By JEFF EMANUEL
March 14, 2008

If the Republican Party is to repair and reclaim its tarnished brand as the party of individual rights and responsibility, of limited government, and of real solutions for the American people, one issue on which it must lead is Health Care.

The mantra of “50 million (and growing) uninsured Americans” has become part of every Democrat politician's big-government advocacy repertoire. The Left, and many members of the media, are treating so-called "universal health coverage" as though it is:

(a) the correct solution to the U.S.’s health care woes,

(b) a foregone conclusion, and

(c) simply a matter of timing an detail at this point.

Further, several polls have shown that a significant portion of the American population views the current health care situation both as an important issue, and as one which -- largely as a result of media activism and Democrat rhetoric -- should be further intervened in, and regulated by, government.

The strength of public opinion on the side of greater government involvement in heath care – which is helped along by media outlets like CNN, who find "lifelong Republicans" who claim they are now going to vote Democrat because they are the party that promises to offer "universal coverage" and who demand that all positions except those in favor of state health care be vigorously defended – dictates that the GOP move slightly leftward from a position on health care that demands strictly free-market-based solutions. However, Republicans can still occupy a niche far to the right (and far more pro-choice) than that in which the Democrats are currently ensconced.

This trend toward support of the Democrat platform on health care means that Republicans must eschew sitting idly by and allowing others to speak authoritatively on the future of the health care system in favor of coming up with coherent, workable response to the Left on health care and health coverage -- lest, through their inaction, they allow the Democrats to permanently own the issue.

As with many issues, health care and health coverage (two entirely separate concepts which have been blurred together in the public and political consciousness) are emotional topics; therefore, they are more easily capitalized on by the sloganeering, “appeal-to-heart-not-mind” Left than by the Right, which -- given the fact that its positions and prescriptions are based on economic and practical reality -- is often required to do a great deal of explaining of their ideas, complete with the numbers and formulae that show why they will actually work.

That being said, if the GOP is willing to make the effort to get in front of the press and the American people for -- not in, but for -- the next three years with health care policy beliefs, proposals, and solutions on their lips, complete with detailed explanation of why these prescriptions will work better than the state-run programs proposed by the Democrats, then they have a very real chance to make progress in educating the American people and in taking back an issue that should -- by all practical rights -- be one on which the Republican party is far more trusted by the citizenry.

Key points must be touched on in this effort to inform and educate the American people, and a very specific strategy must be developed and followed. A suggested portion of that strategy is below.

The GOP must come up with a market-based health care platform – one which is unified and workable, and which acknowledges heath care and health coverage as a necessity while maximizing consumer choice and provider competition. Its leaders and spokespersons should vocally embrace choice-expanding and cost-saving options and solutions like:

• Encouraging voluntary high-deductible, low-premium coverage options like Health Savings Accounts
• Allowing health insurance competition, and purchasing, to take place across state lines
• Continuing to advocate for Tort reform
• Restricting Medicare, Medicaid, and SCHIP to individuals who are actually needy
• Eliminating superfluous mandatory minimum coverages (like birthmark removal and chiropractics) that some states require of all insurance policies sold within their borders
• Providing tax breaks for individuals and businesses who purchase health coverage.

II. Articulate the problems with other state-run health care systems

As the second half of this public relations offensive, the GOP absolutely must make sure that the problems with state-run health care systems around the world are presented to the American people.

For example, in Britain alone:

• In 2004, low-quality, taxpayer-funded health care killed more than 17,000 citizens, and the country had a 29% higher amenable mortality rate than Denmark, Germany, Spain, and France, all of which have health care systems that are less dominated by government.
• Medical professionals are running away from the National Health System at a record rate. Holding true to the proverb "when the rats start abandoning ship, it's a good time to look at hopping off yourself," people should take note of the fact that thousands of practitioners have taken out private health insurance policies instead of remaining covered under the national health system in which they work.
• The NHS is in such dire straits that physicians' groups are now saying that, if the program is to remain solvent enough to keep running at all, they must start refusing medical treatment to the obese, the elderly, and those with chronic diseases or addictions. This would, of course, negate the entire argument for state-run health care: namely, that everybody will be able to be treated.
• With the health system being under the thumb of the government, care is sacrificed for the sake of boast-worthy statistics that ignore the cost of their achievement -- like the fact that, in order to fulfill the government’s promise of "every patient being treated within 4 hours of entering the hospital," thousands of seriously ill patients a year are being kept in ambulances outside hospital emergency rooms for hours because administrators will not let them in until they can treat them within four hours.

Examples of the folly of state-run health care abound, from Canada, where Saskatchewan residents, for example, drive across the border into North Dakota by the hundreds every year and pay cash for magnetic resonance imaging (MRI) scans without waiting the Canadian-standard 6 to 12 months, and where, in 2007, wait times for access to health care in Canada averaged 18.3 weeks across 12 medical specialties, to Russia. By law, every Russian citizen is entitled to “free health care.” What this has wrought – despite President Vladimir Putin's doubling state health care spending during his term – is a system that is astronomically expensive, rampant with corruption, and dependent on massive bribes to get any manner of "quality" care whatsoever.

Examples of the mess that government health care can lead to can be found much closer to home, as well. For example, for a glimpse at what Democrats would lead us into with state-run health care, Americans need look no further than a notorious example here at home: Building 18 at Walter Reed.

This is a crucial component of a winning Republican strategy in its attempts to oppose governmental subsumption of the health care system. People need to be reminded at every turn how inefficient the government apparati and offices they visit and use are, and how much they hate visiting and using them even when absolutely necessary. The DMV, the Post Office, the IRS -- all are government organizations people are forced into contact with, and the thoughts and feelings that come to people when they visit, or think about visiting, those offices are the same thoughts and feelings that should also go into Americans' collective response to talk of a potential government-run health care system.

In short: We need to make the idea of a government-run health care system seem as unappealing to folks as a trip to the DMV. Lord knows it will be every bit as inefficient if ever put into practice.

Conclusion

Health care is an issue that the Republican party can and should lead on, but it will take a concerted, collaborative, and uncompromising effort, and will require far better public relations savvy than the GOP has been known for of late. Solutions are available to the current health care crisis that are much more market-based than what has been offered to date by Democrats, and the Republican party needs to be touting those as frequently and as loudly as possible.

An individual mandate – a governmental requirement that every citizen have health insurance -- is neither enforceable nor advisable. However, the fact is, we require that every driver in the country be insured -- and, while millions of people will get through their lives without ever having needed their automobile insurance, 100% of people will, at some time in their lives, need medical treatment or care. This means that health coverage must be accessible to those who can afford and desire it (as a great number of the "50 million uninsured" are that way because of personal choice), and available in some form to those who cannot afford to insure themselves.

John McCain has proposed a health care reform plan that does a very good job of hitting the points in part I above. His proposal is not perfect by any means, but very little is that can be implemented in the Real World.

For further guidance, a look at legislation recently passed in Georgia should help those seeking to craft market-based, consumer-driven, reformed health care proposals.

Advocating market-based reforms like HSAs, interstate competition, and tax credits will help make that coverage more accessible. Advocating the increased choice that comes with a more free-market approach may help persuade the American people that the Republican party’s platform on this issue is the one which is capable of benefiting them the most.