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Health care solutions

In this June 28, 2012 file photo, Republican presidential candidate Mitt Romney speaks about the Supreme Court ruling on health care in Washington.
In this June 28, 2012 file photo, Republican presidential candidate Mitt Romney speaks about the Supreme Court ruling on health care in Washington.
Associated Press

While still being vilified by his opponents on the left, Republican presidential nominee Mitt Romney has recently come under fire from conservative critics, too. They're upset with his expressed willingness to leave parts of the president's health care reform legislation intact. According to partisan purists, any willingness to acknowledge the value of any of the Affordable Care Act's provisions is ideological heresy. They insist "Obamacare" must be utterly destroyed, leaving neither root not branch.

That would be ill-advised.

We have long maintained that the president's signature legislation is a flawed solution to a massive societal problem. But we also recognize that there is, in fact, a health care problem in the United States, and too many critics of President Barack Obama's reform rail against it without offering any workable solutions of their own. Should they succeed in their exclusively negative efforts, the result would be a return to a broken status quo that costs too much and excludes too many, particularly the nation's poorest and most vulnerable citizens. That would be unacceptable.

It's also intellectually dishonest, as the individual insurance mandate that is now anathema to the Republican establishment was hailed as a uniquely conservative innovation less than a decade ago. When then-Gov. Romney implemented a statewide insurance mandate in Massachusetts, he was lionized by some of the same critics who are now demonizing him. They suddenly view the insurance mandate they once hailed as an unconstitutional atrocity, despite the Supreme Court's recent ruling to the contrary.

Worst of all, they have no suggestions as to how to expand coverage without such a mandate.

Most Americans, for instance, welcome eliminating insurance exclusions based on pre-existing medical conditions. Indeed, this is one of the provisions of the ACA that Romney recently expressed a willingness to keep. But allowing people with pre-existing conditions to get insurance is completely unworkable without an accompanying insurance mandate. Otherwise, everyone would wait until they got sick to get covered, which would make it impossible for insurance companies to stay in business. Without the mandate, liberals will keep pushing for a single-payer system that Republicans despise. So what's the Republican approach? Essentially, there is none.

On the whole, Obamacare is bad medicine. It's bureaucratic, bloated, and, in many ways, unworkable and unsustainable. But it's got some good ideas buried in the morass, and Romney is wise to consider keeping them. All others who would reject the ACA outright have a responsibility to propose positive alternatives that would take its place.