GOP's Big Ideas on Health Care

Kimberley Strassel, writing in teh Wall Street Journal, notes that Sen. Tom Coburn has introduced a big idea health care bill that speaks of choice, empowerment, competition, flexibility and control in terms that Strassel thinks can invigorate the GOP debate on health care. Noting that health care is viewed by some conservatives as a debate lost, because the GOP has not been able to put voice to a plan to counter the Democrat "government run healthcare" universal coverage plan, Strassel writes:

The recent White House and Senate proposals are meant to package these ideas into a more unified, free-market whole. Mr. Coburn, like the White House, would remove the subsidy corporations get for health care, and instead give the money to individuals--putting them in charge of their health expenditures. It would expand HSAs, and allow consumers to buy insurance from any state, thereby avoiding costly regulations. It would modernize Medicare, allowing workers to invest their payroll taxes into a savings account and control their care in their retirement years. It would free up the states to inject Medicaid with new flexibility and competition.

There's plenty of big ideas in these new proposals over which conservatives can argue. Do they get behind tax rebates (à la Coburn) or tax deductibility (à la President Bush)? Do you leave medical liability to the states, or intervene with federal legislation to set up state "health courts"? Or do they write all this off as too hard a political sell, and run for the Schwarzenegger "universal coverage" cover?

The important thing is that debate equals education, which equals understanding, which equals precisely what the GOP needs right now. The Heritage Foundation's Mike Franc says Republicans are still too preoccupied with health-care small-ball--which procedures should be covered by Medicare, how much should generics cost--to get their heads around the broader subject. "This is still outside their intellectual comfort zone, and Republicans never do well in that situation," he says. "But to win this debate--the defining issue of the next 40 or 50 years--they're going to have to address it forcefully, head-on, and with every bit of their intellectual firepower."

I love some of the ideas in Coburn's outline. These are big ticket, big issue ideas and not the "small ball" that Franc laments.

Those on the free-market side are starting to understand the need for a new language, especially if they are to coax more nervous elements of their party into embracing radical change. When President Bush unveiled his health-care tax overhaul in the State of the Union, he stressed that health-care decisions needed to be made by "patients and doctors," not government or insurance companies. Mr. Coburn's bill summary is littered with the words "choice," "empowerment," "competition," "flexibility," "control"--which is not only an honest assessment of what his proposal would provide, but one with which Americans can identify.

With Democrats running the show, Republicans now have the quality time to hash through this debate, and if they're smart, that'll be a priority. The left is so confident it owns the health-care issue, and so bereft of creative ideas, it risks squandering its advantage--just as the GOP lost its own credibility on fiscal restraint. But first, Republicans need to figure out what they believe.

For a long time the Democrats thought they had the education issue sewn up in their pocket until George Bush came along and changed the debate. The same principals, accountability and choice, self-determination and personal control that reshaped teh education debate can now re-shape the health care debate.