Yesterday, we paused on the doorstep of defining Washington’s key roles in the process of fostering DNS or dispersed, networked solutions. Once again, those key roles include: standard setter, catalyst, and backstop.
As standard setter, Washington would establish the basic rules of the road; the fundamental requirements, assumptions, or framework under which the other dispersed nodes of the network (the states and their sub-governments) would operate, as they consider, trial, and implement solutions.
In doing so, Washington would not attempt to prescribe the details of every solution or build mammoth, one-size fits all programs. We don’t need more inside-the-Beltway departments, agencies, and offices that require hundreds of staffers and billions of dollars to implement heavy-handed programs and enforce volumes of meticulous rules. Philip Howard has ably demonstrated the limits of such centralized approaches, which consistently fall short of their aspirations for a number of reasons: they stifle “common sense”; they are a step or two removed from the “real world”; they gloss over (fail to recognize) legitimate exceptions to the rules they establish. Instead, we need outlines, which would generally indicate where the states can go and where they can’t, leaving most of the rest of the process to them.
For instance: On the subject of universal health care, several possible, broad standards come to mind:
* All citizens should be offered a commonly defined “base-level” of coverage.
* This “base-level” of coverage should be offered at rates commensurate with the insured’s ability to pay.
* It should also (importantly) be portable (or replicable) if individuals move from one state/jurisdiction to the next.
* No one should be barred from coverage for pre-existing conditions.
* Those who require treatments that exceed the defined base-level should be offered additional coverage, again commensurate with ability to pay and considerate of options that help “finance” (pay over time) the premiums for the necessary coverage.
* Barring a finite list of uncontrollable circumstances, state insurance solutions should be sustainable, with cost-control and abuse-prevention mechanisms.
I realize some readers will label these sample standards as “unrealistic” or “overly idealistic.” Others will demand refinements to them — e.g., to prevent mission creep, which is no stranger to ambitious programs, here or elsewhere. I accept those criticisms, recognizing that I’m not a policy expert, nor am I trying to play one on TV. Instead, I’m only attempting to illustrate the type of broad, brush-stroke guidelines that might be issued by a federal government that acted as standard setter rather than bureaucracy creator.
Next, within this sample framework of standards, the states would be free to trial-and-error different programs, including mixes of free-market, not-for-profit, and state-sponsored solutions. And that’s where Washington’s second primary role — as catalyst — would come into play.
As states experiment with different approaches, measure/report results, and iterate their way to improvements, Washington could catalyze the process through a mix of incentives (for vetted experiments) and rewards (for programs that prove efficient, effective, and sustainable). Federal funds may not be the only form of said incentives and rewards, but they would probably be the most logical and powerful form, as we’ve seen before; e.g., Reagan’s use of highway-funding threats and promises to establish a nationally consistent drinking age. (Granted, that may not be the perfect illustration — it borders on the type of minutiae the Feds may want to avoid — but, for now, I can’t think of a better example to illustrate the point.)
The ultimate extension of the catalyst role would be for the Feds to gradually move away from their position as a collector and (re-)distributor of funds. Sticking with our health-care hypothetical, a state that proves its universal-coverage capabilities might be allowed to raise its tax rates in proportion to a lowering of the federal tax rates for its citizens. This move would help correct the gross imbalance we see today. Using my state, Missouri, as an example: The Feds (on average) collect and spend nearly four times more per U.S. citizen than Missouri does per Missouri citizen. [These calculations are based on (i) the most recent federal budget for which figures were available online, divided by the estimated population of the U.S.; and (ii) the most recent Missouri budget for which figures were available online, divided by its estimated population.]
One of the more powerful points Barry Goldwater made in Conscience of a Conservative was perhaps his most intuitive point. Toward the end of the book’s third chapter, he wrote: “The people of my own State … have long since seen through the spurious suggestion that federal aid comes ‘free.’ They know that the money comes out of their own pockets, and that it is returned to them minus a broker’s fee taken by the federal bureaucracy.” Translation: If we reduced the administrative charges required by centralized solutions, there would be more money available to help those in need through the governments that operate closest to their needs.
Granted, our citizenry is remarkably mobile, moving from one state to the next, and some states are poorer than others; hence, the worthwhile goal of “equal opportunity” may continue to require some re-distribution of funds, as will the scale of monies required for national infrastructure and defense projects. Net: We may never get to a 1:1 ratio — where the Feds collect and spend a dollar per U.S. citizen for every dollar collected and spent by the individual states on their respective citizens — but I do think today’s 4:1 ratio (or worse) is inefficient and can be improved or re-balanced.
Another reason why the state:fed balance may never be 1:1 is the need for Washington’s third role in a dispersed, networked paradigm; namely, its role as a backstop.
One the more common arguments I hear against a states-driven approach to universal health care is the barrier presented by cycles of economic malaise. In those times, state budgets naturally contract and safety-net projects are often the first to be curtailed.
Thus, as backstop, Washington might act in these situations like it does after natural disasters strike, providing incremental funding and other resources to help state and local governments bridge the gaps and restore their situation to BAU (business-as-usual) status.
Such backstop or bridge funding would not be distributed without conditions. Priority funding might be reserved for the states that present the most realistic plans for budget re-alignment, for managing their way through the budget crisis, including estimates on the level of bridge-funding required and (perhaps) a post-downturn re-payment plan.
Several logical questions arise from this outline of dispersed, networked solutions and Washington’s roles in fostering those solutions; questions like:
* Doesn’t Washington already (largely) act in this manner today?
* Wouldn’t the DNS approach be too slow and haphazard to be accepted by an impatient American electorate?
* Don’t certain issues require a centralized rather than dispersed approach?
We’ll consider these and related questions tomorrow, in the final chapter of this series.