Referring to the states as “laboratories of democracy” is commonplace in federal jurisprudence–a reverential (if somewhat inaccurate),usually pro-forma bow to our system of federalism, in which states retain substantial areas of sovereignty. The idea is that the Founders left significant authority with the states and those states, with their different political cultures, would try different approaches to lawmaking. Some would work, some wouldn’t, but the nation as a whole is thought to benefit–to draw lessons from the various policy experiments.
The reality, of course, has been somewhat less benign. “States rights” has been a slogan and defense for a lot of pretty racist policies (and not just in the past)–policies the federal government should not have countenanced. In reality, “states rights” tend to be honored when the states are doing stuff that Washington approves, either overtly or tacitly. Let a state exercise its presumed autonomy in ways the feds disapprove–by legalizing medical marijuana or permitting assisted suicide, for example–and all that pious respect for federalism and state autonomy tends to disappear.
So it will be very interesting to watch the reactions to recent experiments in Oregon and Vermont.
Oregon is tackling the very real problem of massive student debt:
The state legislature unanimously passed a bill this month that would allow students to attend public universities without paying anything up front. Instead, the proposal, called Pay It Forward, would require students to pay back a set percentage of their post-graduation income for around two decades. The bill does not specify an exact percent or duration, but supporters say it would likely be 3 percent of a student’s income — or 1.5 percent for graduates of a two-year college — for 20-25 years.
Vermont is doing something even gutsier: it has passed a single-payer health plan.
[It is] a law that sets Vermont on a course to provide health care for all of its 620,000 citizens through a European-style single payer system called Green Mountain Care. Key components include containing costs by setting reimbursement rates for health care providers and streamlining administration into a single, state-managed system. The federal health care reform law would not allow Vermont to enact single payer until 2017; Vermont is asking the administration to grant it a waiver so that it can get there even faster, by 2014.
I have not looked at the specifics of either of these initiatives, and as all policy nerds know, the devil is always in the details. So I’m not here to tell you that either state is ushering in Nirvana or even the Next Best Thing. But it is certainly refreshing to see lawmakers trying to solve real problems, rather than spending their time telling women what we can do with our uterii (uteruses??), or figuring out how to keep people from voting.
I wonder how the do-nothings in Washington–most of whom routinely pay lip service to “states rights”– will react to these experiments.
They should be embarrassed by the contrast. But that would require at least a modicum of self-awareness.
Our Heath Care for profit is in shambles and getting worse, I personally have been doubled billed that only stopped when I threatened to take them to court with my receipt, another time had a Dr walk into my examining room and tell me to see another Dr., than charge me $300 for that well educated advice that took five minutes.
I’m friends with a Canadian Blogger who says their heath care works just fine and costs him nothing.
In France it is the same, and free education as well as other perks…How do they do it?
I will pay attention to what happens in Vermont.
Single Payer, in the form of expanded Medicare ( to include all 300,000,00 of us) is the only administratively and economically feasible solution to this intractable problem.
Medicare’s administrative costs are about 1/8th the cost of
private health insurers. And their administrators don’t make
tens of millions in salaries like the for-profit insurers do.
Our insurance systems did not get monstrously out of whack until they became for-profit entities. Profits take priority over health.
Given the concentration of health insurers in Indiana, and given that Obamacare is expected to add 30 million uninsured to insurance rolls; Obamacare should be a massive job creator for Indiana.