It is often said that defense wins games, but offense wins elections.
Donald Trump stayed on offense in 2016 and willed himself to an improbable White House win. But the limits of his offensive skills and connection to working-class America were exposed during the 2018 elections, when congressional Republicans failed to muster anything close to Trump’s tireless campaigning and massive rallies. Instead, they left the party playing defense on the winning issue of the election: health care.
For Republicans to win up and down the ticket in 2020, the White House and congressional GOP must fix this failure. They must be on offense to win the battle of health care ideas.
Right now, the Grand Old Party is driving its latest health care train toward a ledge, rushing to release a plan early this fall, crafted by conservative academics and establishment policy wonks far removed from the 63 million everyday Americans who put Trump in office. It’s not too late to tap the brakes and reset the compass.
My reporting suggests there is a better approach — one for, by and of the people.
First, Republicans must cogently educate the public on how ObamaCare fundamentally altered private health care for the worse — creating mega-medicine giants who have hijacked the patient-doctor relationship, put profit over personalized care and set the stage for the one-size-fits-all prescription of single-payer universal health care.
The stories of patients deprived of quality treatment and doctors thwarted from providing good care must be told. Tales of care-rationing in neighboring Canada won’t suffice. American patients and doctors must tell their personal stories.
Once they’ve made a compelling case against the current and future perils of socialized Big Medicine, Trump and congressional Republicans must forge a populist free-market plan to counter the left’s simplistic “Medicare for All” mantra.
The plan needs 10 or fewer propositions — much like former House Speaker Newt Gingrich’s “Contract with America” that sealed the 1994 election. Choice, affordability, protecting pre-existing conditions and restoring the doctor-patient relationship eroded by ObamaCare must be pillars.
In the end, Americans need health insurance options that preserve their access to favorite caregivers without breaking their budget.
To craft such a plan, Republicans don’t need the ivory-tower ideas of conservative think tanks and congressional and agency policy wonks. Time and again, those have failed to provide a plausible free-market health plan, ever since conservatives used the “Harry and Louise ads” to kill Hillary Clinton’s deeply flawed care plan of 1994.
Instead, Republicans need to do what Trump did in 2016 when he crafted his winning “America First” platform: listen to real people, patients and doctors, and measure their needs, wants and challenges. It’s something the GOP traditionally has done poorly.
Americans don’t want a vague GOP concept with pithy promises. They want a private-plan alternative with options that can be personalized: Each voter should be able to plug in the family’s needs to an online calculator and quickly identify a free-market plan that meets their needs and budget.
With a successful prosecution of the flawed ObamaCare and single-payer approaches and a compelling private alternative, Republicans finally need a marketing slogan as effective and memorable as “Make America Great Again.” With a common battle cry, they also need consistent messaging on what’s right with their plan and wrong with that of the left.
Polling data and my interviews about health care with voters around the country demonstrate that a majority of Americans know the broad pillars of the plan they want: my health, my doctor, my wallet, my choice.
Republicans have a distinct advantage over the Medicare for all plan put forth by Sen. Bernie Sanders (I-Vt.) or former vice president Joe Biden’s one-step-away-from-single-payer approach. Most voters implicitly understand the lesson of the mouse trap — that free cheese smells and tastes good until the trap snaps down. In other words, free isn’t really free. Socialized Big Medicine comes with a heavy cost.
President Trump, House Minority Leader Kevin McCarthy (R-Calif.) and Senate Majority Leader Mitch McConnell (R-Ky.) have an opportunity to create the first market-driven choice health insurance plan in decades. They need to stop the plan that conservative wonks intend to rush out in September and build an initiative with data on voter needs and wants, tangible health plans and Madison Avenue-quality messaging.
The good news is that a group of doctors, patients and small business owners, including the Job Creators Network (which led the successful 2017 drive for tax cuts), has been meeting a few miles from the White House in a row house near Pennsylvania Avenue to build a “three-legged stool” solution. They are crafting their plan in the disruptively innovative way that Apple built the iPhone franchise or Chrysler the minivan craze: with market research, straightforward products and seamless messaging.
They have put into the field a market survey of patients and doctors to measure what they fear in the current system and the choices they’d like to have in the private market. The group has assembled data on how ObamaCare has made a few health care companies richer and more powerful while shrinking the choices, quality and personalization of health care delivery.
They can document, under ObamaCare, how 53 percent of American doctors no longer own their practices, having been forced into insurer-hospital collectives. They have documented how large numbers of ObamaCare recipients who don’t get subsidies have dropped from the program. They have developed an analysis of how Big Medicine has led to unnecessary tests to generate profits, and led to the rationing of personalized care. And they are chronicling the extinction of the independent family doctor across American communities.
This group will release health care plans and easy-to-use calculators to show how the choices of those who were surveyed can be fashioned into affordable, personalized health insurance. And they have assembled an army of doctors, patients and small business owners tens of thousands strong that is ready to take the case to the grassroots.
President Trump and his GOP congressional allies should embrace this private initiative. It has the data to show the perils of socialized Big Medicine, and it has the potential sales points of a new era of personalized health plans on the free market.
Your health, your doctor, your wallet, your choice. Who could argue with that?
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