The first man to die of Ebola in the U.S., Thomas Duncan, was an African man with no health insurance. He was initially discharged by the hospital with an antibiotic prescription even though he had a fever of 103 degrees. The hospital knew that Duncan had just arrived from Africa, which should have been an alarm. Even so, someone with that much fever is very sick, and there was no diagnosis. He was just given antibiotics and sent home.  And one does wonder if a white man, or a person of any color with insurance, would have been at least kept for observation.

Even after Duncan had been diagnosed with Ebola Texas couldn’t get its act together.

It’s clear now that not just the hospital but state and local authorities responded inadequately to Duncan’s illness. His family and friends were quarantined, but left to fend for themselves; county public health officials didn’t even provide clean bedding. “The individuals, it’s up to them … to care for the household,” Erikka Neroes of Dallas County health and human services told the Guardian a week after Duncan had been admitted to the hospital. “Dallas County has not been involved in a disinfection process.”

When the disinfection process began, belatedly, there’s evidence that was botched as well. The Guardian found a team of contractors with no protective clothing simply power-washing the front porch, for instance, when it should have been scrubbed with bleach. A baby stroller sat nearby.

While the increasingly weird Grandpa John called for an Ebola czar, other people pointed to cuts in public health spending at the state and federal level that left us vulnerable. See Sarah Kliff, “The Stunning Cuts to America’s Budget to Fight Disease Outbreaks.” And then let’s go back to this:

The GOP approach to public health was crystallized at the 2012 debate where Rep. Ron Paul – another Texas politician — said it wasn’t the government’s responsibility to take care of a hypothetical young man who showed up in the emergency room very sick after he decided not to buy insurance. “That’s what freedom is all about, taking your own risks,” Paul said, deriding “this whole idea that you have to prepare to take care of everybody …”

“Are you saying that society should just let him die?” moderator Wolf Blitzer asked. And the crowd roared “Yeah!” (For his part Paul answered no, but said hospitals should treat such cases as charity and not be compelled to do so.) Lest you think either Paul or that Florida audience represented a minority sentiment in the GOP, recall that none of his rivals, not even Mitt Romneycare, challenged Paul’s approach at the debate.

But now we know what happens when hospitals fail to adequately care for uninsured people who turn up in the ER: They can die, which is awful, but they may also spread disease and death to many other people. It’s pragmatism, not socialism, that commits governments to a public health agenda.

Republicans don’t do pragmatic. Republicans do tax cuts and then blame Democrats when the tax cuts have consequences.

I don’t pay that much attention to Rand, frankly, but it’s significant that today it appears the entire Right has risen up against him and called him crazy.

The story thus far: Not long ago Rand wrote an op ed for the Wall Street Journal arguing (I’m told; it’s behind a firewall) that the U.S. should stay out of Iraq and not take sides between ISIS and the Iraqi government. I can see that a reasonable argument could be made along those lines, so I’ll assume Rand made it.

But now calls for ignoring ISIS are not politically tenable, so a couple of days ago Rand published an article in Time magazine denying that he is an isolationist and blaming President Obama for not doing enough to stop ISIS and for allowing Syria to become a “jihadist wonderland.” Unfortunately for Rand, the ideas expressed in Time still were far too moderate to pass muster on the Right, so he’s being fired upon from many rightie positions, from the Hoover Institute to NRO to Hit & Run.

Steve Benen notes a recent speech by Rand that took another position from those first two. Like Chickenman, he’s everywhere! He’s everywhere!

On Wednesday, Paul said he had no use for “interventionists” and the “hawkish members” of his own party who are calling for using force in the Middle East. But just 48 hours later, Paul supports U.S. military intervention abroad to destroy ISIS?

Also keep in mind, less than a month ago, Paul was asked about U.S. airstrikes targeting ISIS targets in Iraq. The senator said he had “mixed feelings” about the offensive. Apparently, those feelings are no longer mixed and Paul is now eager to “destroy ISIS militarily” – says the senator who complained last week about Hillary Clinton being a “war hawk.”

At what point do Rand Paul’s loyal followers start to reconsider whether Rand Paul actually agrees with them?

Sarah Smith recently noted that the Kentucky senator has changed his mind about federal aid to Israel, use of domestic drones, immigration, elements of the Civil Rights Act, Guantanamo Bay, and even accepting donations from lawmakers who voted for TARP.

Now, even the basic elements of his approach to using military force are up for grabs.

Oooo, politics is hard.

Sorry for the whiny headline. It’s just that I’m going from wondering how one gets a paying job as a glorified caption writer (although Benny Johnson was sacked; good luck finding another gig that sweet, dude) (update: on second thought, he’s an old Breitbart alum. Wingnut welfare will provide.)  to wondering how come there’s always plenty of money to pay “experts” who don’t know what they’re talking about? Especially conservative “experts”? Well, OK, I know what the answer is, but that doesn’t mean I can’t wallow in the injustice of it for a while.

The buzz from the Right this week was the rebirth of “compassionate conservatism.” The original was never more than an empty slogan, of course, but like good little courtiers the pundit class mostly pretends that’s not true and take it seriously.

Paul Ryan is being praised even in some center-leftie corners for his new anti-poverty ideas. Basically, unlike some of his previous plans, he does not wish to help Americans who are falling behind by taking away their shoes and breaking their feet. Instead, he proposes to treat them all like lazy children so they’ll shape up.

This is most obvious when you look at the portion of Ryan’s draft that has attracted the most scorn, the idea that poor people, if they want to use government programs, should sign a “contract” that would outline various steps and benchmarks they’d be responsible for — or else suffer the consequences of undefined “sanctions.” What kind of steps and benchmarks these are, Ryan doesn’t say, which is perhaps a gesture toward his beloved subsidiarity (the Catholic belief that authority should be devolved as much as possible), albeit one that is particularly hollow within the context of a policy that quite literally would have government agents micromanaging poor people’s lives. The point is, however, that Ryan assumes poverty in America cannot be adequately addressed by doing seemingly obvious things like giving people money or creating well-paying jobs that tackle vital public needs, but that it instead requires the poor to learn from a government-provided surrogate parent how to wrest themselves free from that dreaded “tailspin of culture” Ryan’s previously warned us about.

However, this doesn’t mean the poor will get to keep their shoes.

Every year or so Paul Ryan comes up with a glossy new plan to deal with poverty or spending on social programs. The plans never go anywhere, but they’re not really intended to: They’re designed to make the Republican Party (and Mr. Ryan himself) appear more thoughtful than it actually is on these subjects.

The one he released today is somewhat better than previous efforts, in that it doesn’t propose massive cuts in overall spending (unlike his House budgets), and would even increase the Earned Income Tax Credit, one of the government’s most successful anti-poverty programs. Democrats have also embraced a larger credit, although unlike Mr. Ryan, they would pay for it by raising taxes on the rich rather than slashing federal nutrition programs that Mr. Ryan thinks are a waste of money.

But the lack of seriousness in the plan is demonstrated by its supposedly big idea: It would combine 11 of the most important federal poverty programs into something called an “opportunity grant” that would be given to the states to spend as they see fit. The eliminated programs would include food stamps, what remains of the welfare system (known as Temporary Assistance to Needy Families), Section 8 housing vouchers, and low-income heating assistance, among others.

So, depending on where you live, it’s your state that will confiscate the shoes and break the feet. Gotcha.

Shorter Paul Krugman: Paul Ryan is still full of crap. Do read the whole column, though.

Elsewhere, via mistermix, the very exasperated Matt Bruenig takes apart the allegedly serious conservative intellectual Reihan Salam for misstating basic facts about how anti-poverty programs work. Again, do read the whole thing.

Thomas B. Edsall, who is even older than I am and definitely a geezer, writes that today’s young people might not grow up to be Democrats, after all. That’s because a new Pew Research poll says the young folks are more interested in personal and sexual autonomy than in economic inequality.

Geezer Dude: This is because they are young folks. You could have said the same thing about the Boomers when we were young folks, including the left-wing antiwar ones. Economic issues were not on our radar at all, as I remember. This was partly because the economy had been, on the whole, pretty sweet through most of our lifetimes, and we naively assumed nothing could screw that up. The 1960s- and early 1970s-era New Left was even opposed to labor unions, mostly because unions were run by old white guys who fought integration and badmouthed affirmative action, and partly because we didn’t appreciate what could happen without unions.

Teens and young adults are always primarily concerned about personal and sexual autonomy, because that’s the standard life phase associated with being a teen or young adult. It’s normal. If you’re still struggling with those things when you’re 50, though, that’s a problem.

Teens and young adults also may not yet fully appreciate how screwed up The System is and how everything is skewed to favor the socially and economically privileged. People who are privileged their entire lives often never learn that lesson, of course. They build on familial wealth and connections and consider themselves to be “self-made men” (or women).

Much of the Boomer generation was reasonably well insulated from real hardship in part because of the accumulation of wealth from the end of World War II to 1972, when it all peaked and started to slide backward. And even those of us who missed the economic security boat often were well into middle age before we realized our assumptions were wrong, that we were never going to catch up to where we expected to be, and that economic injustice is terribly and ruthlessly unjust, indeed. If anything, seems to me, the young folks are learning that lesson a whole lot sooner than we did.

In short, I seriously doubt a majority of today’s 20-somethings who aren’t already libertarian randbots will ever embrace some future warmed-over version of Reaganomics. While there is no way to predict where today’s 20-somethings will be when they are 50-somethings, I doubt it will be anywhere today’s Republicans want them to go.

Related: Matt Yglesias asks, How long can the GOP last as the cranky oldster party?

There’s something very oldsterish about contemporary conservative politics. The constant bickering about Ronald Reagan is very odd to anyone too young to have any particular recollection of the Reagan years. Calling a group of people “Beyoncé Voters” as an insult is weird. Some of this oldsterism is just tics, but some of it has policy implications. The sort of budgetary priorities that call for huge cuts in all domestic spending, except no cuts at all for anyone born before 1959 is kind of weird. The huge freakout over New York City starting a bicycle program last summer was bizarre. It’s easy to imagine a political party that’s broadly favorable to low taxes and light regulation without sharing this particular set of tics. And then there was the time George Will wrote a column-length rant against blue jeans.

They do all want to pretend the 1960s either never happened or that they can still be avenged against it (remember the brilliant campaign to get college students to burn their Obamacare cards?). Recently Re. Renee Ellmers (NC-R) actually said,

Men do tend to talk about things on a much higher level. Many of my male colleagues, when they go to the House floor, you know, they’ve got some pie chart or graph behind them and they’re talking about trillions of dollars and how, you know, the debt is awful and, you know, we all agree with that … we need our male colleagues to understand that if you can bring it down to a woman’s level and what everything that she is balancing in her life — that’s the way to go.

The Congresswoman was born in 1964, Wikipedia says. This is the same year Betty Friedan published The Feminine Mystique.