The Other GOP Presidential Pickle
But that doesn't change the fact that health care is one of the top domestic priorities in this country. And I'm not alone on that one. Just about every poll to broach the subject shows that Americans agree on this point, and the agreement often spans the political spectrum.
For instance, a Pew poll last summer found that 89 percent of Dems believe health care is a "very important" issue, while 79 percent of independents and 69 percent of Republicans feel that same way.
So it's certainly not surprising that the Dem candidates have all spoken out on the issue. But what's a bit surprising is the silence on the issue from the right.
Health care blogger Bob Laszewski recently took a peek at the web pages for the three top GOP contenders -- Rudy Giuliani, John McCain, and Mitt Romney -- to find out their thoughts on the issue of health care.
Giuliani and McCain both offer up comments on about ten issues, but none of them even touch on health care. Romney does list health care as the tenth out of eleven issues he discusses, but his thoughts are limited to a couple of statements that center on the idea of personal responsibility for health care. (Side-Note: This is interesting because, as Laszewski notes, "the Massachusetts health reform bill [Romney] signed...does create a new and very large government program.")
So why, if 69 percent of Republicans say health care is a "very important" issue, do the presidential candidates on the right largely avoid talking about it?
One answer, which Laszewski hints at, is that the GOP base is made up mostly of the 1/3 of Republicans who don't see health care as a "very important" issue, and therefore hitting on the topic isn't necessary for winning the GOP nomination.
While I think there's some truth to that, I don't think that tells the entire story. After all, winning the nomination is just one piece of winning the presidency. It would greatly benefit a GOP candidate to start discussing health care, even if only as a side issue during the primary, so that a foundation on the issue is there when the general election rolls around.
But I'd say that the silence exists because it's extremely difficult to blend right-wing free market ideology with a proposal for universal health care. That's why you see Romney actually rejecting the very foundation of his own signature issue as governor of Massachusetts now that he's trying to court the GOP base.
The fact is the government is going to be an integral part of any universal health care plan, let alone one that fundamentally changes the system and, as a result, reduces costs. Simply relying on "market forces" to do the trick is little more than a pipe dream; to be sure, already 1 in 4 Americans relies on either Medicare or Medicaid for their health care, and another 15 percent don't have coverage of any kind.
As Froedtert Hospital CEO William Petasnick put it recently: "We've had 14 years of basically market-driven solutions. And market-driven solutions work up to a point, but I think the outgrowth of the failure of market-based solutions is . . . the 45 million Americans who are outside of the market."
The bottom line is that the government is going to be a necessary part of any viable fundamental health care reform plan. But proposing to use the government as a means for reform isn't anything the Republican base wants to hear.
It's been noted that the GOP candidates are going to have a tough time crafting a message on Iraq that pleases the base for the primary, and then reinventing that message to play to a wider audience in the general.
It seems the same may be true for the top domestic policy issue, as well.