The conservative approach to health reform?

The NY Times op-ed piece is misleadingly titled "How the GOP can fix health care." Exhibit A for why this is misleading is that none of the five contributors is currently in government. It seems that the only chance the GOP has of fixing health care is for the current crop of Republican congressmen to turn over their seats to a new generation (or an older generation) that is actually committed to reform.

None of the five pieces identifies lack of coverage for 50 million Americans as a problem that reform needs to address. Instead, four of the five focus exclusively on containing costs. The exception is James Pinkerton, who proposes that we spend more on cures for costly diseases. There's an idea - let's get rid of disease, and then we won't need to worry about the health care system at all! The fact of the matter is that Republicans have never viewed lack of coverage as a fundamental problem. All Republican "reform" proposals aim at reducing costs. While Republicans claim that reducing costs will expand coverage, no reform I've seen would reduce costs by enough to seriously dent the ranks of the uninsured.

It's also worth noting that some of the best ideas the contributors have - having Medicare pay for outcomes rather than procedures, setting up insurance exchanges - are already in the House and/or Senate bills. Mark McClellan is the only one of the contributors to acknowledge this. In fact, he is the one contributor who seems to be advocating that the Republicans work with the Democrats to improve the Democrats' plan by adding more efforts to control costs such as tort reform, rather than simply starting from scratch. If there were five or ten McClellans in the Senate who were not afraid of opposing their party leadership, we'd have decent health reform legislation by now.