In the initial of governmental functions and tasks most social programs such as social security would be transferred to the states. Thus each state would be responsible for retirement programs, medical programs, unemployment insurance, and programs to aid the poor. Consequently, each state would have to make its own estimate of the appropriate level of social and welfare programs. Currently the federal government has medicare for the elderly, medicaid for the poor. Individuals with fringe benefits have medical coverage through their employers, but millions of individuals do not have medical coverage and do not qualify for either medicare or medicaid.
Local governments provide some medical care for individuals lacking medical insurance.
In the proposed decentralization the states would assume complete operational control over medicare and medicaid. Thus each state would have to make the difficult estimate of what level of medical care each individual would be entitled. In making this estimate each state would have to select somewhere between the extremes of only the medical care each individual could privately afford to the best the medical profession is capable of providing. Currently one trend in social programs is for the states to make them required programs of private firms for employees. As informational society develops such a trend would be reversed.