SCHotline

by CHARLES BIERBAUER

Somewhere between the Ides of March (always a downer) and the first day of spring (hope eternal), the calendar shrank dramatically. Then just as we passed the equinox, the equilibrium was further upset. All this will be far more evident by this time next year when, for all practical purposes, the 2008 presidential nominees may be settled.

Any hopes of a gradual crescendo allowing presidential candidates time to build on early successes were wiped out during the past week when Gov. Arnold Schwarzenegger scratched California’s primary off the June calendar and wrote it on February’s page instead. The change, Governor Schwarzenegger said, would give California “the influence it deserves” in the selection process.

California’s eagerness to get in the game has tectonic implications, but then California famously sits on fault lines that produce major earthquakes. Florida delivered the aftershock when its state legislature took steps to move the Florida primary to January 29.

South Carolina, sitting on both seismic and political fault lines of its own, had figured to be the state to shake up early candidate rankings in both parties. Our primaries, expected January 29 and February 2 (don’t make me explain that partisan quirk here), would have been the first after traditional kickoffs in Iowa and New Hampshire (also too idiosyncratic to get into now). The notion, not a bad one, was that South Carolina would cast the first fairly representative vote that would start to winnow the anticipated large field of Republicans and Democrats in the 2008 race.

Should we worry? Should we be angry with Arnold? The Floridians? Have we been dissed?

South Carolina now may have to share the first good shakeup of the candidate fields. But California’s action, especially, has turned what might have been a string of aftershocks into a mammoth tsunami on February 5th with 20 or more states joining that day’s super-sized primary.

The frontloaded calendar could make South Carolina’s role all the more important and its glow all the briefer. Even as candidates traverse the Palmetto State looking for support, they will be looking beyond us to the massive number of voters—more importantly, convention delegates—at stake a week later. Don’t expect any to linger here.

What does it mean to us?

• South Carolina’s candidate debates will take on greater significance. Three are already scheduled:
*Democratic candidates will be at South Carolina State University in Orangeburg on April 26th.
Yes, that’s this year. MSNBC will broadcast that debate.
*Republican candidates will be at the University of South Carolina on May 15th with Fox News broadcasting.
*CNN (anxious not to be left out) and the Congressional Black Caucus will sponsor a Democratic candidates’ debate in January, 2008, time and place still to be announced.

There will be other debates in other states. There just won’t be time between Iowa/New Hampshire and Super Tuesday for all to share the limelight.

• The media will be more important to the candidates than meeting voters face to face. The grumbles are already heard from New Hampshire voters that the candidates are not showing up in their kitchens and cafes this season.

Media attention comes in different forms:
*There’s free media. A candidate merely comes to town and the local print and broadcast press report on the event—usually favorably.
*There’s earned media—you actually make news.
*There’s my own media—a candidate’s web site.
*There’s paid media—currently only Republican Mitt Romney is paying for ads. Substantial paid media will come in a blitz close to the South Carolina primaries.

Campaign funds, though seemingly vast, are allocated strategically. Some candidates may spend more ad money here, desperate to make an impact and because South Carolina television markets are a lot cheaper than southern California’s or Florida’s. Some candidates surely will divert ad funds away from South Carolina to more favorable Super Tuesday states. No one, not even Hillary Clinton, is likely to have enough money to play in every state. The shortened calendar means early winners will have just a few days to spark their fund-raising. The rest will need all the free media they can get, though waning stars do not attract media attention.

There may be fewer stars in the southern constellation because of the calendar compression. The winnowing is under way. Iowa Governor Tom Vilsack has already left the field. Nebraska Senator Chuck Hagel vacillated last week, much like New York Governor Mario Cuomo’s “to be or not to be” hesitation in 1992. Hagel suggested he could make a decision later this year. Maybe not. Former House Speaker Newt Gingrich seems poised to jump in if all other Republican candidates falter. Democrats seem to be sifting their way to Hillary, Barack Obama and “somebody else.”

South Carolina will certainly get its fill of presidential candidates for the next ten months. That has not changed. The suspense just may not last as long. We can, I suppose, thank Governor Schwarzenegger for that.

###

Charles Bierbauer covered presidential campaigns for CNN from 1984 through 2000. He is now dean of the College of Mass Communications and Information Studies at the University of South Carolina. His views and analysis are his own, and not those of the university. Dean Bierbauer is also the senior contributing editor and consultant to www.schotline.com.

by Oscar F. Lovelace, Jr., MD

Medical care in our nation is being hit by a “perfect storm”, and it is shaking at its foundation. The increasing number of uninsured patients, the aging of our society, and increasing costs of providing medical care, especially sky-rocketing malpractice insurance costs, cause many to believe that our health care delivery system is at the brink of collapse. Legislation to limit non-economic damage awards has yet to translate into any relief from soaring malpractice insurance costs for physicians providing essential medical services to communities all across our state. The depth and magnitude of the problem is most easily seen in graduate medical education training programs in both primary and specialty care. Approximately half of the first year residents in our nation’s family medicine residencies have graduated from foreign medical schools. Thoracic and cardiovascular surgery residency training programs were no more successful – filling less than half of the available positions in the initial 2005 match and only partially filling the remaining positions in the scramble after the official match.

Our government has played an expanding role in providing health care through Medicare and Medicaid, approaching 50% of every health care dollar spent in America – especially in SC, one of the poorest and most senior-populated states in the nation. In fact the Governor of SC is the single most influential person affecting health care in our state. The Governor appoints the director of Health and Human Services (DHHS) who administers the Medicaid program and the board and chairman of the Department of Health and Environmental Control (DHEC). The DHEC Board basically sets public health policy in our state.

In order to withstand the challenges of this storm, we must focus on strengthening key aspects of prevention and primary care in our state. We now have the dubious honor of having the lowest cigarette tax in the nation at 7 cents/pack, compared to the national average of 92 cents/pack. We must confront cigarette smoking, America’s number one preventable cause of death. In 2004 South Carolina brought in 74 million dollars of Tobacco Settlement revenue and 31 million dollars in tobacco tax revenue but spent no state revenue on youth tobacco-use prevention. This has held back more progressive public health policy and led to a hidden annual tax on every SC household of $578 to pay for government funded tobacco-related health care costs. If we matched the national average on the cigarette tax and then used the increased revenue as a renewable source of funding for Medicaid, we would simultaneously increase government revenue from cigarette taxes, lower health care costs, prevent teen smoking, and, most importantly, save lives. We must also pass legislation that provides clean indoor air in public places – or at least gives communities the option of passing clean air laws that are more stringent than current state law.

South Carolina’s Medicaid program is the health insurance safety net for nearly a million poor citizens who would otherwise have no health care coverage. The 2004 Medicaid budget represented 19% of the state’s annual budget. Governor Sanford’s Medicaid Waiver proposal represents the most sweeping change in Medicaid since the program’s inception in the 1960’s. A key component of the governor’s waiver proposal seeks to outsource the Medicaid program to private Medicaid managed care contractors, most of which are out of state. Currently DHHS runs Medicaid on a 3% administrative overhead. The waiver proposal assumes that a system of competing private insurance plans and medical home networks will emerge to provide Medicaid recipients with access to more cost-effective, and at least equal quality, health care services. Because of aggressive marketing techniques used by large Medicaid managed care contractors, it is likely that locally developed Primary Care Case Management (PCCM) models will not be able to effectively compete when the flood gates are open to the Medicaid managed care contractors.

From 1994 to 1996, I met with physicians who were assembled at the request of SC DHHS to develop PEP, Physicians Enhanced Plan, a better Medicaid delivery system – one that empowered patients to use primary care physicians for cost-effective medical care. We were asked by Governor Campbell’s administration to develop “South Carolina’s answer to Medicaid Managed Care.” I understood this to mean that the governor wanted to develop a Medicaid delivery system that would empower the primary care delivery system in the state, thereby keeping our federal and state tax dollars in SC and allow the state to be the beneficiary of any cost savings. When my group practice in Newberry County was asked to pilot the PEP program in 1996, SC DHHS reported that the program had saved the state a million dollars in one year on the 1,100 patients enrolled at our site.

The Medicaid PEP program reimburses a primary care physician a flat monthly payment for medical care provided in a physician’s office and requires that the primary care physician be available 24 hours a day, 7 days a week, to authorize services provided by specialists, hospitals, and other health care providers. A major emphasis of the program is to divert non-emergency care away from the hospital emergency room to the primary care physician’s office. Understandably, this also means that emergency rooms are able to be more available to treat true emergencies instead of continually being bogged-down addressing routine medical problems.

In the Carolina Medical Review’s Spring 2002 newsletter (written by Mary Barnett, Chief of Staff at SC DHHS), the results of a comparison study were reported. The study performed by SC DHHS from January 1999 through June 2000, comparing traditional Fee-for-Service Medicaid and PEP, revealed that PEP members received more primary and preventive care services and prescription drugs than patients under the traditional fee-for-service program. In addition, the PEP model – through reduced utilization of lab and x-ray services, as well as reduced hospital inpatient, outpatient, and emergency room services – achieved significantly better overall cost savings.

Unfortunately, the PEP program model has never been fully implemented. After ten years of half-hearted statewide implementation, only about 5000 of the one million Medicaid patients are enrolled in the PEP program’s much broader and successful primary care “medical home” model of care. Instead, an increasingly larger portion of the state’s Medicaid budget is being spent on hospital charges (24.4%), and progressively less on physician services (9%). In fact, in 2004 there was an overall decline in the number of Medicaid recipients receiving physician services.

In early 2003, the Governor’s Healthcare Task Force (which I chaired) recommended the further implementation of other medical home programs like the Medically Fragile Children’s Program. The Medically Fragile Children’s Program, also implemented in 1996, has saved South Carolina Medicaid an additional one million dollars each year by providing a similar medical home for 56 medically ill foster children. Tri-County Project Care developed in Charleston, Berkeley, and Dorchester counties also created a successful medical home model for the working poor and uninsured citizens of our state and needs careful consideration for state-wide implementation.

MUSC health care economists have shown that private Medicaid managed care in South Carolina has proven to be more expensive than PEP and FFS Medicaid, because managed care plans tend to enroll healthier patients and avoid the chronically ill. If there is statewide implementation of the Governor’s Medicaid waiver there will likely be a further decline in primary care physician services for the chronically ill resulting in more patients receiving medical care in local emergency rooms. Over time this will lead to higher Medicaid costs from unnecessary hospitalization resulting from delayed treatment of preventable medical problems.

As a young person, who grew up knowing and eventually caring for an aunt with cerebral palsy as her family physician, I appreciate the important role our state’s Medicaid Program plays in the lives of the most vulnerable South Carolinians.

As citizens we cannot sit back and watch South Carolina’s future go up in smoke from regressive public health policy, soaring medical liability insurance costs, and a flawed Medicaid waiver. “While I breathe, I hope” for clean fresh air in public places and for common sense healthcare policy that is in the best interest of all South Carolinians. Our cigarette tax should at least meet the nations average and where it could be used to provide real medical homes for our Medicaid patients – a relationship with a primary care physician - not a relationship with an out of state Managed Care Corporation Working together, we can make a difference for a brighter future in South Carolina.

The following signs have been posted in the City of Aiken, SC which state: “Adopt an Aiken Parkway - SRS Gay Lesbian or BI Employees”

The implied message of the “SRS” is unknown. However, the Savannah River Site, a n*clear production facility, is located in AIken County and uses that abbreviation.

To date, no profit or nonprofit organization has been listed on the SC Secretary of State website to identify the organization that claims itself to be caretakers of the highways.

Also, several of these signs are located across the steet from elementary church schools.

Yep, and the blue sign above the city list the mandated Character Traits all citizens shall possess.

This is truly a city of characters.

Reporting to you from Aiken, SC.

R.E. Sutherland, M.Ed./sciences

Freelance investigative Reporter

Taking a second look
Ramesh Ponnuru

‘I got some encouraging news this morning in the USA Today,” says Sen. John McCain, holding a copy of the paper with his picture on the front page. “McCain firm on Iraq war,” it says above the fold. He flips it over to show the rest of the headline: “despite cost to candidacy.” “I can’t worry about it,” he says. “With something like this, you just can’t let it concern you. The issue is too important.”

Actually, McCain’s campaign is doing better than it seems to be. It is true that the unpopularity of the Iraq War, and specifically of the surge he has long advocated, is dragging his poll numbers down. It is true as well that in many polls he is now behind Rudolph Giuliani.

But Giuliani is a useful opponent for McCain. The good news of the senator’s season is that another rival, former Massachusetts governor Mitt Romney, has so far failed to unite the Right behind him. In a McCain-Romney race, Romney would have most conservatives and portions of the party establishment behind him — and might win the nomination.

Giuliani is a different story. He supports taxpayer funding of abortion, sued gunmakers for selling guns, and went to court to keep New York City from giving the names of illegal immigrants to the federal government. Polls show that many Republican voters are unaware of these aspects of the former mayor’s record. It is hard to see how he wins the nomination once they learn about them. In a three-way race, some people who prefer Romney to McCain will nonetheless back McCain to head off Giuliani. This year, then, a real threat to McCain has failed to materialize — and a fake one has replaced it.

McCain’s apostasies from conservatism, unlike Giuliani’s, are well known. The mayor’s polls form a ceiling. McCain’s could be a floor, if conservatives are willing to reconsider their view of him. If they do, then the current Giuliani moment will be succeeded by a McCain moment. I think conservatives will give him a second look — as they should.

It has become common to complain about the weak Republican field. Actually, it is a strong field. The three leading contenders are smart, competent, serious, articulate, and accomplished. (So is Newt Gingrich, who ranks fourth.) In some of these respects they exceed the incumbent. It just isn’t a very orthodox field.

Romney, at least in his 2007 version, is the most conventionally conservative. If elected, he could make a fine president. But he has a big disadvantage as a presidential candidate: He is a Mormon. In December, a FoxNews poll found that 32 percent of voters would be less likely to vote for a candidate if he were Mormon. Speculation about the effect of Romney’s Mormonism on his chances has centered on evangelical Christians’ theological differences with him. But evangelicals were only slightly more hostile to Mormon candidates than the population at large. Democrats were much more hostile. So even if Romney’s conservative social positions get him through the primaries, his religion is a liability in the general election. (It may be that many secular-minded voters consider Mormonism particularly alien and threatening.)

This is unfair to Romney, and to his coreligionists. But this country has elected a non-Protestant president precisely once in its history. If the Republicans were going into 2008 with a large margin of error, it might be worth finding out how voters would react to a Mormon candidate. But Republicans are not going into this election in a strong position. Nominating a Mormon is too risky.

RUMBLES LEFT AND RIGHT

Most of McCain’s conservative detractors concede that he would be a formidable candidate in November 2008. They question his ideological bona fides. But it would be a remarkably narrow definition of conservatism that excluded McCain.

“I think the important thing is you look at people’s voting record,” says McCain, “because sometimes rhetoric can be a little misleading.” Over the course of his career, McCain has compiled a pretty conservative voting record. Neither Giuliani nor Romney, as McCain implied, has a record to match. An objective observer looking at Bush and McCain in 1999 would have had to conclude that, based on their histories, McCain was the more conservative of the two.

The senator’s reputation changed during his exciting, disastrous 2000 presidential campaign. During the previous years, he had become a true believer in campaign-finance reform. His attack on monied special interests, and his bitterness at the Bush campaign’s attacks on him, seemed to pull him left across the board: on tax cuts, on the environment, on health care. The effect was to enhance McCain’s standing with independent voters and journalists while repelling conservatives. What further soured conservatives was that they were then starting, for the first time, to take a strongly negative view of campaign-finance reform, hardening into the conviction that it was an assault on free speech (and particularly on conservative organizations).

Independent voters and Democrats gave McCain some primary victories, but without Republicans he could not win the nomination. Still, he was America’s most popular politician, and for the next few years he continued to play the “maverick” Republican — and to reap the rewards in his press clippings, which annoyed conservatives at least as much.

From 2004 onward, however, McCain has been moving rightward again, emphasizing his support for the Iraq War and the War on Terror. So far, this move appears to have cost him support among independent voters and reporters without buying him many friends on the right. Conservatives still have the impression of him they formed when he was tacking left. Besides, even in the last two years he has taken some stands to which a lot of conservatives object.

The good news for conservatives is that some of McCain’s un-conservative positions concern trifling subjects, and some of them have little ongoing relevance. (Some of them are important, though, and I’ll get to them later.) After 9/11, McCain shepherded a bill to federalize airport security through the Senate. That’s not an issue that’s going to come up again. The corporate-accounting scandals gave McCain an opportunity to rail against malefactors of great wealth, which he took. He zinged Bush’s Securities and Exchange Commission for its inaction and urged more transparency in executive pay. But he gives no sign of itching to impose more regulations now. He supported a scheme of taxes and regulation to fight smoking. His bill didn’t become law, but it is no longer an issue since most of its provisions were adopted by the states.

Even campaign-finance reform isn’t the issue it once was. President Bush signed McCain’s bill, and the senator says he doesn’t want any more legislation. “I think that we need to give this law a chance to work.” He doesn’t think the Federal Election Commission needs any new powers, although, like most Republicans, he does want it to crack down on “527 groups” that fund political ads.

McCain supported a “patient’s bill of rights” that would regulate HMOs. But that bill has gone nowhere, and even if it passed it would not be a large step toward socialized medicine. It was small change compared with the gargantuan Medicare prescription-drug entitlement of 2003. (President Bush, and many conservative congressmen, supported that bill; McCain voted against it.)

McCain wants to make people who buy guns at gun shows pass a background check, ending what he considers a loophole in current law. Gun-rights activists have strong objections to this proposal. But they will have to measure his offense against Giuliani’s past, and never-repudiated, advocacy of licensing gun owners.

Some conservatives hold McCain’s participation in the “Gang of 14” against him. In 2005, most Senate Republicans, frustrated by unprecedented Democratic filibusters against judicial nominees, wanted to change the rules to prevent such filibusters. Seven Democrats and seven Republicans reached an agreement: The Republicans would leave the rules alone so long as the Democrats used the filibuster only in “extraordinary circumstances.” There were good arguments for and against the deal, although there were no good arguments for the preening collective self-regard with which the 14 senators announced it. McCain notes that months after his intervention, the Senate confirmed both John Roberts and Samuel Alito. He thinks it “would have been almost impossible” to confirm them in the aftermath of a bitter fight over a rules change. “That’s why they called it the nuclear option, the Senate was about to blow up.” Conservatives might disagree with that assessment, while still regarding it as the type of prudential calculation on which allies can disagree.

In 2005 and 2006, McCain differed with the Bush administration about how to interrogate suspected terrorists. The senator, having survived torture himself at the hands of the North Vietnamese, understandably wanted tough anti-torture language put into law. The administration worried that such language, particularly if susceptible to creative interpretation, might make it impossible to conduct coercive interrogations even if they fell short of torture. In the end, Republicans reached a deal that preserved tough interrogations while addressing McCain’s concerns.

That leaves three substantial issues between McCain and conservatives. The first is global warming. McCain has been a believer throughout the Bush years. Most conservatives have associated the fight against global warming with environmental zealotry and overregulation. But McCain has tried to come up with a free-market solution, and he is now emphasizing nuclear power as a way to fuel this country without emitting greenhouse gases. “I don’t often like to imitate the French,” he says, but France is right to use nuclear power. His proposal, with Joe Lieberman, may not get the balance exactly correct, but right now it looks as though McCain was more prescient than most conservatives.

McCain was one of a few Republicans to vote against Bush’s tax cuts. He said that the tax cuts were fiscally reckless and too skewed to the rich. But he now accepts those tax cuts as a done deal. Reversing them now, or allowing them to expire, would constitute a tax increase, and McCain has never voted for a general tax increase. When I ask him whether there were any circumstances in which he would accept a tax increase, for example to get the Democrats to agree to spending cuts, he says, “No. None. None.” It seems pretty clear that a President McCain would seek spending cuts before tax cuts. But if you take him at his word — and he is a man who takes honor seriously — he won’t raise taxes.

Finally, there is immigration. McCain sees eye to eye with Bush on this issue. He thinks a guest-worker program would reduce illegal immigration, and that we should give illegal immigrants already here a path to citizenship since we aren’t going to deport them all. A lot of conservatives want tougher border security, period. Nothing McCain can do now will please some of his critics. But if his bill passes this year, he may try to move on. Or he could try to mollify his reasonable critics by supporting an amendment. Last year, Sen. Johnny Isakson of Georgia proposed that the bill’s border-enforcement provisions go into effect first, and be shown to work, before illegal immigrants could start on their path to citizenship. McCain is open to the concept.

A SOCIAL CONSERVATIVE

McCain gets a bad rap from social conservatives. He opposes the Federal Marriage Amendment on the theory that states should set their own marriage policies. But he opposes same-sex marriage, too, and says that he would support a constitutional amendment if the federal courts ever tried to impose it on reluctant states. As a practical matter, it is hard to see how any president could get such an amendment enacted without that type of provocation.

The senator has been rock-solid on abortion. Unlike anyone else in the race, he has a pro-life record stretching back to the early 1980s. Like President Bush, he says that the Supreme Court made a mistake in Roe; he goes further than Bush when he adds that the Court should overturn it. He voted to confirm all of the sitting conservative justices, plus Robert Bork.

McCain muddied the waters with one foolish remark in 1999. He was trying to make the point that the country is not ready for abortion to be prohibited, but in the course of trying to say that he said that the country wasn’t ready for Roe to go. He corrected himself quickly, but that lone remark has been used to portray him as a secret pro-choicer or a flip-flopper.

He really has broken ranks with pro-lifers twice. In the early 1990s, he voted to fund research using tissue from aborted fetuses, and he now supports federal funding for research on embryos taken from fertility clinics. But he draws the line at stem-cell research involving cloned human embryos. He says that he would prohibit that, even mistakenly claiming that he has co-sponsored legislation to that effect.

Social conservatives think that Republicans have repeatedly betrayed them. At the highest levels of national politics, that’s not true. The reason that social conservatives haven’t achieved many of their objectives even though they have helped to elect a lot of Republicans over the last generation is that those objectives are hard to achieve. It has been slow work to fight the pervasive liberalism of the elite legal culture. But when President Reagan appointed Anthony Kennedy and the first President Bush appointed David Souter, they weren’t trying to betray conservatives; they didn’t know how those justices would turn out. McCain thinks that type of mistake can be avoided if presidents pick nominees who don’t just say the right things, but have track records of judging soundly. He’s right. Conservatives’ reception of McCain shouldn’t be colored by historical mythology.

For some conservatives, these discrete issues matter less than what they say about McCain’s instincts. His friendly relations with journalists — one of his campaign aides was only half-joking in 2000 when he called the media McCain’s “base” — often make conservatives suspicious. But McCain’s steadfast support for the Iraq War, and his advocacy of the surge, belie the claim that he will do anything for good press.

Grover Norquist, the anti-tax activist who has long clashed with McCain, says that the senator is worse than a flip-flopper: By voting right, tacking left, and then tacking right, he has shown himself to be devoid of principle. But as the foregoing review of his record suggests, most of McCain’s zigzags have been matters of tone and emphasis, not changes of position. He hasn’t switched his views as much as Romney or even Giuliani.

There are genuinely disconcerting elements to McCain’s politics. He talks about cutting spending, but he rarely connects limited government to individual freedom. He is an inveterate moralist, which eludes many observers because he is concerned about honor rather than virtue. In many of the cases discussed earlier, his moralism slid very quickly into support for regulation: of campaign contributions, of tobacco, even of boxing. At times, his rhetoric about the need for individuals to subsume themselves in the life of the nation verges uncomfortably close to idolatry of the state.

But McCain’s merits are considerable as well. He has been tough on spending, and been willing to ally with the most conservative members of the Senate to fight earmarks. He has been a stalwart free trader: “Since Phil Gramm left, there’s no greater free-trader in the Senate than I am.” (McCain supported Gramm’s presidential campaign in 1996, and Gramm is supporting his now.) Curbing the growth of entitlements, he says, will be one of his top priorities as president. He has long supported personal accounts.

Leave all of that aside for a moment. For a lot of conservatives, the War on Terror is paramount. That’s why some of them are willing to overlook Giuliani’s faults. But if toughness on terrorism trumps everything else, with toughness defined as competent execution of the administration’s basic strategy — and that’s the way it has to be defined for this argument to work for Giuliani at all — then McCain is hands down the best candidate. He has better national-security credentials than Giuliani, having been involved in foreign policymaking for more than two decades while the latter has barely been involved at all. More than any other candidate, he has shown a commitment to winning in Iraq. He has supported it, indeed, more vigorously than Bush has waged it, and he has put his career on the line.

McCain has the moral authority to get a country that has grown tired of the war to listen to him, an authority President Bush has seen slip away. That isn’t just because he is a former prisoner of war with one son serving in the Marines and another in the Naval Academy — although that helps. It is because he is not seen as playing politics with the war, as most Democrats and Republicans are, and he never will be.

Conservatives may need to reach some understandings with McCain before throwing their support to him: on the vice-presidential nominee, on immigration, maybe even on the number of terms McCain will serve as president. (He is 70.) But he can win both the nomination and the election. He is plenty conservative. And he deserves a long second look.