States can set up federal fight on health care reform

By Tom Patterson
Goldwater Institute
Remember the Freedom of Choice in Health Care Act that was on the ballot last year and barely failed with 49.8 percent of the vote? The Legislature has already ensured it will be back on the ballot next year, where it’s likely to pass. If it does, it could be joined by other states around the country to trigger a much-needed reset of the relationship between the states and federal government.

The 2008 ballot proposition was plain vanilla. It would simply have prohibited laws that restrict a person’s choice of private health providers or the right to pay for medical services. The opposition, well-funded by insurance plans and business groups, argued simultaneously that it would do nothing and that it would limit future legislative options. Whipping out the fear-of-the-unknown card, they claimed, falsely, that Medicare and Medicaid patients could lose coverage. It was all typical technique for a “no” campaign, but in the end they confused enough voters to eke out the victory.

Today, Americans are much more focused on health care policy and they have more reason than ever to build firewalls for themselves against an over-reaching federal government. The powers in Washington keep marching forward, determined to eventually bring our health care options under their control.

The history of past federal programs also suggests a strong need for caution. Courts and bureaucrats have a habit of morphing federal programs into forms vastly more comprehensive than originally intended. Social Security was created as a modest supplement for poverty-ridden seniors. Today’s retirees receive a fraction of the income they could have received if they could have saved and invested their own payroll contribution dollars. Yet Social Security owes to future beneficiaries trillions of dollars that we don’t have, casting a pall over the economic future of the country.

So Arizonans are only being practical to seek protection at the state level from relentless federal intrusions. Yet, even if the Freedom of Choice in Health Care Act passes on the state level, it will be challenged on the grounds that federal legislation pre-empts state law.

The complicated legal arguments about pre-emption will have to be duked out in court. But the threat to freedom-loving people today is the centralization of power in a federal government that ceaselessly expands and intrudes. Surely, our system of federalism doesn’t permit the feds to extend more control over the decisions of our daily lives while the states helplessly look on. Let’s hope the Freedom of Choice in Health Care Act will be the driver for fundamental change.
Tom Patterson is chairman of the Goldwater Institute and a former state senator. A longer version of this article first appeared in the East Valley Tribune.


  1. Is this the same Tom Patterson, M.D. who used to have a company who contracted with local hospitals to provide Emergency Room MDs?

  2. If this ballot measure is approved, will Arizonans be able to choose an abortion?

  3. Dr. Patterson didn’t reveal his personal connection to the health care issue. I think it is interesting when people withhold their backgrounds or credentials from the reading audience. Here is what the Goldwater Institute bio says:

    Tom Patterson has been Chairman of the Goldwater Institute since 2000. He was elected to the Arizona State Senate in 1989, and served as Minority Leader from 1991-92 and Majority Leader from 1993-96. Patterson was the author of legislation creating Arizona’s cutting-edge charter school system and welfare reform program. Until 1998, he was a practicing physician and president of Emergency Physicians, Inc., a 60-physician practice serving emergency departments in the greater Phoenix metropolitan area. Patterson also served as president of the Arizona chapter of the American College of Emergency Physicians. He is a graduate of Yale University and the University of Nebraska.

    Unless Mr. Patterson turned in his license to practice medicine, he is still Tom Patterson, M.D.

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