The federal government could certainly pass a free market consumer bill of rights that guarantees consumers and insurers the right to negotiate terms and conditions which are agreeable. That would preempt state mandates. Will the bill go that far? No. At the risk of ending the theoretical speculation I had an email exchange with someone who asked to be identified only as someone assisting in the Rudy plan’s development. As for both these issues the idea is to give states benchmarks to meet to reduce mandates and increase availability of affordable coverage. If they don’t succeed, the plan would then open up interstate sales. This person acknowledged that states will want to continue to play a role and that the idea is not to entirely pre-empt their role.

My interpretation now: Applying pressure to remove state mandates and moving toward a national market are steps in the right direction. It was a breakthrough in education when school choice advocates pushed through plans to allow parents to send their kids to other schools if their home school failed. They didn’t rail against the idea because parents did not from the get go have the right to select any school. Is it pristine free marketism? No, but I do recall a Friedmanism. He often said “I am in favor of cutting taxes at any time, in any way, in any form.” I for one favor any increase in freedom in health care, at any time, in any way, in any form. If others have better ideas I’m all ears.