The beauty of Federalism in the health care debate

Instead of a centralized power, our Founders established the Federal system they called the United States of America. The Federal government didn’t grant authority to the states. Rather, the individual states, being closer to the people, had the authority over everything not specifically granted to the federal government.

This setup is perfect for trying out various schemes to improve society in different states, and then importing to other states those ideas that actually work. For health care reform, one could go to Massachusetts or Minnesota to see what they have implemented—what are the benefits, what do they need to change?

James Q. Wilson, writing in the Wall Street Journal Online, (A Life in the Public Interest )talked about what happens when the Federal concept is ignored and the process is top-down instead of bottom-up. He mentioned the law of unintended consequences:

“Launch a big project and you will almost surely discover that you have created many things you did not intend to create.

This is not an argument for doing nothing, but it is one, in my view, for doing things experimentally. Try your idea out in one place and see what happens before you inflict it on the whole country.”

The bills currently being developed in Congress don’t seem to have learned from the smaller experiments in separate states; and they certainly don’t project future experiments to try out reforms in smaller markets, and then to promote those reforms for other states. Instead they are attempts to jam down unproven reforms on everyone everywhere in the country.

Being Christian In A Political Debate

I have written previously here and elsewhere about the health care (or health insurance) reform issue. I learned firsthand that stating an opinion in public can encourage debate, but it can also bring out the worst in people.

In a recent ScriptoriumDaily.com post, “7 Suggestions for Christians in the Public Square” John Mark Reynolds wrote “It is hard to talk to someone when you have nothing in common.”

Sometimes it is even hard, but not impossible, to talk with someone when you share some common values because of “how we prioritize values when good come into conflict.” We may “agree on the values”, but prioritize and apply them differently.

A few years back I encountered some faithful Christians with some doctrines that were radically different from mine. I was startled to conclude that they actually believe these things they are saying, but I respected them personally and I realized I needed to continue to relate to them as fellow believers. Sadly, some of them did not reach the same conclusion.

The same thing can happen with the health care debate. That brings us to one of Reynold’s suggestions: "Attacking ideas is different than attacking people". In response to one email about health care I sent which went viral, one person (who admitted that she didn’t know me) named me personally as a “Deather”. She was referring to those who seek disclosure of Barak Obama’s birth certificate and are called “Birthers” (but she didn’t refer to the “Truthers” –9/11 Conspiracy Theorists). Instead of debating the ideas presented, she attacked me.

Reynolds is right though in his 2nd suggestion: “Strong opinions encourage authentic dialogue.” It is only as people with strong convictions speak up and engage in civil debate with others of strong convictions that authentic dialogue takes place. If you strongly disagree with a policy or an idea but say nothing when others present their opinions, there is no dialogue. The recent town hall meetings may have been boisterous (and some participants may have gone over the line at times), but they had the desired effect of getting both sides of the issue before the public and their elected officials.

I encourage you to read the entire article 7 Suggestions for Christians in the Public Square.

In a previous post, John Mark Reynolds quoted Jim Wallis’ comment that health care is a “deeply theological issue, a Biblical issue and a moral issue”, and then replied that “Health care is such a deeply theological, Biblical, and moral issue that it cannot be trusted to the government.

Increasing government control over health care increases the number of ethical issues where government authority will have to be on one side or the other of these disputes.

Sometimes increasing state power is necessary, but it should also be done with care. When religious leaders like Jim Wallis pretend that it is obvious that government should increase its involvement in health care, they have confused the goal (universal basic care) with the means (government programs).”

Again, I encourage you to read the entire article: Too Great a Good for Caesar: Health Care Reform .

There are some health care issues that involve ethical decisions that cannot be entrusted to politicians or bureaucrats whose decisions are politically, not morally, based.

Christians have a responsibility to speak up about moral and ethical issues and not abdicate that responsibility to others. However, we must also be Christian in the manner in which we debate. I applaud John Mark Reynolds for his helpful suggestions as to how that debate can be Christian in tone and manner.