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.