The battle lines on health care reform are pretty clear, but what isn’t as clear is what each side stands for.  Both Democrats and Republicans have been talking about competing ideas, but the overarching debate is actually one about governing philosophy – and polls still show that the public is somewhat skeptical of the Democrat ideology.

The Democrats’ plan includes a national insurance plan – the now-famous “public option,” a cheaper version of every other insurance plan that somehow, our leaders assure us, won’t put those other insurance companies out of business.  The Republicans’ plan involves driving down costs by limiting liability reform, but there’s a more interesting tidbit buried deep down in their discussion: the idea of each person buying their own insurance, made easier by tax incentives.

Unfortunately, the GOP isn’t trying to change the terms of the debate – something they desperately need to do.  Those who seem to support the Obama plan are helping a bit.  A New York Times Magazine article makes a case in favor of public health care rationing (a concept even the administration avoids like a plague which can’t be treated by an in-network provider) and in doing so, uses the following graphic to make their point:

It’s a valid question, and one the “public option” will have to answer – maybe not during the legislative process, but certainly when put into practice.  The first participant in the ABC Obama Health Care infomercial asked a similar question; the President sidestepped and did not answer.

This is a powerful strike against Obamacare, and one Republicans can exploit.  But eventually, bashing health care reform proposals will not help the GOP win elections.  The other side must advance their own brand of health care reform – something completely different, although the seeds are, as aforementioned, already planted.

Our health care system as it currently exists is tied to employment – much like other benefits, such as a retirement pension, have been for decades.  If you work in the same job for a long period of time, that’s good.  But as the American worker becomes ever more likely to switch jobs several times during a career, the employer-based model is simply not as effective.  We no longer live in a company where people get jobs out of high school or college, work for fifty years, and get a pension and a gold watch upon retirement.

A system which promotes portable, individually-purchased health care and health insurance would not only help expand people’s control over their health care, it would drive costs down.  Current health insurance costs are often inflated by the existence of insurance; care for uninsured patients currently costs less than care for insured patients.

No election was ever won on defense, and Republicans – and, for that matter, conservatives – can ill afford to let their opponents draw the battle lines.  In fact has already started, with President Obama claiming the opponents of his plan are “defending the status quo.” As long as this message resonates unanswered, Obama can continue to claim the middle ground while painting his opponents as reactionary forces dug in to withstand change.  Republicans must make their own case that their proactive solutions are better than the opponents.