With Texas Gov. Rick Perry's entry into the 2012 Republican presidential nomination, it's worth taking a look at his views on health care, which remains one of the most critical domestic policy challenges facing the nation and one where the next president will have a game-changing impact on the nation's future.
Perry's actions have made his position clear. He has consistently opposed President Barack Obama's health care law, has joined the state lawsuit against the individual mandate, declined to participate in the new federal high-risk pools, and made public his refusal to create a state-level health insurance exchange mandated by Obamacare.
Perry's tort reform push has paid dividends for his state, with 21,000 new doctors and a 60 percent increase in applications since 2003, providing many rural Texas counties with OB/GYNs for the first time in generations. And Texas leads the nation in the creation of new health care jobs - and basically every other type of new job, for that matter.
Yet Perry's personal experience with a recent back surgery also illustrates his perspective on health policy. His surgery involved the use of an adult stem cell therapy that is approved by the Food and Drug Administration (FDA) only for bone marrow transplants. If Obama's FDA has its way, doctors and others will be punished if they promote or advertise in any way the kind of therapy Perry received. Perry's successful surgery shows the value of choice, the kind of choice the Obama administration opposes at every pass.
Throughout his career, Perry has advocated for the freedom of states and individuals to direct their own paths, while understanding this will result in some following the wrong route. He would rather policy decisions be made closer to the people who will experience their ramifications instead of having self-styled elitists legislate all aspects of our lives from Washington.
Unfortunately, those D.C. people won't give up their power easily. Medicaid is a perfect example. Texas has to struggle every year to find additional billions of dollars to fund this broken program. In an effort to gain the flexibility to prioritize care for those who need it most, Perry has had a waiver request in front of the federal government since the Bush administration. Forty months later, Texas still has received no response.
While the political left has criticized Perry for Texas's high uninsured rate - driven almost entirely by the massive influx of immigration and the state's unique demographics - it has refused to allow the state any freedom to innovate or adapt programs to meet its citizens' needs.
Instead, the only ''freedom'' available is for states to remove what little power consumers have left. Vermont, for example, is using Obama's health care law to implement a single-payer system. No similar opportunity exists for states to pursue the opposite course, freeing themselves from bureaucratic limits and applying successful pro-consumer Medicaid reform models, such as those in Rhode Island.
With roughly one of every three Americans on Medicare or Medicaid or both, and our health care future governed by waivers granted at the whim of the Obama administration, the federal government can block any attempts at real innovative reforms. And the Obama administration consistently has done exactly that.
Perry's decision this year to sign on to a health care compact, along with Ohio, Georgia, Missouri, Oklahoma and other states, signals the approach he would take to health care policy. Perry wants each state to have the right to go its own way. If states such as Vermont decide to impose bad policies and drive their economies into the ditch, that's their choice - but other states should have the freedom to create a consumer-directed system and open marketplace offering the care people deserve at a cost lowered by competition.
That kind of freedom would allow people to see and judge for themselves which states end up with lower premiums, better coverage, and a thriving economy.
This is the essence of Perry's policy approach, and not just on health care. His firm embrace of innovation and competition may not find approval among Washington elitists, but it has at least one thing going for it - his solutions work, while Washington's fail.
Domenech (bdomenech@heart land.org) is a research fellow at The Heartland Institute.