Over the past half-century, the federal government and other institutions have increasingly taken control of every American's health care. It is time to restore that control to individuals and families, both as patients and as consumers. This will require a uniquely American solution to our health care crisis--a solution that can and should arise from the states.
States have a crucial role in ensuring that every American has the opportunity and the ability to choose the health insurance and medical care that offers the best value for their health care dollars. For too long, key health care decisions have been made for patients by someone else, often employers or the government. Too often, this has meant that the interests of others are given priority over the needs of patients. It is only when individuals and families are able to choose for themselves among competing private insurance plans that health insurers and health care providers will have the right incentives to provide patients with better products and better results at better prices.
An essential characteristic of American health care reform must be that any reform respects the diversity and autonomy of the states. Significant variations exist among states, not only in geography and demographics, but also in how their health insurance markets and medical delivery systems are organized and financed. The states must be permitted to retain and exercise their authority to customize solutions to meet their citizens' particular circumstances and needs.