A Healthy Experiment

The nation's governors have assembled in South Carolina for their annual meeting and are discussing, among other things, health care reform.

Two years ago, the nation's governors were wrestling with soaring healthcare costs, rising populations, and agonizing choices over how to keep their Medicaid programs afloat.

Now, as governors are holding their annual summer meeting, healthcare seems less hopeless. Their choices are vastly different as many states embark on unprecedented experiments to revamp the healthcare program for the poor, and healthcare overall.

Massachusetts has captured the spotlight with a universal health insurance plan that demands everyone in the state get insurance, and gives them help to get it. In different shapes and sizes, other states have begun experiments, from West Virginia to Idaho, Florida to Maine.

At the moment I'm less interested in what each state is doing (since New York isn't doing much, and that's where I live) than in the fact that many states are doing many different things. That aspect of the present system is one of the least articulated but strongest arguments against a single system, regardless of who administers it. In a unified system, when things start to go wrong, there is simply no escape.