Health care reform has turned into a fratricidal war among Democrats. Liberals vs. moderates; Reid vs. Lieberman; Ben Nelson vs. the world. Meantime, poll numbers for the president, Congressional Democrats, and the reform effort are falling through the floor. The latest Wall Street Journal/NBC News poll shows more Americans would rather do nothing than pass the Reid bill – not a good situation for a majority making a case for the urgency of reform.

This all points to a degree of success for Republican opposition to health care (and stimulus, and cap and trade). But the success is limited. While GOP poll numbers have ticked up slightly, the public isn’t overly enamored of Congressional Republicans either. And that’s probably because voters aren’t sure what Republicans want – other than whatever Democrats don’t want.

It may be time for Republicans to move their opposition strategy to the next phase, and health care offers a good opportunity. Conditions are ripe for a Republican white knight bill that pulls together the Republican caucus and 20-25 Democrats who agree on a few principles. With so much of the debate around the margins of reform – and particularly around a government-run health plan – the consensus middle ground has been ignored.

I see a consensus bill containing five provisions:

• Insurance companies can’t drop people from coverage when they’re sick;
• Insurers can’t deny coverage on the basis of pre-existing conditions;
• Create a federal high-risk pool for people who have extreme difficulty obtaining coverage (a smart friend who works in Congress suggests that a re-insurance scheme would actually be better and more palatable to Republicans);
• Individuals who buy their own insurance should be allowed to deduct their premiums from their taxes;
• Reform the medical malpractice system by establishing some alternative dispute resolution regimes with teeth (President Obama claims to support this – make him live up to it).

Centrist Democrats and Republicans can each find something to like here, and while the regulatory burden might be a little too much for some conservatives, I doubt anybody would want to vote against measures one or two.

Furthermore, by eschewing “community rating” and the Reid bill’s coverage mandates, Republicans would be preserving price and coverage flexibility and encouraging consumers to choose the coverage that’s right for them. They’d also be incentivizing people to get covered, because even with no pre-existing condition exclusion, people who wait to get coverage until they get sick would face much higher premiums.

A potential pitfall: Because of the tax treatment for individual health plans, the CBO would likely score this bill as costing more than liberal Democratic alternatives. But the current numbers are fictitious anyway, relying as they do on Democrats voting to cut half a trillion dollars out of Medicare in the next ten years – when they haven’t voted to cut a dime out of it in 40 years.

To placate fiscal watchdogs, perhaps the bill could contain a provision calling for some sort of commission charged with looking at long-term solutions to the pending Medicare crunch. And, if all else fails, a bargaining chip might involve some of the medical industry “fees” contained in the current Senate bill.

Many of the details would have to be ironed out – and that’s OK. An announcement about the broad outline of a package in the next few days would relieve the country of Harry Reid’s absurd Christmas deadline and provide some breathing space to do more negotiating in January.

For Republicans, the political benefit would be showing voters heading into 2010 that after a year of smart and necessary obstruction, they have the maturity and level-headedness to lead. For centrist Democrats – particularly those up for re-election in what looks like an increasingly hostile year – this effort would allow them to create daylight between themselves and the more rabid liberals in their party.

And for the country, this package would mark progress in making it easier for people to get coverage – without a major leap forward in government activism, taxes, or false promises about Medicare.

In other words, exactly what voters have been asking for.