I’ve been promising for some time to write about what Republicans might and should do once they run Congress.  There were some other posts I wanted to get to first because I like to keep things in chronological order, but I was inspired to put down a little bit about health care strategy after reading this article in the Wall Street Journal (registration required) this morning.  Grace-Marie Turner lays out six options the Republicans have to “put the brakes on ObamaCare.”

She predicts that there will be an initial showdown on the whole thing- and hey, why not, no harm in trying a Hail Mary pass, burning up the phone lines, and seeing what can happen.  It also gives Republicans a chance to show they are serious about both repealing and replacing ObamaCare.  After all, we do need health care reform, the problem is that ObamaCare takes us in exactly the wrong direction.  However, she’s also right that the chances of that sort of bill passing with Obama in the White House are essentially nil.

Here are her six ideas-  Defund it, dismantle it piece by piece, delay it, disapprove regulations enacted on it, direct oversight and investigation, and delegation to the states.  What this adds up to is far better than what I had yet considered.  I had thought, well, we need to wait until 2012 and bring it all back up for the public to review right before the election.  Her prescription is for almost all-out war on ObamaCare right through the entire Congress.  I hadn’t thought of so many ways that Republicans could keep the issue alive for so long, but it seems they certainly can.  I guess when you write a 2700 page bill, there is lots of bureaucratic machinery to gunk up and lots of unpopular bits to bring up, each of which sparks a political and media battle.  This is where defunding it, delaying it, disapproving regulations, and oversight come in.

So keeping the issue alive is the first tooth on the key to repealing and replacing ObamaCare.  The next tooth, once the issue stays potent, is staying on the right side of public opinion on the issue.  This will be easier when Republicans are in Congress.  Up until now, Democrats have been able to accuse Republicans of taking the most unpopular positions advocated by conservatives anywhere, in particular, by implying that Republicans want to repeal ObamaCare and replace is with nothing, and destroy Medicaid, Medicare, and Social Security to boot.  With Republicans in Congress, the Republican position will be defined not by what Democrats accuse us of, but rather by what we actually try to pass.  This is also part of the larger issue of rebranding the Republican Party as a party with real solutions and represents a major opportunity to rebuild trust with the public.  The hard part is to consider and pass legislation popular enough to win support by large majorities and, on at least some issues, actually become law, while at the same time keeping the base happy and motivated even though what we (the base) really want has no chance of becoming law for another couple of years.  This means defunding unpopular bits like the expansion of the IRS, dismantling elements which some Democrats are on the record as opposing or which are very clearly and directly harmful to the economy.  Turner recommends delaying or eliminating the cuts to Medicare, and I would add that this must be done with caution.  Republicans must avoid being tarred again with the big-spending brush.  Big spending always hurts Republicans more than Democrats because it disheartens our base and lets Democrats paint us as hypocrites and spend and don’t taxers.  When Democrats spend, their base loves it and people aren’t all that surprised.  More importantly, big spending is just bad.  However, until we can get proper reform in place, fixing the damage done to Medicare and Medicaid are political no-brainers, and people shouldn’t be hung out to dry in the meantime before we can start bringing down costs.  After all, the Republican goal is not to dismantle these programs- its to open up the power of the free market to cut health care costs and make these programs affordable.  For this to work, the base needs to be impressed with aggressive regulatory oversight and endless Congressional hearings which generate news and keep up the drumbeat for repealing ObamaCare.

The third tooth to the key is in presenting a viable alternative to ObamaCare that accomplishes the supposed goal of ObamaCare, which was drastically reducing the number of people who don’t have health insurance and is the opposite of what ObamaCare actually does, while reducing costs.  There is only one way to cover more people for less money- the efficiency of the private market.  Turner mentions delegating this to states, which is a fine idea.  A lot of these ideas have already been implemented in one state or another, and having more states follow will help people in those states see how free market reforms work, and test out ideas for roll out with the national Republican health care agenda.  Congressional Republicans should see to it that the federal government doesn’t interfere with these efforts, and it should introduce many of these reforms, along with ObamaCare’s repeal, in national legislation- at the beginning of the term, as they likely will, but also just before the 2012 elections.  After another 2 years of experimentation, Republicans will have a better idea than ever of how to implement a popular health care bill that emphasizes cost savings through free-market principles.  And it will be a great political move to put up such a plan before the elections.  If health care is still one of the major issues in 2012, that is great news for the Republicans.