Jim Frogue, of the Center for Health Transformation, says that conservatives must take the initiative on health care reform, and not simply respond to bad ideas [like SCHIP expansion?] by trying to fend them off.

Sound policy demands it.

Conservatives must make Medicaid reform a top priority . The issue has become too big to ignore and without conservatives who understand markets, incentives, and fiscal responsibility, the debate is sure to keep resulting in policies bound to fail.

The standard approach to Medicaid, he says, has been cut, cut, cut, and complain. Instead, he says, Gov. Jeb Bush accomplished a lot during his tenure in Florida. Frogue gives Bush kudos for two lines of argument: the existing Medicaid system was immoral, and left-wing solutions were ... absent.

The Bush plan involves paying Medicaid enrollees to practice healthy living. Of the complaint that this the wrong path, Frogue replies that it's cost effective.