Peter J. Nelson, of the Center of the American Experiment, has been watching the designs of lawmakers in Minnesota's capitol.

Though there has been a lot of legislative activity since he wrote this essay, the principles endure.

He writes in part:

"I went to a number of the meetings at which policy experts and lawmakers discussed these ideas and, frankly, I was impressed. The discourse revealed that lawmakers knew the issues and were serious about finding solutions. The trouble is that they rarely allow their designs to be subject to the competitive forces that winnow the bad and reward the good within private markets.

For example, the task force recommends establishing a health-insurance exchange to sell individual and small-group insurance products -- but if voluntary use fails, then "use of the Exchange may need to be mandated." In other words, if alternative outlets for insurance remain more attractive -- i.e., more competitive -- the state may ban them!"

Nelson then explains that much of the problem with health care today is the "near absence of health-plan consumerism" and lack of competition among health care providers.