It’s not quite true that conservatives have no health policy ideas. On the day they first voted to repeal Obamacare, Republican legislators off-handedly mentioned numerous possibilities -high-risk pools for the very sick, allowing the purchase of insurance across state lines, reducing coverage mandates to make health plans cheaper-that might be part of a future alternative. Many of those ideas are still floating around the party’s policy byways today, waiting to be tethered to a specific proposal.

What Republicans don’t have is a theory-a broadly shared vision of how health care ought to be delivered in America. Without such a shared understanding, one that can be easily and succinctly described by politicians and activists alike, it’s hard to unite around, or even talk about, any particular plan. The result is that many Republicans would rather discuss the specifics of Obamacare’s failings while presenting their alternative ideas in catch-phrase generalities like “patient-centered care,” “affordability,” and “preserving the doctor-patient relationship.”

That’s not to say that no one is advancing alternative principles for reform. A handful of conservatives, libertarians, and even some elected Republicans have proposed a variety of plans and principles in recent years. Their suggestions feature varying degrees of complicated details and secondary priorities, but most of them revolve around the central idea of uprooting the tax system’s existing preference for individual insurance by reforming the tax treatment of health benefits.