Those of us in the Hamiltonian tradition sit crossways in this debate. Alexander Hamilton was not shy about concentrating power in Washington if he thought centralized authority was necessary to achieve national goals. On the other hand, he did not believe central decision-makers had the ability to direct an infinitely complex and changing world. He centralized goal-setting while decentralizing decision-making.

In that tradition, my own view is that the individual mandate is perfectly acceptable policy. We effectively have a national health care system. We all indirectly pay for ill, uninsured people who show up at emergency rooms. If all Americans are in the same interconnected health care system, I think it’s reasonable for government to insist that all Americans participate in the insurance network that is the payment method for that system.

But I think the Obama administration made a disastrous error in centralizing so many of the cost-control elements of the new health care system. I don’t care how many comparative effectiveness research studies they commission, there is no way centralized dirigistes can keep up with a complex, innovative system. There is no way government can adapt quickly to failure.