By Kimberley A. Strassel, WSJ
Now is the time for Republicans to sell the public on innovative, pro-market health-care reforms.
‘You can’t fight something with nothing,” muses Tom Price, the Republican for Georgia’s Sixth District. That adage, which the surgeon-turned-congressman is now repeating to any colleague who will listen, is gaining steam within the broader GOP.
As the ObamaCare disaster dominates the public debate, Republicans are engaged in an animated discussion behind the scenes about their next move. Health reformers like Dr. Price, Reps. Phil Roe and Steve Scalise, and in the Senate Tom Coburn and Mike Lee, are pushing colleagues to go on offense and start selling the public on innovative, pro-market health reforms.
They’ve been met with reluctance, and some of it understandable. The ObamaCare meltdown has been a political gift for Republicans, many of whom don’t currently want to risk getting in the way of the law’s collapse. Putting out a GOP “alternative,” they say, would simply allow Democrats to refocus headlines by attacking a Republican plan.
Some worry conservative proposals don’t offer enough political cover on touchy issues, like the number of Americans insured, or pre-existing conditions. Others are opposed to any big bill, given the public backlash to ObamaCare’s size and complexity. Yet others fret that too many of their own members still aren’t able to competently discuss health care.
These are risks, yes, though in politics everything is relative. And as the reformers are rightly pointing out, there is a greater risk to the GOP right now of doing nothing.
The biggest of these risks is put succinctly by Sen. Coburn, who warns: “The failure of ObamaCare will not guarantee the success of free-market health reform.” The president’s law is destroying the private market, and the left will seek to capitalize on that. “If Republicans don’t present a clear alternative the American people can understand and support we run the risk of single-payer becoming the default fix,” says Mr. Coburn.
Tactical GOP silence also does nothing to combat Mr. Obama’s favorite talking point. Republicans, he insists, just “want to drag us back into a broken system.” As unhappy as America is with ObamaCare, that line hits home. While the U.S. health system before 2010 was the best in the world, it was still too inefficient, too regulated and too costly for too many people. Consumers don’t want that back, either, and Republicans suffer if their party is tagged with that position.
Republicans have hopefully learned, too, that political nature abhors a vacuum. The party’s failure this summer to delineate an ObamaCare strategy opened the way for louder voices to demand what became an ill-fated shutdown. If leadership isn’t going to drive this agenda, it risks even more divisions with outside groups and with a grass roots that is hungry for some aspirational leadership. It risks once again reacting to events, rather than shaping them.
Finally, the party could throw away a huge opportunity. Democrats have owned the health issue for decades, but their ideas have now been exposed as abject failures. They are about to head home for Thanksgiving recess to be shellacked by angry constituents. Rarely has there been a moment where the public has been better educated on the health-care issue and more open to pro-market alternatives.
The GOP also has built up a surprisingly rich body of those policy reforms. This has been a longtime in the making—not to mention hard and unrecognized work for many of the trailblazers. The process has been aided by an influx of doctors to the GOP caucus, who have used their experience to craft original health reforms on everything from medical malpractice to high-risk pools, as well as thinkers like Paul Ryan, who has directed his budget expertise to policy reforms for health entitlements.
Those reforms have accumulated in a number of bills: the Coburn-Ryan proposal of 2009; a bill by Mr. Price; a Roe-Scalise plan endorsed by the Republican Study Committee; and more. No one of these proposals is perfect, but the GOP doesn’t need one, big bill. They have an impressive framework of ideas that can be promoted and explained as a modern and dynamic health system—one that not just overthrows ObamaCare, but eclipses the system that preceded it.
Policy aside, Republicans might use this unique moment to redefine the broad concept of health care: Patient-centered, patient-driven, patient-owned (even when workers change jobs); a deep well of competitive choices that ensures access by all; fairness in tax treatment; ease of use; and a more streamlined and limited safety net.
Talking about these concepts, and the policies that underlie them does not get in the way of the ObamaCare collapse. Quite the opposite: It provides a contrast that could hasten the law’s end.
The GOP’s long reticence to address health care provided Mr. Obama with the moment to pass his law. The GOP is now faced with another such moment, only this time the party is far better positioned to show policy boldness. If it only will.