January 25, 2010 12:01 AM
Scott Brown and his truck killed ObamaCare. Now what?
New York Times columnist David Brooks laid out the options for President Obama and Senate Democrats this week. Brooks believes Dems have four options: (1) move forward anyway through the reconciliation process; (2) incremental reforms; (3) strip the tax hikes and Medicare cuts out of the bill and pretend like nothing happened; or (4) blame each other. In the incremental reform column, Brooks mentions a state-by-state, super-federalist approach.
Nearly 80 years ago, the great liberal Supreme Court Justice Louis Brandeis described federalism as experimental government. Under federalism, Brandeis wrote, "A single courageous state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country."
Though Brandeis was on the wrong and losing side of the case in which he wrote that oft-repeated phrase, he was right on the basic idea. There are two primary and interrelated benefits of federalism. The first is that it allows citizens to have greater control over their own lives. It is far easier for the average citizen to have an impact in their state capitol than in Washington, DC The second great benefit is experimentation. On issues of great import, we can try different systems in different states and compare the results.
Two relatively recent examples prove the merit of this approach. In the 1990s, Wisconsin proved the effectiveness of welfare-to-work policies before welfare reform was adopted by the federal government. In the 1970s, the federal government deregulated the airline industry only after a few intrastate carriers in Texas and California proved a deregulated industry could lead to lower costs and higher service for consumers.
Unfortunately, health care policy is not fully subject to full-fledged competitive federalism. Under the current regime, the federal government sets strict rules on Medicaid preventing states from trying new approaches to providing care for the indigent and disabled. A state must follow the rules of the federal Department of Health and Human Services or else lose federal funding. Given the Hobson's choice of matching federal dollars for Medicaid with strings attached or no federal dollars at all, state legislatures across the country have taken the money.
With the election of Scott Brown to the Senate, however, hope is renewed for a competitive federalism approach to health care reform. Democrats should forget about imposing socialized medicine on the entire country and instead allow states to try different approaches.
Vermont could decide to adopt ObamaCare on a state level. Texas could adopt a radical free market approach. Give the states five to ten years. Measure everything. Figure out what works. Then, come back to Washington with better data and pass a bill full of proven reforms.
Just last week, Missouri's House Republicans passed a symbolic resolution rejecting ObamaCare. But it's not enough to merely be the party of "No." Over the past decade, there have been plenty of good ideas on market-based reforms that have been kicked around the Missouri General Assembly, and, for that matter, other state legislatures around the country. But state-based efforts have been hampered by strict federal rules.
Obama and the Democratic Congress could change that. And Missouri Republicans should do what they can to move reform in a better direction. To kick-start further debate on the super-federalist approach, perhaps they should pass another resolution asking Washington for permission to pursue free market approaches here in Missouri.
Jay Barnes is an attorney and writer in Jefferson City, Missouri. He was
formerly chief speechwriter for Missouri Governor Matt Blunt. His columns can
be found at the Missouri
Record.
Hope is renewed for a competitive federalism approach to health care reform. Democrats should forget about imposing socialized medicine on the entire country and instead allow states to try different approaches.
