Neither health care nor health insurance generally are federal issues. Although a problem may occur “nationwide,” it is not necessarily federal. National is not the same as federal. The United States is neither a nation, nor a nation-state, but a union of states. An issue is federal only if it pertains to the Union itself, not whether it occurs in every state or would affect the economy of all the states, which is not a government responsibility. Federal responsibilities are enumerated in the U.S. Constitution (Article I Section 8). Domestic responsibilities are generally the responsibility of the states. Because the states are diverse in many ways, a policy which might be suitable for one might not be suitable for another.
This separation of powers is the principle of federalism established by the Founding Fathers. Federalism prevents the federal government that was created by the states from becoming too powerful at the expense of the rights of the states and the people.
Health care or health insurance are only issues in federal territories or other areas of federal control like military bases or Indian Reservations. It is also a benefit promised to veterans. Otherwise, to the extent that it is a government issue at all, it is a state matter. There is nothing federal about health care or health insurance. Therefore, President Barack Obama’s proposed federalization of health insurance would violate the principle of federalism, in issue which should be left to the states.
Federalism is an example of a larger principle based upon Scripture and first developed by Catholicism that would be called “subsidiarity.” Subsidiarity is the principle that the lowest unit of government as possible should exercise power. It is a principle that is opposite of centralization of power. Centralization makes people less free because it makes government ever more remote from the people, and thus too large to be flexible enough to respond to their needs. It also makes people more dependent on the centralized power. Furthermore, the significant increase in government spending and taxation would reduce the liberty of the people to spend their money as they see fit.
The federalization of health insurance would cause a centralization of power in the federal government of something that it is unnecessary for it to address, as the matter is better left to the states, or to the people. The application of the principle of subsidiarity, through the constitutional principle of federalism, would necessitate opposition to the federalization of health insurance in order to maintain the liberty and independence of the states and the people. With the exception of reforming those few areas where the federal government influences health insurance, such as limiting huge awards in federal civil suits for medical malpractice, any reforms of health insurance must be done privately or by the states.