Ignoring partisan overtones, this point is still a good one. Perhaps it is by neccessity that the debate over health care is framed in terms of national policies--particularly given the crisis in funding "entitlements," namely Medicare and Medicaid (as well as Social Security).
No one is disagreeing with the argument that the institutional infrastructure of health care in the U.S. is complex--and when nationalized, somewhat inefficient. Yet we're wearing rose colored glasses if we neglect another reality: that health care coverage is equally affected by more local legislation through state governments. Some states are "stingier" than others--thus, fewer people are covered by Medicare and Medicaid in states in the South and Southwest.
Look at it this way:
"There's a big regional backdrop to this," said Harvard health policy professor Robert Blendon. "Those who are the beneficiaries of all this money that's going to be floating around is one group of states, and who's going to have to pay for the taxes if they lift this exemption is another group."McGillis concedes that some of these disparities might be worked into the nationalized plans--but at the cost of complicating the tax code, and undercutting the overall effort to reform health care.
For example, he said, if you're a New York policeman married to a nurse and your combined salaries are $80,000, your health insurance will be taxed to pay for a family in Mississippi. "I'm trying to figure out how Chuck Schumer can raise his hands and say this is a good thing if New York workers are going to be such losers based on taxes," he said.
Perhaps the most disturbing aspect of this argument, however, is its novelty (at least in the Post, which by habit I read the most regularly). Why isn't this part of the national debate covered by the media?
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