Where’s the Beef?

Republican presidential candidates love to deride so-called "Obamacare" as a socialist evil destined to lead to the demise of the republic; and so on. But jumping up and down and hurling criticisms at the Patient Protection and Affordable Care Act (PPACA) is the easy part. When it comes to their own plans for addressing the health care concerns of Americans, all you can hear are whispers from the Republican field.

Even conservatives such as Michael Franc, Vice President of the conservative Heritage Foundation, has been quoted as saying that candidates should also be talking about their ideas for what the health care system should look like moving forward. But we have not heard any such ideas from any of the candidates so far; just criticisms of the reforms that have been put in place.

All of the candidates have promised that if elected, they will unravel provisions of PPACA they find offensive to conservative values. But the reality is that if they do win and attempt to fulfill such campaign promises, they will need specific plans to put in the place of the PPACA. In other words, if successful with their efforts, they will own the problem. So what are the options?

"Tort reform" for medical malpractice cases, such as caps on damages and "loser pays" laws are often go to concepts for the political right. Unfortunately for proponents, there is no empirical evidence that implementation of these concepts, or any others bandied about, will make any meaningful difference when it comes to rising health care costs. The experiences of a number of states who have tried various versions of these concepts can attest to that. But the ideas make nice sound bites during campaigns and debates.

The irony about the current debate? One of the most vilified provisions of the PPACA is the requirement that nearly all Americans have health insurance by 2014. That very concept has previously been supported by the Heritage Foundation, Newt Gingrich and Mitt Romney. In fact, in 2006 when Mitt Romney was Governor of Massachusetts, he helped push through a health care plan that required nearly everyone in the state to have insurance. But now, like the Heritage Foundation and Gingrich, he claims that such a requirement for the nation is an assault on freedom.

To be presidential is to lead. That requires ideas and leadership. Ideas and leadership are what lead to passage of the PPACA in the first place. That is what the current field of Republican field lacks.