This means that while the energy of activists may be pushing the Republicans to the right on size-of-government issues, the concerns of their central constituency could end up pulling them inexorably leftward on entitlements.
This wouldn’t be a terrible things if Social Security and (especially) Medicare accounted for, say, ten percent of the federal budget. [...] [W]e could easily end up with a straightforwardly big-government party in the Democrats, and a G.O.P. that wins election by being “small government” on the small stuff (earmarks, etc.) while refusing to even consider entitlement reform. That’s a recipe for one of two things: Either the highest taxes in American history and a federal government that climbs inexorably toward 30 percent of G.D.P., or a Greece or California-style disaster.
We're pretty much already at this point, when it comes to the party platforms. I don't subscribe to the "big-government Democrat" argument, but Douthat is right in that we're on an unsustainable path. A big step toward fixing this would be health-care reform. The only real Republican nods toward small government and entitlement reform are the Ryan/Coburn health care plan and the Ryan Roadmap. Neither has much support among Republicans, and both are unacceptable to anyone who wants the US to have any kind of safety net for its citizens. This leaves the imperfect bill currently in the works. It's a start. It needs to pass. And then it needs to be improved.