand Medicaid. Rich voters are abandoning the Grand Old Party, while a working-class base clamours for better healthcare. For the most part, Republican politicians have not paid attention.
One partial exception is Donald Trump. “We’re going to have insurance for everybody,” he told the Washington Post in 2017. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” Michael Wolff reported that in a meeting on healthcare, Trump scandalised his advisers by asking, “Why can’t Medicare simply cover everybody?”
But like most of Trump’s promises, this one has not been kept. Instead of proposing a system of gold-plated Trumpcare, Trump outsourced his healthcare efforts to Paul Ryan, a principled conservative who, like many principled conservatives, treated as matters of principle things that were really questions of prudence – most notably tax cuts and healthcare spending.
A pragmatic centre-right party would have acknowledged during the Obama years that something like Obamacare was inevitable, and countered with its own plan. Such a plan could have reduced inefficiencies, forbade healthcare spending on elective procedures and abortions, and encouraged communal life by funneling healthcare spending through intermediary institutions such as religious bodies.
In other words, it could have forestalled some of the worst elements of Obamacare. Catholics rightly lament that Obamacare has been used to attack and discredit the Church. A pragmatic Republican Party would have allowed them to champion a plan that helped poor Americans without violating religious conscience. Instead, Republican leaders pleased the donors and ideologues.
Whoever wins the next election, Republicans should shore up their emerging working-class base by delivering economic benefits to working people of all races and creeds. Otherwise they will be caught between the woke left and the alt-wrong, each of which seeks in its own way to divide America rather than remind us of what we have in common.
Matthew Schmitz is senior editor at First Things