Holding the GOP accountable, part 3: health care edition

Ezra Klein

Sens. Ron Wyden (D-Ore.) and Scott Brown (R-Mass.) introduced the “Empowering States to Innovate Act.” The legislation would allow states to develop their own health-care reform proposals that would preempt the federal government’s effort. If a state can think of a plan that covers as many people, with as comprehensive insurance, at as low a cost, without adding to the deficit, the state can get the money the federal government would’ve given it for health-care reform but be freed from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else in the bill.

In general, giving the states a freer hand is an approach associated with conservatives. On Wednesday, Sen. Orrin Hatch (R-Utah) sent a letter to the Republican Governors Association advocating exactly that. “The most effective path to sustainable health care reform runs through the states, not Washington,” he wrote. If it’s really the case that the states can do health reform better, Wyden and Brown are giving them a chance to prove it.

One state that wants to prove it is Sanders’s Vermont. “As a single-payer advocate,” he says, “I believe that at the end of the day, if a state goes forward and passes an effective single-payer program, it will demonstrate that you can provide quality health care to every man, woman and child in a more cost effective way. So I wanted to make sure that states have that option.” Vermont’s governor-elect, Peter Shumlin, is on the same page. “Vermont needs a single-payer system,” he said during the campaign.

Single-payer, of course, is even more objectionable to conservatives than the existing health-care law. But that’s the beauty of this option: It allows the liberal states to go their way, the conservative states to go their way, and then lets the country judge the results.

This is excellent. It's a put-up or shut-up plan. No more rhetoric, no more theory, put your ideas into action and let the nation judge what works. If Vermont's single-payer system proves to be the least-costly with the best benefits, it will be adopted by the other states. If a consumer-based system like Tennessee wants proves to be more workable, it will win adoption by other states.

This is democracy in action and should be acceptable to conservatives as it puts health care in the hands of the states, the market and the people.

I've grown tired of the dishonest arguments coming out of the right and I'm very much in favor of proving to them that progressive ideas work. Let them do the same. In the same way that I'm in favor of letting Rick Perry try to secede and see how that works out, I'm also in favor of letting the states be the laboratories of democracy.