Liberal Thoughts from a walk in the Seattle rain

We'll never have single payer health care in the US, but a few questions I've got after watching "Sick Around the World":

Regardless of what our bumbling federal government decides, would it be possible for state governments in Washington, Oregon and California to refuse to pay drug companies more for prescription medicine than British Columbia does, make it illegal to sue doctors or hospitals except in cases of abuse or gross malpractice, make it illegal for insurance companies to deny coverage in our states, put a cap on doctors' salaries and (especially) administrative salaries at hospitals and insurance companies, and cover insurance costs for individuals who can't afford to pay for it? What rights do states have? Could Seattle decide to do that?


Shayne Mathis said…
A couple years ago some legislation was introduced in the house that addressed some of the things you mention. Essentially the legislation was going to place power to provide health care for citizens into the hands of individual states. Some of the money to support the legislation was to be provided by the government through redirection of Medicaid funds among other things. The bill deals mainly with providing universal health care at the state level as well as reducing administration costs passed on to the consumer. I'm in now way a Constitutional scholar but I'd imagine that the other things you brought up wouldn't be off limits to states either. I think California even tried to pass legislation limiting medication costs a few years ago, although it might have been another state.

One of the things I actually like about our system of government is the amount of power placed in the hands of state and local legislatures. As long as a law doesn't violate the Constitution state and local governments have a good amount of leeway in passing laws. I bet those chumps "the forefathers" are spinning in their graves for allowing THAT loophole to slip through.

Here's a link to that legislation I mentioned too:
wes said…
What is this 'states rights' nonsense I see? We're all in this together. These are national problems for one nation under god! We cant have a handful of rogue states determining their own political, economic, and social future. Thats like...federalism. Or some silly word that doesnt have meaning anymore.
tim said…
Alas, it's true. But we are still constitutionally federalist, right? Why don't we ever talk about that anymore? Are we afraid of another civil war over medical marijuana, healthcare systems and gas prices? Maybe we should be these days.
wes said…
No, and sadly, federalism has been obliterated. Regardless of how the government was designed, anti-federalist ideals have won out over the federalist. Under a federalist system, states goverments have more power than the federal, and the federal has less functions. Also, union was voluntary--until 1865.

Actually in the past few years more than a few news stories have come out concerning the secession of the west coast from the rest of the U.S. Some New Englanders have also expressed a desire to self-govern. We have this strange idea that opting out of the union is some unpatriotic notion--the union must be preserved! Lincoln did so much for us all...we cant throw that away.

It makes sense, however. Why should one part of the land be subject to the views of any other part in disagreement? Democracy gives to the majority, but not to the concurrent majority.

Look that up: concurrent majority. I think you will like the concept. You may not like John C. Calhoun, but he was rather brilliant with the idea. It applies to our age fairly well.
tim said…
Interesting. The NZ Anglican Church actually functions according to a similar sort of principle. Since about 1990, the Maori and Polynesian "tikanga" (let's just say "parties" for simplicity's sake)--minorities--have had veto and decision making power equal to that of the white majority on church issues.

I'm not sure I'm ready to secede, but I can easily move to Canada or NZ if I want to. Others without that choice, I can see the desire. It would be nice to move back towards a real federalism. For me there's a sort of moral problem with that (or with secession), b/c it doesn't necessarily do much to distrubute wealth more equally in our society if the rich coastal states secede and leave behind the poorer midwestern and southern states, or even drift towards a state focused federalism, but then again, let's be realistic. Equal distribution of wealth across the US is probably never going to happen, and not even really what people want.

The tyranny of the masses. No better than the tyranny of the monarch it seems.

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