Health Care Compact among states is the alternative to Obamacare

Op-Ed by Leo Linbeck III and Eric OÕKeefe
Washington Examiner

April 6, 2011

Most Americans agree that our health care system is broken. No one can blame President Obama for taking up health care reform as a priority of his administration; the system was financially unsustainable. But after one year under the Patient Protection and Affordable Care Act, we are even further from a cure.

Supporters of the Patient Protection and Affordable Care Act claimed that the new reform would address the symptoms. But the early results suggest that it limits freedom and increases costs. This is evidenced by the 1,040 waivers granted to states and organizations that sought exemptions from new regulations.

When looking at the health care problem as a whole, the fundamental issue here is not a problem of policy. It is a governance problem.

Our health care system is too large and too complex to manage at the federal level-- and too important to be debated outside the earshot of citizens. That is why states are uniting around the Health Care Compact.

The Health Care Compact is a governance reform. It would change who decides health care policy, not who or what is covered. The Health Care Compact enables citizens to engage in the policy process at the state level, and to prescribe laws that match the needs of their communities.

Unlike most such initiatives, the compact does not presume to "solve the health care crisis." It does not promise, for example, to guarantee coverage to the 47 million Americans who reportedly lack insurance.

The compact's goal is different. We just want to make it possible for Americans to exercise greater control over their health care options. This would be accomplished by relieving the federal government of the responsibility for health care policy and returning it to the states. As decision making is transferred from the federal government to the states, so would control over federal health care dollars.

The Health Care Compact is needed because no centrally planned, top-down reform can fix health care throughout the United States. Each state should craft its health care policy to fit the needs of its residents.

Some states may choose a single-payer system, while others may opt for a health savings account system with subsidies for seniors and low-income residents. Under the Health Care Compact, each state decides which plan is best for its citizens.

The interstate compact is not a radical idea. Compacts are simply voluntary agreements between two or more states.They have been used throughout U.S. history to allow states to coordinate in important policy areas.

Authority for compacts was established in the Constitution (Article I, Section 10), and more than 200 such agreements are currently in effect. They are voluntary agreements between states that, when consented to by Congress, have the force of federal law.

Citizens and state legislators in 12 states are working to get the Health Care Compact passed by their legislatures, and the compact is being actively discussed in at least 25 additional states.

Over the past year, we have seen evidence that health care reform should not be made in a centralized bureaucracy and that states and local organizations should instead seek the responsibility and authority to regulate this system for their residents.

One year ago, Obama was asking the question "Who or what should be covered?" We know the question central to effective policy discussions is "Who decides?"

For that question, the Health Care Compact has an answer.

Leo Linbeck III is vice chairman of the Health Care Compact Alliance, CEO of Aquinas Companies LLC, and a faculty member at both Rice University's Jones Graduate School of Business and Stanford University's Graduate School of Business. Eric O'Keefe is chairman of the Health Care Compact Alliance and CEO of the Sam Adams Alliance.



Who should make decisions about health care for you and your family – Washington insiders or you? We think you should decide. Let’s put citizens back in control by implementing The Health Care Compact.