Sunday, March 6, 2011

Should Healthcare Be Provided on a State by State Basis as Romney Says?

First of all let’s get one thing straight the real conservative objection to the new healthcare law is not based on their viewing it as a costly government expansion, an intrusion into their lives or a mandate that everyone have insurance. Oh sure, some of the flock have ingested that kool-aid but the leadership knows that the law will reduce the deficit, cover another thirty-five million people and inhibit the insurance companies from treating policy holders like second class citizens. And therein is the rub. The real objection is that the insurance companies, hospitals and pharmaceutical companies do not want the negative impact on their bottom lines or the loss of control over an industry they consider their private playground.

It would be easy to turn this writing into a rant against insurance companies, hospitals, pharmaceutical companies or politicians who sell their votes to assuage the special interest in whose pockets they ride around in. Anyone with any common sense already has that piece of the puzzle figured out though and it would be preaching to the choir and a waste of time. Unless of course it added to the national disgust over politicians selling their votes just enough to push us into a grassroots effort to implement real fundamental campaign finance reform and congressional term limits but that is not likely even though my hope springs eternal.

My focus instead is on Romney’s ill thought out defense he is postulating relative to the bill he designed and pushed through the Massachusetts legislature. In many respects it is an almost exact precursor to the new healthcare act. President Obama has even given Romney credit for helping to design and formulate the national bill first on a state level. He of course is not thrilled that the president singled him out for such praise because the rest of the republican presidential hopefuls have turned it against him by pointing out what they want everybody to perceive as the bills faults and Romney’s endorsement of them. He has responded with the rather weak argument that the bill was an experiment designed for local use in Massachusetts and that while he thinks it works pretty well in that state there are some things he would change about it and that he would never use it as a template for a national plan.

He then gets into a convoluted and dubious conversation about states’ rights and his opinion that healthcare should be a local problem with local solutions and no intrusion by the federal government at all. This argument makes him look and sound pathetically weak, intellectually challenged and desperate to hold the highest office in the land even if he has to look foolish in the attempt. If healthcare were ever to be a strictly local problem solved on a state by state level it would be an unmitigated disaster. What would states like Mississippi & Arkansas, West Virginia & Tennessee, South Carolina & Montana and Kentucky and Alabama do when all of their residents moved out of state because their healthcare was only equivalent to that of a turn of the century village where the doctor and the dentist were the same individual?

Those states like the ones mentioned above with very poor populations and minimal resources if left on their own to provide healthcare without any intervention (money) from the federal government would soon see a mass exodus that would start with the sick and spread from there. Then there are the states with low population counts like Wyoming, Vermont, Alaska and The Dakotas that would have the same problem in that they would not have the economic resources to provide top quality healthcare for everyone if it were managed strictly on a local basis. Even California would be unable to cope without federal assistance. So no Mr. Romney healthcare cannot be solved, provided or of high quality without the combined effort of the whole country including the federal government.

Maybe the place to start the conversation is whether we as a country see healthcare as a right or a privilege? If it is a right that imbues to all of us like life, liberty and the pursuit of happiness and we come to a consensus in regard to that it changes the nature of the conversation from one where all the special interest are trying to protect profit, territory and control to one of how do we as a nation ensure, codify and provide that right to every person. If after a national dialogue led by our president and politicians we decide it is a privilege the conversation also becomes easier to have in that we all know who the privileged are in this country. They are the top one percent of wage earners who get all the tax breaks. In that case healthcare will remain as it is and as justice is in this country slogans over the supreme court to the contrary, you will get the volume and quality of each that you can personally afford end of conversation, finis.

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