Block grants are a hot topic these days. The Republican Study Committee has proposed legislation to effect the block granting of Medicaid to the states.  While this is not an end-all solution to the bankruptcy that the entitlement programs guarantee, it is a start.  Having said that, here’s a few random thoughts.  

I have said before that I didn’t think that it was right or fair that  a family should have to cancel their vacation because someone across town they didn’t even know was in a motorcycle wreck. By the same token, the same family shouldn’t have to delay their child’s college education because someone across town (once again someone they don’t even know) needs heart surgery.  You say,” health care is a basic right!”  ”We all have to chip in to maintain this social safety net!”  If that is true, why is it only true within the borders of this country?  If health care is a right, then why is an individual’s obligation to pay for another’s health care limited by arbitrary national borders?  Why wouldn’t a motorcycle wreck in Paris, France create the same obligation as one in Lexington, Kentucky?  You say, “The folks in France should take care of their own!”  If that’s true, is that not an admission of the doctrine of subsidiarity?  Shouldn’t the folks in Kentucky take care of their own?  Why should folks in Texas pay for the motorcycle wrecks in Vermont?  

I guess this is my point.  If health care is a right, then why is it a right only for folks in the U.S.A.?  If limiting our liability for another’s misfortune is a good idea on a national level, why doesn’t it make sense to extend that to the state level?

Block grants demonstrate the fatal conceit, do they not?  Whatever incompetence illustrated by government at the state level, it will not be nearly as perverse as that at the federal level, a level that is more removed from those victims of bureaucratic malfeasance and incompetence.

Kind of a back-handed endorsement of block grants, no?

G. Keith Smith, M.D.