Who Is the Republican Health-Care Candidate?

The Wall Street Journal and most NRO writers have pretty much written off both Mitt Romney and Newt Gingrich as acceptable Republican presidential candidates because of perceived weaknesses on health care. Health care has become the third rail of American politics — just not the way we used to understand it.

Until recently, a Republican could churn out crowd-pleasing sound bites about fixing health care but never put the pedal to the metal by investing political capital in a serious proposal for reform. Republicans understood that when the talk turned to health care, Democrats won the debate and Republicans lost. It was just a fact of life. Not anymore.

As Romney and Gingrich bind their wounds, I’m sure that they are more surprised than anybody at the hostile response their recent comments have drawn. After all, it is true that trace elements of the “individual mandate” can be found in conservative policy proposals from the days of yore. Our friends at the Heritage Foundation considered such a mandate in the 1990s, but have long since rejected it. And the quality and quantity of the Heritage Foundation’s current research on health policy, which  unambiguously rejects every part of Obamacare in favor individual choice and fiscal responsibility, leaves no room for excuses that there are no conservative alternatives to mandates and tax hikes.

On the other hand, when I look at Gingrich’s campaign website’s section on health care, I see nothing inexcusable. He champions repealing Obamacare and lists ten reforms, all of which one can find in the publications of one conservative think tank or another. (I don’t find all ten convincing, but while I don’t think it’s Congress’ job to pass a law on medical-malpractice liability, for example, it wouldn’t be the end of the Tenth Amendment either.)

So, how did one unfortunate interview on a Sunday TV show do so much damage to the launch of his campaign? I think it’s a matter of trust. Repealing Obamacare is not something Republicans can waffle on in the slightest. And attacking the congressional caucus that voted for Medicare reform is very close to attacking their vote for repeal.

We cannot afford a “national conversation” on repealing Obamacare. Every day that it persists is another day that doctors, hospitals, pharmaceutical firms, health insurers, medical-device manufacturers, and all the other concerns in the health sector invest more time and energy “implementing” its harmful provisions. Every day that goes by is another day in which those interests dig themselves deeper into the new status quo, making Obamacare harder to defeat.

Every single Republican presidential candidate will promise to repeal Obamacare; that’s the price of a ticket to the dance. But between election night on November 6, 2012, and the inauguration on January 20, 2013, there will be plenty of opportunities for the president-elect to find excuses for delaying repeal in favor of a “national conversation.” After all, that’s what many business interests will want.

And conservative voters know it, too.  Campaign bromides won’t work this time.  The winning Republican candidate will have to prove beyond any shadow of a doubt that he (or she) will immediately sign the one-page repeal bill that will be the first legislation to land on the president’s desk after the inauguration. There can be no risk of dithering in favor of a “national conversation.”

I don’t know what a candidate can say to prove that he (or she) will do this. But now I know what he cannot say.

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