The latest Gallup results suggest infusing more geographic competition into the health care marketplace, which Republican ideas support, would be a good idea

Ryan Streeter
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Here's another reason why repealing ObamaCare and replacing it with consumer-driven health care reforms would be a good idea: it would fit well with our well-established tradition in America of interstate competition.

Why has Texas been the subject of numerous comparisons with California? Because it has been creating jobs and attracting migrants into the state with a low cost of living and ease of doing business while the Golden State is hemorrhaging residents and jobs. States that resemble Texas, with lower taxes and lighter-touch regulatory environments, did well in the last Census.

States compete with each other in America, and they always have. It's part of what makes our society so dynamic.

So these latest Gallup results raise some interesting questions.

People with investable assets over $10,000, which the Gallup poll refers to as "investors," rate being close to good medical facilities as the top factor determing where they will retire. Low taxes and lower cost of living are also important.

In another question on the survey, 72% said that the cost of health care will have a major impact on their decision about when to retire.

The implication here is that the premium support, defined contribution model of public health care, combined with other reforms such as the ability to purchase health care across state lines, would infuse "health care competition" into the marketplace in a healthy way. To be clear, this is a step beyond where the GOP/Ryan plan currently is. The premium support model in the GOP plan would be modeled on the health plan that members of Congress currently enjoy, in which seniors select from a list of providers.

But if we were to go a step further toward greater geographic competition, states could use their health care policy environments as a way to attract people in their later years - at a time when many of them have plenty of interest in keeping health care costs low to free up as much disposable income as possible for golf, visiting the grandkids, and travel.