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Health Care / Free-Market Reform

The Benefits of Federalism and Self-Government

By John Payne on Jan 12, 2011

Here is a fantastic video made by the students of Young Americans for Liberty at the University of Virginia (full disclosure: in my spare time, I am the Missouri State Chair for YAL) showing how we can make more people happy by keeping the ability to make choices at more local levels:

The idea has almost innumerable applications, but the most relevant example for Missourians today is the federal health care reform bill. Missourians overwhelmingly rejected the portion of the law requiring all Americans to purchase health insurance when they voted for Proposition C in August. However, barring repeal (effectively impossible) or a court injunction (more likely, especially if more attorneys general, like Missouri’s Chris Koster, join the pending lawsuit on the matter), we will all be forced to participate in a program that most of us dislike.

If decisions about health care policy were left up to the states, we could have a multitude of systems, which would better reflect the wishes of individual voters and generate more information about which policies work best. Some politicians in Vermont, including the new governor, have floated the idea of creating a single-payer health care system for the state. I think that’s a terrible policy because it removes competition from the system, and along with it any incentive to perform better-quality work for less money, but it is certainly within Vermont’s rights under the Constitution to try it. If the program succeeds, great. If it fails, we can all learn a valuable lesson and it will be far easier to change a state law than federal law.

Of course, the best system would be no system at all: Allow all individuals to decide what kind of health care plan they want. (We could design a health insurance voucher program for those without the means to pay for it on their own. This would allow them to choose among a number of options instead of being forced into a government program.) Government rules are one-size-fits-all by nature, but each person has different needs and wants. We are happiest when we can pursue those goals as we see fit.

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John Payne

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