Why not apply the federalism principle. This comment https://news.ycombinator.com/item?id=6622746 by protomyth on another Obamacare topic points out "The writers of the law wanted a top-down centralized approach and that isn't how the US Constitution or US States are structured." and why we shouldn't be surprised by it's abject top level failure.
ADDED: to the initial responses to this: no, not even close. E.g. explain where the Federal government has a role in this beyond the FDA's standards establish what can be sold, which are in part an economy of scale.
E.g. the Naval Observatory and NIST each maintain independent ultra-precise time bases for the nation, which strikes me as just right. At the national level, Daylight Savings Time is promulgated, but states like Arizona (minus the big NE Indian Reservation) and Hawaii where it's not a good idea don't observe it.
But most things should be left to the "50 Petri dishes" of the states (or groups of them, e.g. the Multi-State Lottery Association http://en.wikipedia.org/wiki/Multi-State_Lottery_Association ). Romneycare? Sure, why not try it? Obamacare? I think you know my answer to that.
And please don't make replies that don't factor in the Federal government's interference in this starting with WWII.
You mean, set national standards and leave the implementation to the states within those standards, with feds only stepping in if the states refuse or fail?
That's exactly what PPACA does for most things -- including the exchanges.
"You mean, set national standards and leave the implementation to the states within those standards, with feds only stepping in if the states refuse or fail?"
No, that's a modern bastardization of the idea, where the Federal government claims to be following the letter of the idea but steps in with all sorts of central mandates and requirements even so. They've got some pretty good rackets going on with "optional" compliance to programs tied to truckloads of money, too.
Federalism would be... let the states handle it. No Federal requirements. No Federal interests. No Federal laws. If Vermont wants full on state health care with no private option and Texas wants full private healthcare with little more than disability assistance, let them. Washington DC interferes with neither.
The PPACA hasn't got a drop of Federalism in it.
Whether you consider that a problem is up to you. I'm just explaining that it doesn't have any.
Kind of an ironic story to bring that up with. Perhaps if more states had taken advantage of their freedom to apply the federalism principle, things would have gone better.
ADDED: to the initial responses to this: no, not even close. E.g. explain where the Federal government has a role in this beyond the FDA's standards establish what can be sold, which are in part an economy of scale.
E.g. the Naval Observatory and NIST each maintain independent ultra-precise time bases for the nation, which strikes me as just right. At the national level, Daylight Savings Time is promulgated, but states like Arizona (minus the big NE Indian Reservation) and Hawaii where it's not a good idea don't observe it.
But most things should be left to the "50 Petri dishes" of the states (or groups of them, e.g. the Multi-State Lottery Association http://en.wikipedia.org/wiki/Multi-State_Lottery_Association ). Romneycare? Sure, why not try it? Obamacare? I think you know my answer to that.
And please don't make replies that don't factor in the Federal government's interference in this starting with WWII.