The EFM Feature

Some conservative commentators scoff at Mitt’s argument that his Massachusetts reforms are entirely consistent with a federalism-based approach to health care and that one can entirely consistently support the essence of MassCare while opposing Obamacare.

Yet consider this: Federalism has at least two great benefits. First, as many have noted, a federalist approach allows for states to be the “laboratories of democracy,” where ideas are tried, tested, and reformed before they are nationalized (if they ever are nationalized). But equally importantly, federalism is fundamentally more democratic than nationalization because it gives the citizens of any given state greater control over their own government and own lives. In other words, the citizens of different states may want different health care programs and may choose to spend their tax dollars differently.

I’m reminded of this second benefit by a new poll showing that fully 84 percent of Massachusetts residents are satisfied with the state’s health plan.

Wait a minute! I thought MassCare was a failure. An albatross. The kiss of death. But how can a “failure” achieve such high marks in Massachusetts? Perhaps because the plan — passed with overwhelming bipartisan agreement — represents the kind of health care that its citizens want. Obviously Texas or Alabama or Ohio residents don’t want MassCare, but Massachusetts citizens like it. That’s federalism at work.

Obamacare is a one-size-fits-all monstrosity. MassCare is targeted for the needs of a particular state whose citizens have different desires and goals than citizens in other states. This isn’t political spin; it’s political reality.

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