Block grants and the resurgence of federalism

In an address, this past summer, to the National Convention of State Legislatures, President Reagan captured to essence of the block grant proposal in a sentence. "Our task," the President said, "is to restore the constitutional symmetry between the Central Government and the States and to re-establish the freedom and variety of federalism." Consolidating the current profusion of complex and often overlapping Federal health grants into four State-administered packages will greatly reduce administrative costs and allow us to make wise use of scarce health dollars in a time of economic trial. At the same time, these changes will give States the managerial and policy flexibility that they need, but have lacked, to respond to their own most pressing needs. Of perhaps most importance in the long run, this system of grants will return a just portion of responsibility for the preservation and improvement of our health care system to the States, their communities, and the people. It is precisely this kind of equilibrium, this symmetry, that the President had in mind and that, for too many years, the Federal-State-Private partnership in health has been without. The restoration of this equilibrium, it should be noted by all, is underway.