Contrasting the States and Washington DC When It Comes To Health Reform

Speaker "All politics is local" O'Neill

Years ago, when the Disease Management Care Blog was participating in the AHIP managed care executive program, it was introduced to the organization's staff responsible for monitoring all fifty States for changes in health policy, laws or regulations.  The young DMCB quickly learned that while Washington DC's impact on health care was considerable, it was the States that were the most progressive, experimental, dangerous or exciting. 

Behold the "federal" system of government and the truism that "all politics is local."

It's still true.  While New York's legislation enabling same sex marriage is slightly off-topic, the DMCB finds it gratifying that a critical mass of Democrats and Republicans in the Empire State managed to find common ground on a contentious issue.  Good for them and good for the citizens of New York.

Recall also that Massachusetts' own health reform law was passed by a Republican governor and a Democratic-controlled legislature.  While it has its problems, state-wide support for the law appears to be holding up. 

At a personal level, the DMCB has corresponded with both its State Representative and State Senator.  It has also shook the hand of and exchanged words with its current Governor.  In the meantime, two letters to Senator Toomey have rudely gone unanswered and President Obama has unbelievably not once mentioned this blog in any of his speeches.  And while our President has professed support for marriage equality in the course of seeking donations and campaigning, his actions have been riddled with the usual cynical political calculus.

Lesson for the DMCB: Want to get it done?  Make something happen?  Make a change for the better?  The best answer may lie in your State capital, not in Washington DC.  Here's why.