GOP lacks health care ideas

My conservative brethren in the op-ed commentariat have made a disquieting discovery: The Republican candidates for president are saying nothing that addresses the economic anxieties of the American middle class. Both David Brooks and Michael Gerson, writing last Friday in The New York Times and The Post, respectively, expressed a mixture of amazement and horror at the disdain that the candidates display toward broadly centrist proposals to bolster Americans’ economic security, and at the candidates’ apparent indifference to their need to craft such proposals of their own.

“The Democrats propose something” such as expanding health care coverage for children or providing federal matching funds for 401(k) accounts for families of modest means, bemoaned Brooks, “and the Republicans have no alternative.” Gerson grumbled that the candidates were taking gleeful potshots at the “baby bonds” notion – providing newborns with small savings accounts – that Hillary Clinton briefly floated, despite the fact that the idea has won support from the right as well as the left.

In fact, with the honorable exception of long-shot candidate Mike Huckabee, the Republican field seems content with an economic program that comes down to opposing whatever Hillary Clinton proposes. Rudy Giuliani, campaigning hard to convince the Republican base to overlook his heresies on such cultural hot buttons as abortion rights, seeks to win over the faithful by claiming the mantle of Hillary-Basher Club Champion. A tax credit for parents struggling to pay their children’s college tuition? Matching funds for 401(k)s? Baby bonds? Crazy notions all, not because of their substance – Rudy can’t be bothered with their substance – but because they were proposed by – get this – Hillary! The GOP crowds roar.

As a road map to governance, this is both dim and skimpy. President Giuliani, Romney, McCain or Thompson can reliably be counted on to be against whatever Clinton is for. Beyond that, if we total up their domestic and economic policy proposals, they intend to do almost nothing at all.

Romney will punt to the states the problem of the decreasing willingness of employers to provide health insurance. Giuliani says everybody should just buy their own policies – and if the insurance companies don’t want to sell to the sick or middle-aged, that’s just too bad. John McCain focuses on the rising costs of treating chronic diseases rather than the declining level of coverage. Fred Thompson wants to take a whack at Medicare.

What unites these positions is more than just a common opposition to Hillary’s (or John Edwards’ or Barack Obama’s) proposals for universal coverage. They also adhere to the fundamental Republican laws handed down by Goldwater and Reagan: All government interventions on behalf of the people are inherently wrong. They erode freedom. The market can do a better job of whatever it is that needs doing.

What the Republican field fails to realize is that the America that Goldwater and Reagan defended against the presumed predations of government no longer exists. When Barry and Ronnie walked the earth, most Americans had enduring relations with their employers (ensured, in many cases, by a union contract), and their employers often provided them with health benefits and a pension. Clearly, the private sector that Barry and Ron extolled while denouncing government ain’t what it used to be, and Americans know it.

Somehow, news of this transformation has not reached the Republican candidates, who still rail against government assistance to help Americans pay for college and health care and offer glowing affirmations of free trade. Nor has it reached the Republican Party or the conservative movement more generally. The serious postmortems for President Bush’s ultra-Reaganite and uber-Goldwateristic plan to privatize Social Security – the questioning of the sanity of such a proposal at a time when employer-provided pension plans were dropping like flies – have yet to be conducted in conservative circles. Indeed, Fred Thompson is still mumbling about cutting Social Security. Ol’ Fred may have slept through 2005 but did the entire party?

The Republicans’ problem isn’t just the silence of their candidates. It’s the silence of their ideology, which has neglected to notice that the world has changed.