Compacts solve single payer
Clancy ’14 (Dean Clancy – Valedictorian @ Overland High School, Voted “Most Likely to Succeed,” member of the Speech and Debate Team, MS in Journalism @ Columbia University, former Senior Health Policy Advisor @ the United States Senate, former Special Projects Manager @ the US House of Representatives, “Health Care Compact: Let states take the reins of health care away from the federal government,” 16 May 2014, http://www.unitedliberty.org/articles/17644-health-care-compact-a-flawed-idea-whose-time-has-come)
Individual states would voluntarily enter an agreement (an interstate compact) to take over health care spending from the federal government. In those states, most existing federal health programs would be cashed out and folded into a single, gigantic grant to be administered by the state. (Defense and veterans health would be excluded. So would the big tax breaks for employer-sponsored health benefits, which come through the tax code.)
In non-compact states, the status quo would continue unchanged.
Remarkably, the grant would come with no strings: the state would just have to use the money to improve health care. Member-states could even suspend federal health care regulations within their borders!
Each state would receive the amount of money the feds spent in that state, on the relevant health care programs, in 2010, plus an add-on payment to reflect any inflation and population growth. If the HCC were in effect today in all fifty states, the total spent on it in 2015 would be around $937 billion, or about 24 percent of that year’s projected total federal spending of $3.9 trillion.
Think about that: one quarter of the federal budget, handed over to the states.
The Pros
Compact supporters predict this would save a bundle: at least $3 trillion over ten years, assuming all fifty states opt in. That’s because because the grants would grow less rapidly than health care inflation, and thus less rapidly than the current-law programs they’d replace.
Opponents, of course, think that’s a downside. How dare we cut health care spending! But I think most normal people would see the prospect of less federal spending, more local control, no more Obamacare, and the possibility of universal coverage (in participating states), as a plus.
The Left should love this idea. States would suddenly have more than enough money to provide all of their residents with a basic level of health coverage (thanks to all that Medicare money, which they currently have no access to), with maximum freedom to try new ways to deliver care.
So, for example, some states could institute single-player, while others could emulate Singapore and give everyone a Health Savings Account. It would be “laboratories of democracy” on steroids.