Newt Gingrich’s health-care problem — and the Republican Party’s

(© Jonathan Ernst / Reuters) On Saturday, David Fahrenthold wrote that “more than a year after Republicans first pledged to ‘repeal and replace’ President Obama’s new health-care law, the GOP is still struggling to answer a basic question. Replace it . . . with what?”

This shouldn’t be such a problem. Health care is a big issue. It’s been around a long time. The Republican Party should, in 2011, have a position on it. To understand why it doesn’t, it’s worth reading Newt Gingrich’s April 2006 comments on then-Gov. Mitt Romney’s Massachusetts reforms.

“The most exciting development of the past few weeks is what has been happening up in Massachusetts,” wrote Gingrich, or someone speaking for Gingrich, in his “Newt Notes” newsletter. “The health bill that Governor Romney signed into law this month has tremendous potential to effect major change in the American health system. We agree entirely with Governor Romney and Massachusetts legislators that our goal should be 100% insurance coverage for all Americans. ... Individuals who can afford to purchase health insurance and simply choose not to place an unnecessary burden on a system that is on the verge of collapse; these free-riders undermine the entire health system by placing the onus of responsibility on taxpayers.”

In 2006, in other words, the Republican Party had an alternative to Obamacare. The only problem? It was Obamacare.

Between 1990 and 2007, the reigning Republican theory of health-care reform was that instead of handing the health-care system over to the government, they would put private insurers and personal responsibility at the core of their health-care reforms. During this period, everyone from Bob Dole to Jim DeMint to the Heritage Foundation endorsed this approach. But then Democrats, looking for a compromise, endorsed those same plans. And then Republicans, rather than pocketing the policy win, ran from their own ideas.

But insofar as the Republican Party had a plan for health-care reform, the individual mandate was it. That’s why Mitt Romney, Newt Gingrich, Tim Pawlenty, and Jon Huntsman either passed, endorsed, or expressed openness to an individual mandate. And that’s why Romney hasn’t paid for his plan: Almost every other serious candidate for the Republican nomination supported an individual mandate, too. It’s hard for Gingrich to take a clear shot at Romney for proposing what Gingrich called “the most exciting development” in health-care reform.

It’s also why the Republican Party can’t figure out an alternative to the Affordable Care Act. The Affordable Care Act was their alternative. Now they need an alternative to the alternative. But there are only so many policy approaches that make sense as an answer to our health-care problems. And Republicans have pretty much run out of them.

Related: My interview with Mark Pauly, the conservative economist who came up with the individual mandate.