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Thursday, March 25, 2010

Welcome Home: Health Care Reform Bill Passes Congress

I just got back from 2 weeks in the Haitian island of LaGonave to find out that in my absence congress actually passed health care reform.  Organized medicine is generally in support of it, as I am generally in support of it, and I hope that we can now get to work and do what we can to make it live up to what I see as excellent potential for reducing costs and improving quality and accessibility.

On my dining room table, though, was the local newspaper, with a headline about our governor, Butch Otter, who had been fuming that Idaho would resist enactment of the new bill. Some information just makes me tired, and seeing this explosion of outrage over something which, though certainly not perfect, is a really good start, makes me tired. I then read an article in the New England Journal by T.S. Jost which addressed the issue of state resistance to health care reform.  He expresses the issues well, and with good detail.

"I know of two other significant state campaigns — one ongoing, one historical — to rally or support state citizens in resisting federal law. In the ongoing effort, more than a quarter of the states have now legalized medical marijuana in the face of a federal prohibition. Although the Supreme Court has emphatically upheld the authority of the federal government to outlaw medical marijuana, the Justice Department announced last fall that the prosecution of users of medical marijuana was not “an efficient use of limited federal resources.”5 It is possible that the federal government will eventually conclude that it is not possible to enforce the individual mandate for health insurance. But if individuals successfully resist accepting responsibility for being insured, there will be no way of expanding affordable coverage in a system that depends on private insurers. If government funding of health care must therefore be increased, it may not be the result resisters want.
In the historical effort, demagogues such as the late Senator Harry Byrd (D-VA) mounted the Campaign for Massive Resistance to school desegregation in Virginia and other states during the 1950s and 1960s. Virginia passed a series of statutes intended to maintain the strict segregation of its schools, even going so far as to close the public schools in one county for 6 years. The legislation was held unconstitutional by the federal courts, and the campaign eventually collapsed. Today, most Virginians regard the whole episode as an embarrassment. The state legislature has even adopted reparations legislation to help people who were denied an education during the campaign. Perhaps if health care reform is successfully implemented and Americans come to fully appreciate its benefits, they will look back at the current efforts with similar embarrassment.
These resistance efforts are not about law — they are about politics. But of course at this point, health care reform is only about politics, except insofar as it is still about the morality of equal treatment for all."

This article was published before the package was signed into law, a couple of weeks ago.  The republican efforts in congress now to weaken this law are painful to watch. From my vantage point it looks like they are diverting energy that should be spent on other issues, wasting taxpayers' money on political posturing.
P.S. I will be posting some very cool stuff, with pictures if I can figure out how, on Haitian culture, positive social change and sustainable technology.

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