THE COMING FEDERALISM DIVERSION. As Republicans fight in the coming years to preserve an indefensible health care system, one argument is inevitably going to be that health care should be "left up to the states" rather than being addressed by a "one size fits all" federal solution. As Bush's actions yesterday make clear, however, this is unprincipled nonsense. Republicans have no problem with federal standards and programs in health care if they mandate a lower baseline for support than states would otherwise choose, involve funneling large amounts of subsidies to pharmaceutical companies, etc. As is almost always the case, federalism is simply a dodge to avoid discussion of substantive issues someone would rather not engage on their merits. This argument will be necessary in health care debates because a rational, universal health care system will require federal intervention to succeed, but crying "federalism" is a lot easier than trying to defend a health care system that ensures less coverage for more money without better health outcomes than other comparable democracies. --Scott Lemieux
