On Sunday, the House Republican leader, Rep. John Boehner (R., Ohio), appearing on NBC’s Meet the Press, said that many Americans are “scared to death” about President Obama’s health-care plan. Moderator David Gregory pressed for detail:
MR. GREGORY: . . . If you don’t want to be the party of “no,” what are you prepared to do? What hard choice are you prepared to make as a party to put some ideas forward and get something done on health care?
REP. BOEHNER: Listen, we’ve outlined a number of ideas to make the current system work better. Why not allow small employers to group together through national associations so they can buy health insurance for their employees like big companies and unions can today? Why not get serious about medical malpractice reform and, more importantly, the defensive medicine that doctors practice because we haven’t reformed our tort system? These are ideas.
Indeed, all of the above are solid, conservative responses to Obamacare. Yet watching Boehner list them on Sunday brought to mind what Sam Tanenhaus might call a case of rigor mortis. The House GOP leader seemed exasperated; resigned to the reality that those ideas will continue to play but a minor role in the health-care debate. “I outlined some of these ideas in a letter to the president back in May, asked to sit down with him and his administration,” said Boehner. “And we got a nice, polite letter back that says: ‘Thank you for your ideas, we’ll see it at the end.’ I’ve not been to the White House since late April, early May. There’s been no bipartisan conversation on Capitol Hill about health care.”
Boehner’s comments, of course, didn’t generate much Sunday buzz — it’s hard to generate much of anything when the president appears on five news programs. Still, Boehner has a point: Republicans are struggling to be heard on health care, even as support for Obamacare fades. Regardless of the merit of their ideas, the public’s impression of the GOP is that of a party that sounds shrill (“You lie!”) when talking about Obamacare’s defects and flat when talking about its own case for reform. Sure, the president and Democrats are ignoring them, but that’s no reason for Boehner and company to feel irrelevant. Being on the sidelines, for now, may actually be to the GOP’s long-term advantage — if Republicans can use their time in the shadows to win minds on the bigger questions as well as tangle over legislative minutiae.
One member of Congress who agrees with this approach is Rep. Paul Ryan (R., Wis.), the ranking member of the House Budget Committee. Ryan’s own health-care proposal, the Patients’ Choice Act of 2009 (H.R. 2520), was introduced in May and includes many of the ideas mentioned by Boehner on Sunday. Speaking with NRO, Ryan admits that a scenario where a bill resembling his replaces the Democrats’ current version has very little chance of happening. Nonetheless, he’s not discouraged. “Democrats will try to run the gauntlet,” he says, “they’re so unwilling to concede that their plan is a lost cause. Right now it’s a circus in the Senate Finance Committee. They’re circling the firing squad on the Baucus plan.”
While the Democrats spar, Republicans, Ryan says, now “need to forget about political ‘third rails’ and talk about the future of this country. The way I look at it is this: What is on the ballot in 2010 and 2012 is a referendum on the American idea. Do we forget the American idea and transition to a European social-welfare state? Or do we take the principles that this country was founded upon and renew them? [Republicans] have got to get through the fear and have confidence in our arguments. The people will listen.” Ryan would know: He was reelected to his House seat last year with 64 percent of the vote in a district carried by Barack Obama.
“We can speak about health care from a different perspective, a patient-based perspective,” says Ryan. “We can talk about health-care quality, and letting consumers shop for value. We can talk about creating risk pools in states for pre-existing populations. We can push for more transparency on prices. If we do these things, you reject the collectivist pathway, the move toward a socialized medicine system. Maybe the Democrats will say our pill is too big to swallow. But, if you keep politics in mind, and they had to choose between our pill and a failed presidency, well, they may just change their minds.”
Ryan adds that Democratic infighting is interesting to observe but ultimately not as important to the health-care debate as the broader lessons he learned this summer. “I had 19 town-hall meetings this past summer, with over 5,000 attendees,” says Ryan. “People are participating at a level unlike anything I’ve seen before. They’re concerned about the bailouts, the stimulus, the debt, the takeover of the car companies, and now health care. They see how government has gone so far, so fast. They’re not nuts. These are real citizens, with real concerns. Anyone who belittles the critics is making a mistake.”
For now, Ryan says he’ll be keeping a close eye on how health-care legislation moves through Congress. “Procedurally, there are a lot of things to look out for,” he says. “The Budget Committee will bring this bill through. If it comes down to reconciliation for the Democrats, it will be complicated. There is a lot of parliamentary voodoo with reconciliation, it is murky stuff. Democrats will try to create a vehicle for the bill to pass in October, at least according to what we hear from [House Majority leader] Steny Hoyer. Then, they would have to take the bill to the Senate, where it gets weird: They would have to do two separate bills,” one for money-moving policies and another for non-financial policies. “It would be an ugly piece of legislation,” says Ryan, “with the non-finance bill able to get perhaps 60 votes, while the bill dealing with fiscal-impacting policies could maybe only get 50.”
Complicated stuff, to be sure. Then again, as Democrats strong-arm each other over Obamacare in the eleventh hour, Ryan says it is time for Republicans to join the debate, not just by contesting this plan or that, but by standing up for conservative principles. “It’s about the American idea,” he says. “We can’t forget that.”
— Robert Costa is the William F. Buckley Jr. Fellow at National Review Institute.