Clay Risen makes a point about health care in Tennessee that goes just as well for Rhode Island:

But focusing on Bredesen solely as a slash-and-burn free-marketeer misses the real nature of Tennessee politics and, I think, a strong argument for a national health care system. Tennessee had a great, if bloated, system in need of reform, not gutting. But the sharp rightward turn in state political sentiment in the 1990s–a turn that, amazingly, continues to gain speed today–means that any effort to raise revenue is a non-starter, and that the only acceptable reform is to eviscerate the system. It’s a case in point for the downside to state-level experimentation, and evidence that, at least in conservative states, voters are willing to move backwards, not forwards. That’s no way to build a better health-care system.