I remember the day my attitude towards William Weld shifted from a mild dislike to active antipathy. It was back in the mid 80s, when Weld was Governor of Massachusetts. He had recently proposed a drastic change in Massachusetts' housing policy, which, many people feared, would lead to a lot of people winding up homeless. (I think it was a drastic curtailment of section 8 funds, but I could be wrong. I was spending a lot of time with housing policy wonks back then -- a bunch of very smart, very well-informed people, mostly centrists, to whom good evidence-based policy mattered a lot more than ideological correctness -- and they were all terrified about what the change would do.) One day Weld was asked about the possibility that his program would leave a lot of families homeless, and he said, in this absolutely cavalier way, that if it turned out that a lot of people were thrown out onto the street, he'd just change the program back the next year. (The 'cavalier way' is crucial here: I could imagine someone expressing doubts about the program, and explaining why he'd chosen to support it in a way that did justice to the problems it might cause. That would not have disturbed me in the same way. What bothered me was that Weld's response was not thoughtful; it was flippant.)
As though just changing the program back again would be enough. As though that would make things all better again.
I thought: consider a family who were, as they say, working hard and playing by the rules, who were just barely making ends meet with help from Section 8 (or whatever it was), and who, as a result of this change, lost their home. Consider the effects on their children, who have to try, somehow, to get their homework done in a van or a homeless shelter. Consider the fights that might erupt between the parents as a result of the stress and misery of trying to figure out how to keep their family together on the streets. Marriages break up over less, and it's hard to imagine that the stress alone wouldn't take a serious toll on everyone around, including the kids. Consider the humiliation, for the parents, of having to take their kids to shelters and food banks, and the cost to the kids whenever one of their classmates asked: so, where do you live? (This is supposing they stayed in school. If not, consider the cost to them of dropping out or missing large chunks of school time.) Consider the impacts on their health of life on the streets. Think of all the damage that living on the street would do to a family.
Now imagine William Weld saying: Oops! my bad!, and changing the program back. This family might reapply for assistance, and in a few years might get it. But an enormous amount of damage would have been done to them in the meantime. Life on the streets is not good for anyone, especially for children. You don't have to be some sort of miracle of empathy to recognize this. And the contrast between the thought of that damage and Weld's completely cavalier attitude to it just enraged me.
I feel the same way about Medicare Part D. Because a lot of the damage that will be done to people as a result of Medicare Part D is like the damage done to a family by becoming homeless in this respect: you can't just wave a magic wand and make things better again once you realize your mistake. The damage is permanent, and it cannot be undone. And that makes the thoughtless, cavalier way in which this policy was written and adopted completely outrageous.