Ross Douthat has a persuasive column arguing that, when it comes to health-care policy, conservatives are placing too much faith in their Milton Friedmanite free-market instincts and not enough in Edmund Burke’s respect for the wisdom of tradition. That is probably true but, in practice, is also likely unavoidable. The irony is that conservatives are faced with going too far too fast into uncharted waters of free-market reform because they spent decades in thrall to a pig-headed version of Burkeanism.

Broadly speaking, the Right spent the years between 1992 and 2008 loudly defending the American health-care system as the greatest in the world. In their view, it could be damaged only by leftist, government-run, socialized medicine. It was all defense, all the time.

There were conservative wonks who put together more market-oriented health-care plans, and Paul Ryan, Mitch Daniels, and other politicians who stuck their necks out to try to expand access to health savings accounts and catastrophic health-care plans, but they were the exceptions. Whenever health care came up, radio talk-show hosts would mutter something about tort reform and then change the subject to capital-gains taxes or missile defense or anything. They didn’t want to talk about health care, and there is no reason to think their audiences wanted to hear about it. A health-care system shaped by 1940s price controls and 1960s Great Society programs had somehow become the best that we conservatives reasonably hoped for. Inherited wisdom and all that.

The truth is that this was all more Burkean than the real Edmund Burke (who was a reformer rather than a reactionary), but the long period of conservative stasis has had consequences. Conservatives, from much of the congressional membership down to the talk-radio listener, had slighted positive health-care-policy arguments for a long time. Now that Obamacare has been partially implemented, conservatives are having decades’ worth of reform arguments happening all at once. Obamacare was a mess, but it was also the product of many years of preparation. This is like if the Democrats had tried to write and implement Obamacare in a couple of months – in 1993.

In other words, conservatives are stuck in the position of being more Friedmanite than is ideal because Obamacare has to be replaced soon, and conservatives (with some honorable exceptions) wasted the years between the failure of Clintoncare and the election of Barack Obama.