Big Ideas From Boring Old Stump Speeches

Podiatry? Yes, podiatry. On this evening in Perry, Iowa, the presidential candidate is passionate about the issue, and connecting with the audience. The topic is the perverse incentives of a health-care system that pays for intervention instead of prevention. Why, the candidate asks, do insurance companies pay for an expensive operation to amputate the foot of a diabetic, but won't reimburse for cheaper preventive visits to a podiatrist that could make surgery unnecessary?

That's Hillary Clinton, right? Yes, but Republican Mike Huckabee also routinely tells this podiatry story to make the exact same point. John Edwards, Barack Obama and the other Democratic candidates are also talking about the backward economics of the health-care industry. Check back in a couple of years and it's a good bet more insurance companies will be reimbursing your local foot doctor for treating diabetics, and the number of amputations may even decrease. That will be a sign that a major transformation of the health-care system toward prevention is underway, courtesy of our much-maligned presidential campaigns.

It is the Law of Unintended Campaign Consequences. Amid the endless polls, attack ads and silly flaps, a strange dynamic is at work. Secondary issues—often stump-speech afterthoughts—can work their way into the political bloodstream and yield larger results than the issues that seem to be the major concerns of the day. The originators of these ideas don't always win the election, but they leave us something important to remember them by.

There's a long history of seemingly minor statements from the campaign trail resonating far beyond Election Day. During the 1960 Democratic primaries, Minnesota Sen. Hubert Humphrey talked about a bill he had proposed that was going nowhere. The idea was to send idealistic young Americans overseas to help in the developing world. Humphrey lost the nomination to John F. Kennedy, who featured Humphrey's notion in a speech that he gave at the University of Michigan. After JFK became president, the idea reached fruition as the Peace Corps.

In 1976 former Georgia governor Jimmy Carter was the first to use the Iowa caucuses as a springboard to the White House. His message was "a government as good as its people," and buried in his remarks was a vague reference to matching progress on domestic civil rights with a new emphasis on human rights abroad. After he won, this became the cornerstone of his foreign policy and, three decades later, human rights remains central to today's debate.

When Bill Clinton was roaming New Hampshire in 1992, trying to distract himself from his troubles with Gennifer Flowers and his draft record, he often waded deep into policyspeak. His aides rolled their eyes when he mentioned something called the "earned income tax credit," a minor Reagan-era program to help the working poor keep a little more of their wages from the IRS. But by the time President Clinton's term ended, the EITC was one of the most powerful anti-poverty programs in American history, lifting millions into the middle class.