David Brooks makes a compelling case against singular “global” responses to emergencies like swine flu:
The correct response to these dynamic, decentralized, emergent problems is to create dynamic, decentralized, emergent authorities: chains of local officials, state agencies, national governments and international bodies that are as flexible as the problem itself.
Well, that seems reasonable — and the polar opposite of the Obama administration’s approach on virtually everything. Healthcare is going to be “reformed” by a single, federal, one-size-fits-all plan, complete with a uniform standard (arrived at in Washington) for making all records electronic. Cap-and-trade is a Rube Goldberg system of industrial control, again, run out of Washington. Education Secretary Arne Duncan and the president are all for school reform, but not insofar as it might entail leaving in place a successful “local” program for school vouchers in their own neighborhood.
For a very avant garde guy Obama is sporting an agenda that is straight out of the 1960s. Federalism and free markets are out; big federal government is in. It is the antithesis of what Brooks is recommending. There is little room for innovation or experimentation at the state or local level in the Obama agenda. What if Massachusetts has a better idea for healthcare? Too bad. Maybe vouchers work in D.C. just fine. Too bad. Obama has very smart people, you see, and they know best.
Moreover, the programs he is devising are all hugely complicated and exquisitely detailed. His vision is premised on the notion that if we simply hire enough Washington bureaucrats and write a sufficient number of pages of federal regulations we will master the intricacies and contingencies that arise in each of our citizens’ lives. Our experience shows how easily government messes up on simple things (e.g., a New York fly-over, a DHS report), yet Obama is certain that massive new programs seeking to micro-manage health, education, and industrial output all will come off with nary a glitch.
Imagine instead if healthcare reform aimed for a “dynamic” and “decentralized” system, allowing states to try different approaches. We might repeat the experience of welfare reform where innovative governors (e.g., Tommy Thompson) laid the foundation for smart federal innovation. We might learn from a body of real data to formulate a federal scheme, or decide that people are perfectly happy with a diversity of plans.
That option never seems to dawn on the Obama team. No, they have it all figured out and will, it appears, on a party line vote, revolutionize healthcare for 300 million Americans. Not very dynamic or decentralized. And not very likely to get it “right.”