One of the biggest mistakes conservatives made after defeating the Clinton health care plan in 1993-94 was to declare victory and go home rather than pursue policies that would create a freer market in health care. To the extent that Republicans got involved in health care policy at all, they either defended the status quo or promoted incremental steps toward a more government-controlled system — Kennedy-Kassebaum, SCHIP, and the Medicare prescription drug benefit. The one exception has been relatively modest expansions of health savings accounts.

Republican presidential candidates tout more or less free-market health care plans on the campaign trail just to have something to say when they issue comes up. Then they promptly chuck these plans once the election has passed. The failure to present a real alternative means that even when we dodge a bullet, as we have done repeatedly since the Truman years, it’s inevitable that the issue is going to come up again on liberal terms.