Confronted with the odor of establishment GOP flop sweats — an all-too-frequent occurrence in these staunch and heady days of unforced Republican retreats — the WSJ notes, “Paul Ryan’s GOP critics are ObamaCare’s best friends”:

Underneath Newt Gingrich’s rhetoric last week about Paul Ryan’s “right-wing social engineering” was a common anxiety about the politics of Medicare: Is this the right moment for entitlement reform? Did the GOP endanger its House majority by giving Democrats a campaign strategy for 2012, and is Mr. Ryan’s proposal really too “radical” after all?

[…]

[…] Republicans now tempted to retreat at the first smell of cordite need to understand that they are taking even larger political and policy risks than Mr. Ryan is. The Medicare status quo of even two years ago, much less 20, is irretrievably gone, and anyone pining for its return is merely making President Obama’s vision of government-run health care inevitable.

This reality is underscored in the just-released annual report of the Medicare trustees. Democrats sold ObamaCare as a way to slow the growth of costs, but the report shows that the program’s finances have deteriorated even since last year. Medicare is carrying $24.6 trillion in unfunded liabilities through 2085, and chief actuary Richard Foster says even that does “not represent a reasonable expectation for actual program operations.”

As a matter of simple arithmetic, this problem can’t be solved with tax increases, because health costs and thus government spending on health care are rising so much faster than the economy as a whole is growing. The U.S. capacity to pay for Medicare on present trend diminishes every year.

And that’s simply that: the humiliating bitch slap of fiscal reality.

— Which means we have a choice to make: do we follow the left in its move toward a kind of health care politburo, with our medical care determined by a panel of “experts” (let’s not call them a “death panel’; that’s far too provocative. Instead, let’s call them an “expert panel of super-dooper smarties who, in the public interest, will decide whether or not you, client number 2,247,289 can go on living”)? Or do we retain our autonomy and some measure of choice, in what was once a free-ish country?

And more, should we not be making that choice as stark as possible, as a function of selling the electorate on our classically liberal principles — and reasserting liberty over an ever-encroaching, voracious Leviathan government run by an invisible hive of buzzing bureaucrats?

With ObamaCare, Democrats offered their vision for Medicare cost control: A 15-member unelected board with vast powers to set prices for doctors, hospitals and other providers, and to regulate how they should be organized and what government will pay for. The liberal conceit is that their technocratic wizardry will make health care more rational, but this is faith-based government. The liberal fallback is political rationing of care, which is why Mr. Obama made it so difficult for Congress to change that 15-member board’s decisions.

Republicans have staunchly opposed this agenda, but until Mr. Ryan’s budget they hadn’t answered the White House with a competing idea. Mr. Ryan’s proposal is the most important free-market reform in years because it expands the policy options for rethinking the entitlement state.

“Premium support” is not a new idea, but it has long been dormant, and Republicans will need to continue their effort to reintroduce it to voters. Seniors would receive a fixed-dollar subsidy from the government to choose from private insurance options, with higher payments for the poor and sick. Consumers would make cost-conscious choices at the margin, and insurers and providers would compete on health-care value and quality.

Mr. Gingrich is right that reforms of this magnitude need to be grounded in a social consensus built over time. But that means the task for Republicans is to educate the public about market principles and more consumer choice. Mr. Ryan’s model is flexible enough to adjust the level and rate of growth of the premium-support subsidy. The Ryan Medicare plan was never going to be adopted this year, but it is the first credible, detailed alternative to Mr. Obama’s approach.

Some GOP critics, like Mr. Gingrich, claim that it would be politically safer to introduce premium support but give seniors a chance to keep traditional Medicare. The problem is that this leaves all of Medicare’s distortions in place and does little to stop its explosive costs. As long as the major incentive in health care is Medicare’s fee formula, very little will improve.

— not to mention, if I may interject here, that Gingrich’s position rests on the foundational assumption that it is the government’s job to do something about health care in the first place — a concession free market capitalists needn’t (and shouldn’t) make.

And while he’s certainly correct that a solution that retains what is unsustainable and broken — but whose familiarity is a kind of electoral safety net — is politically safer, he is in making such an argument in effect conceding that he is willing to trade away workable and necessary reform for votes, and he is doing so under the misapprehension that the American people can’t be persuaded to do what is in their best longterm interests.

Which is the kind of inside the Beltway condescension we’ve many of us grown weary of.

Republicans have been passing such reform quarter-measures for 20 years, with little to show for it. Medicare Advantage already offers private insurance options to one in four seniors, but this camel’s nose hasn’t led to a reconstruction of the larger Medicare tent. The same is true of health savings accounts in the 2003 prescription drug benefit, or the current Republican talking point that medical malpractice reform will somehow solve every problem in health care.

All of these are important but don’t reach Medicare’s core problem of government-controlled prices and regulation, and in any case Democrats always gut the reforms once they return to power. In retrospect, this play-it-safe strategy paved the way for ObamaCare.

The political forces unleashed by ObamaCare will grow unimpeded if Republicans now retreat from offering an alternative. Once the White House’s efforts to limit costs by fiat fail—as they inevitably will—liberals will turn to even harsher controls. This future is already emerging in post-Mitt Romney Massachusetts, and also in Vermont, which wants to move to single government payer.

And this is the end game: it is what the left wants, and what they know will happen.

Only one “side” of this argument is concerned with reform; the other side wants control and power, and they have put in place a plan that will of necessity lead us there.

If we don’t have the stones to make the case to the American people — and many in the GOP don’t, having spent the majority of their political careers giving shit away and pandering rather than actually reforming an inefficient and ever-growing government — we will wake one day to find ourselves in the very malaise Carter tried to will us into, a soft-tyranny run by a beneficent centralized authority. And by beneficent, I mean “beneficent provided you don’t complain, lest you find yourselves on the wrong end of the government stick.”

We wrote earlier this year that Republicans would get no objection from us if they postponed Medicare reform until they had a GOP President, but the House went ahead anyway. Far be it from us to criticize politicians for having too much courage. But having committed themselves, Republicans will appear (and will be) feckless if they abandon reform only weeks after voting for it. Trying to change entitlements can be agony, but it is fatal to try and fail. The voters will conclude the critics were right.

Mr. Gingrich has done great harm to his party and the cause of reform with his reckless criticism of Mr. Ryan, forfeiting any serious claim to be the GOP nominee. But equally as culpable are the self-styled conservative pundits who derided Republicans for dropping the reform mantle during the Bush years but now tremble that Mr. Ryan has gone too far.

The reality is that Medicare “as we know it” will change because it must. The issue is how it will change, and, leaving aside this or that detail, the only alternatives are Mr. Ryan’s proposal to introduce market competition or Mr. Obama’s plan for ever-tightening government controls on prices and care. Republicans who think they can dodge this choice are only guaranteeing that Mr. Obama will prevail.

[my emphasis]

This is why the type of candidate I will support will be one grounded in certain principles that are not politically negotiable. This is not, as some have asserted, a call to “purity”; it is a reminder that leaders lead, and that they do so based around the trajectory of their beliefs, not as a sop to political expedience.

If 2012 is, as I believe it will be, a referendum election, we must make stark the choice between Obama’s democratic socialism and the kind of free-market, pro-liberty principles — grounded in natural rights and the rule of law — upon which this country was envisioned and ultimately founded.

This seems simple enough to do. All we need do is find those willing to draw the frame.

(h/t geoffb)