The Corner

Ryan: ‘We Owe the Country a Referendum Election’

Rep. Paul Ryan (R., Wis.) tells National Review Online that Republicans, especially presidential contenders, need become more “provocative” when speaking about health-care reform. “We need to be provocative,” he says. “We owe the country a referendum election. We owe them a policy alternative.”

Specifically, Ryan urges the field to focus on Medicare. “It is the issue, pure and simple,” he says, noting that it encompasses the “debt issue, the deficit issue, and the economy issue.” To help them along this afternoon, Ryan, the Budget Committee chairman, outlined his health-care ideas at the Hoover Institution in Palo Alto, Calif.

His remarks, aides say, are part of Ryan’s push for more “optimistic” and “serious” proposals following House passage of Ryan’s entitlement reforms earlier this year.

With the Democrat-controlled Senate resisting that bill, and the presidential campaign heating up, Ryan hopes to prod Republicans to sharpen their attack on President Obama’s health-care law and renew their commitment to “replace” the legislation with individual-based policies, with an emphasis on choice and competition.

“We know that the first step toward real, bipartisan advances in health policy must start with a full repeal of the president’s partisan law,” Ryan told the Hoover crowd. “But the case for repeal must be matched with even greater intensity by a case for replacing the law with structural reforms and real solutions.”

At the core of Ryan’s refurbished reforms is his effort “to move away from defined-benefit models and toward defined-contribution systems.”

“Under a reformed approach, the government would make a defined contribution to the health-care security of every American, rather than continue to offer open-ended, well-intentioned, but ultimately empty promises,” he said. “In other words, defined contributions should underpin a system driven by patient choice and centered on patient needs — one that offers real security instead of empty promises.”

Ryan’s ideas are anything but — and will, as ever, likely catch flak from Democrats. For instance, his position on insurance reform is, as he might say, provocative. “With regard to health insurance for working Americans, patient-centered reform means replacing the inefficient tax treatment of employer-provided health care with a portable, refundable tax credit,” he said. “You can take [the credit] with you from job to job, allowing you to hang onto your insurance even during those tough times when a job might be hard to find.”

Speaking with NRO before the speech, Ryan reiterated that his Hoover message, be it on insurance or Medicare, is not intended only to be heard by his Capitol Hill colleagues. Instead, the popular fiscal hawk wants to play a role in shaping the 2012 debate — reminding candidates to drop the talking points and detail policy.

“We can do a lot from the House to help bring the party, and therefore the presidential candidates, into the mode of offering a very clear and specific alternative to President Obama’s vision for the country,” he says. As Ryan told me in August, he wants to play a “Jack Kemp–like role” this cycle.

“He taught me that big ideas are the best politics,” Ryan said then.

“They will always be challenged, and they will sometimes be controversial, but you have to do what you think is right, what you’re passionate about, and be a strong advocate for it. If you do that, you can shift the debate in major ways. He showed me how you can do that.”

Robert Costa — Robert Costa is National Review's Washington editor and a CNBC political analyst. He manages NR's Capitol Hill bureau and covers the White House, Congress, and national campaigns. ...

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