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Wednesday, December 7, 2016

If you haven’t seen the video or photos yet, trust me, you will. Rand Paul in blue scrubs and hiking boots, bringing sight to the blind in an operating room in Guatemala — could there be a more perfect visual for a White House hopeful? And that’s before we even get to the metaphors about restoring vision and fixing problems.

A flattering segment on NBC’s Meet the Press was just the start of extracting the gold from this rich political vein. Campaign ads inevitably will feature video of the senator-surgeon performing the pro bono eye operations, as will a Citizens United documentary about Paul. The conservative group sent a camera crew and a drone to shoot footage him in action in Guatemala.

Let’s stipulate that whatever you think of Paul’s views or the political entourage he brought along, the Kentucky Republican transformed lives on that trip. It was a wonderfully compassionate volunteer act — and that’s where things get complicated.

Paul has been working steadily to create his personal brand of compassionate conservatism, and it’s more substantive than outreach. His causes include restoring voting rights to felons, reforming drug sentencing laws and — after Ferguson — demilitarizing the police. He is a champion of charter schools, which many black parents are seeking out for their children. He has proposed economic incentives to try to revive Detroit. He and Democratic senator Cory Booker are pushing legislation to make it easier for people to create new lives — including expunging or sealing convictions for some juveniles and lifting bans on post-prison food stamps and welfare benefits for some offenders.

All of that is broadly appealing. It’s also consistent with libertarian and conservative principles such as more personal choice, less government intrusion, lower taxes and — in the case of the prison and sentencing reforms — saving government money by reducing recidivism and prison populations. The emphasis is on the “conservative” part of the phrase.

The man who invented the brand and rode it all the way to the White House, George W. Bush, focused on the compassion part. To the dismay of conservatives, he enlarged the federal role in education (he called it “the civil rights issue of our time” and signed the No Child Left Behind Act) and spent a bundle of borrowed money to fight AIDS in Africa, launch a Medicare prescription drug program and try to impose democracy on Iraq.

What you might call fair-weather compassion — compassion that’s limited to policies that cut spending or, at the very least, don’t cost more — is a conservative hallmark in the post-Bush era. But Paul trumped his colleagues and won plaudits from groups like FreedomWorks with a 2013 budget that would have balanced in a lightning-fast five years. It repealed the Affordable Care Act and killed the departments of Commerce, Education, Energy, and Housing and Urban Development. It also privatized Medicare, allowed private Social Security accounts, and shifted Medicaid and food stamps — designed to grow and shrink depending on need — to a system of capped grants to the states. “Gut” was the liberal verb of choice.

Paul’s 2011 budget blueprint would have phased out all foreign aid. “This would cause misery for millions of people on AIDS treatment. It would betray hundreds of thousands of children receiving … malaria treatment,” former Bush aide Michael Gerson said last weekend on NBC after the Paul-in-Guatemala segment aired. “This is a perfect case of how a person can have good intentions but how an ideology can cause terrible misery.”

The ACA, with its premium subsidies and Medicaid expansion, is designed to help just the types of people Paul served in Guatemala. In fact, more than 290,000 newly eligible people had signed up for Medicaid in his home state by mid-April. Yet last year Paul was willing to shut down the government in an attempt to defund the law.

Paul did not release a budget this year, and he said in May that he is “not sure” that Kentucky’s ACA insurance marketplace (Kynect) should be dismantled. Is he giving himself some room to maneuver? Unclear. He continues to favor repeal of the entire ACA and seems most concerned about its impact on local hospitals. One had to lay off 50 people due to the law, he said, so “now we’ve got more people in the wagon, and less people pulling the wagon.”

What he said was debatable — CNHI News Service reported that the hospital, T.J. Samson in Glasgow, is expected to do better financially under the new health law than it did under previous policies. Beyond that, does Paul really want to snatch Medicaid away from nearly 300,000 of his least fortunate constituents? The answer to that question will help determine whether those compassionate images from Guatemala are merely images, or something more.

Follow Jill Lawrence on Twitter @JillDLawrence. To find out more about Jill Lawrence and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

Photo: Talk Radio News Service via Flickr

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