The bill also allowed the expansion of health savings accounts, which have the potential to change private-sector health insurance the way that Section 401(k) of the tax code has changed private-sector pensions. HSAs are expanding rapidly, and polls show seniors highly pleased with the prescription drug plans they've chosen -- and competition is holding down costs.
To be sure, this is big-government conservatism. But who thinks we're going to get rid of big government? Bush's approach has been to enhance choice and accountability, to rely more on markets and less on government commands.
It's the only realistic conservatism for America today.
Note that conservative policy successes have taken some issues off the political table. Republicans won a lot of suburban districts in 1994 on the issues of crime, welfare and taxes. Crime and welfare are not major issues anymore. And the Democrats' obvious unwillingness to raise taxes substantially after their defeat in 1994 took taxes off the table, too -- though the issue may come back in 2008, when voters could face a choice between Republicans who promise to extend the tax cuts that expire in 2010 and Democrats who may be eager to let those taxes go back up again. That might switch some of those suburban districts back toward Republicans.
What issues could Republicans raise in 2008? They would do well to look to the states, and especially to Florida, where Jeb Bush has enacted innovative policies on school choice and healthcare. They could look at some Democrats, as well, like Tennessee's Gov. Phil Bredesen, who has been reforming an overly generous Medicaid program.
They could highlight the proposal of Republican Rep. John Shadegg of Arizona to allow people to buy health insurance across state lines. They could consider Clinton Treasury Secretary Robert Rubin's proposal to get lower-income workers to save and invest with tax credits for IRA contributions. Republicans aren't going to win elections with the new ideas of 1980, 1994 or 2000. They need new ideas for 2008. |