Health Care is simply too large and complex to manage at the federal level.  How can we expect Washington bureaucrats to solve a problem that they’ve helped create over the past several decades?

In a Wall Street Journal article, former Governor Mitch Daniels of Indiana says, “Unless you're in favor of a fully nationalized health-care system, the president's health-care reform law is a massive mistake. It will amplify all the big drivers of overconsumption and excessive pricing.”  

Governor Daniels and twenty other governors signed a letter to Kathleen Sebelius requesting more flexibility on health care reform.  That’s a step in the right direction and we think the best solution is to return the responsibility and authority for health care to the states, where the problem has a better chance of being solved.

Missouri State Representative Eric Burilson says, "Our bloated national healthcare system is in desperate need of reform and innovation. Instead of focusing on more big government systems we need to restore authority to the states to seek patient-centric solutions."



Congressman Doug Collins (R-GA) introduced a House Joint Resolution legislative proposal for the Health Care Compact, a breakthrough governance reform that allows states to clean up the health care mess created by the federal government. Click HERE to read H. J. Res. 50.


The Health Care Compact moves the responsibility and authority for regulating healthcare from the federal government to the states. Is this a good idea?

Yes, for two primary reasons:

  1. Healthcare is simply too large and complex to manage at the federal level.
  2. States have generally been shown to be more effective regulators than the federal government.

To demonstrate the challenge of regulating healthcare at the federal level, consider the following facts:

  • A federal system impacts 300+ million people
  • Healthcare spending exceeds $2.3 trillion annually
  • More than 14 million people work in the healthcare industry
  • There are 2,688 pages of regulations for Medicare and Medicaid

Centralized planning of an industry that is this large and complex is not possible, and has never been successful in the history of mankind. By comparison, the US military "only" spends about $1 trillion and employs about 2.5 million people - and has the benefit of providing a public good, rather than a consumer service.

By pushing responsibility and authority down to the states, the problem becomes much more solvable. Many states have only a few million citizens, and there are dozens of developed countries in Europe and elsewhere that have effective regulatory regimes operating at this scale.

With regard to the second reason, when comparing state vs. federal regulation, ask yourself the following questions:

  • Which transportation system runs more efficiently? Your state highway system or Amtrak?
  • Would your state university get better results if it were run by the Department of Education?
  • Which security system is more responsive and effective? Your local sheriff's department or the TSA workers at the airport?
  • Which must operate with a balanced budget? Federal or state government?

State governments, of course, are not perfect. State officials have the same types of incentive and power relationship issues as federal officials. But they serve smaller districts, live closer, and are more accountable to their citizens than the bureaucrats in Washington DC. And the elected officials are easier to replace because of small district sizes.

Given a choice between a state-based and a federally regulated healthcare system, we believe that the people will prefer returning responsibility to the states.

Join the Movement!

Become a part of the Health Care Compact today!