Who Is Best Able to Fix the Problems with Health Care?
The states, with real encouragement from Washington. There is a good reason that the U.S. has a federal system: It works. And there is precedent for allowing states to lead the way in reforming ineffective federal programs: Encouraging states to experiment helped fix the welfare system by allowing controversial work requirements and time-limited benefits to be tried in a few states first. If the federal government wants to push states to improve coverage, it can set agreed targets with individual states. The states can propose ways of achieving those goals — including removal of bureaucratic and statutory rules that block innovation. If a state does not reach those goals, then Washington could propose a new agreement with the state based on what has been learned in the meantime from other, more successful states — not a predetermined public plan designed by committee years earlier. Stuart M. Butler, Ph.D., is Vice President for Domestic and Economic Policy Studies at The Heritage Fou
