"We owe the country a referendum election. We owe them a policy alternative."

Rep. Paul Ryan (R., Wis.) tells National Review Online that Republicans, especially presidential contenders, need become more “provocative” when speaking about health-care reform. “We need to be provocative,” he says. “We owe the country a referendum election. We owe them a policy alternative.”

Specifically, Ryan urges the field to focus on Medicare. “It is the issue, pure and simple,” he says, noting that it encompasses the “debt issue, the deficit issue, and the economy issue.” To help them along this afternoon, Ryan, the Budget Committee chairman, outlined his health-care ideas at the Hoover Institution in Palo Alto, Calif.

His remarks, aides say, are part of Ryan’s push for more “optimistic” and “serious” proposals following House passage of Ryan’s entitlement reforms earlier this year.