Democrats Should Embrace States’ Rights
Alex Massie argues that the current inability of the Democrats to pass meaningful health care reform, one of their signature issues, despite overwhelming control of the government shows the system is broken.
It’s more difficult than it was in LBJ’s day, mind you. All the horse-trading that once went on in private now takes place in a world of Twitter and blogs and email and 24/7 news and a permanent campaign that is exhausting to follow, never mind survive. Everything is judged prematurely, nothing has time to settle and there’s very little opportunity for proper contemplation.
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Of course, that broken system is very useful when the other party is in power. Democrats didn’t mind that the system helped defeat George W Bush’s social security reforms. Now, however, the boot is on the other foot. And it’s fair to say that plenty of smart liberal commentators are feeling pretty bad about it.
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Congress, of course, is massively unpopular regardless of which party controls it. The public wants Congress to do stuff but also wants Congress to frustrate the bad or scary ideas the other mob propose. That’s a recipe for confusion and, in the end, legislative constipation. It’s like trying to brake and accelerate simultaneously.
There’s an argument to be made, then, that the United States is currently in the midst of an experiment that will go some way towards demonstrating the limits of liberal democracy. Or, to put it another way, how scaleable is democracy? And how scaleable is it in a country as diverse and disputational as the United States? Can you actually govern a country of 300m people effectively while also operating within the framework of enlightenment thought?
His solution: Send it to the states.
If everyone gets to supply ingredients for a cake baked by Congress it’s hardly a surprise that the end result is indigestible. Fewer ingredients and more, but smaller, cakes might produce a better result. National legislation, almost by definition, must ignore local tastes and preferences. Nor, in a country as vast as the US, does national legislation necessarily offer efficiencies of scale that outweigh their drawbacks.
It makes a lot of sense. Indeed, the bluest states, the ones that want it most, would presumably pass some sort of state-run or state-option system rather quickly whilst the reddest states would remain holdouts. Everyone, excepting perhaps blues living in red states and vice versa, would be happy.
Alex is engaging a little gun jumping, doncha think?
Unfortunately, federalism is inconsistent with progressive utopianism. The idea of convincing someone with a smaller pilot project that it is in their best interests to implement some sort of social engineering program instead of forcing everyone to do it becayse you just know what is better for them would seem to be anathema to most progressives.
It seems to me that I took some crap in this space a month or so ago for noting that federalism was meant to allow a lot of little experiments in democracy where the better ideas would win out over time. Sadly, some folks seem to think they already have all the answers and their hubris blinds them to the deficiencies and unintended consequences of their hasty, ill-considered actions, e.g., rushing through forklift legislation for a massive change in health care for everyone that few have read and even fewer understand rather than implementing an incremental approach that gives the affected cultures and organizations time to adapt to what must be very significant changes, no matter what shape reform ultimately takes. The ludicrousness of the assertion that something, anything, must be done right now is exceeded only by the insane presumption that the sausage being produced will be the perfect sausage, delivering miraculous levels of service to more people at a lower cost with minimal effort and no sacrifice! Why, who could possibly be against that?
The public’s distaste for Congress is more than just what they do and don’t do. The public rightly sees congressmen as being for sale, corrupted by the drive for reelection and power. State legislatures are similarly corrupt but no to the same degree and still somewhat accessible to the common citizen.
Like Sam I think it may be too early to make a call on health care but we can hope it fails. Why not let the states test new policies before the nation takes them on?
From a practical standpoint, you have to deal with the federal preemption of state laws on employee benefits under ERISA and possibly even the tax incentives from the federal income tax’s treatment of such benefits.
But also wasn’t their evidence or at least concern that the Massachusetts program was drawing less healthy people into their state?
I’m not sure the blues living in the bluest states would be that happy. See Mass. and their health care.
I do agree that it is the right way to go (and is actually the way the constitution envisioned the country working). Then we could let the blue states create their utopias and study the results. Again, see Mass.
I’m assuming that those of you who support this type of federalization would also support the reallocation of federal tax dollars that would be necessary to support it. Since most red states are net recipients of federal money, I somehow think that the residents of the red states would not be as welcoming of this proposal as Alex and James may think.
Sure, although it would be a more general system. Basically, the federal government would offer funding (whether in the form of a percentage of costs or a lump sum payment, or even in the form of delegating a certain amount of federal tax revenue) to the states (earmarked for health care), provided that they created a system that met certain standards in providing universal coverage and care, and agreed to allow the federal government to investigate potential abuses and conduct studies.
That would allow the states to experiment with a variety of universal health care models, while adapting to the variation in costs on a state-by-state basis.
States are almost always open to more money as long as the money stays there (and they don’t get slammed with an unfunded obligation later when it runs out), and that usually applies even when the program is controversial. A major part of the integration of the school system in the 1960s, for example, was due to a massive expansion in federal school funding to schools who met the requirements.
For what it is worth, Canada and Germany both have federal systems, and both have socialized medicine (of very different types, I would add).
Alex is almost proposing a confederal arrangement which also oversimplifies the blue/red dichotomy.