October 13, 2015

Health Care Compact States Choose Autocracy over Democracy

Robert Graboyes

Senior Research Fellow

Matthew D. Mitchell

Senior Research Fellow
Summary

In a bold effort "to protect individual liberty and personal control over Health Care decisions," nine states have approved a Health Care Compact to claim some autonomy from the Affordable Care Act, Medicare and Medicaid; two other states are considering joining them. The problem, however, is that in health care, most of the compact's signatory states have poor records with respect to individual liberty and personal control over care.

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In a bold effort "to protect individual liberty and personal control over Health Care decisions," nine states have approved a Health Care Compact to claim some autonomy from the Affordable Care Act, Medicare and Medicaid; two other states are considering joining them. The problem, however, is that in health care, most of the compact's signatory states have poor records with respect to individual liberty and personal control over care.

The controls and strictures that these states place on patients and health care providers differ from the Affordable Care Act in style, but not in spirit. In both, the central guiding principles are paternalism and protectionism. The states, or their appointed medical boards, forbid patients and providers from using safe, effective modes of care and protect the finances and turfs of doctors, hospitals and others by shielding them from competition.

As a result, the supply of medical services and the development of new modes of care are both stymied. The compact states could unilaterally grant their residents individual liberty and personal control – no federal approval necessary. They have chosen not to do so.

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