Showing some teeth

The federal government is cracking down on dubious charges and sometimes elaborate "financing schemes" involving "creative bookkeeping and other ploys" used by some to avoid "paying their share," says the February 16 New York Times.

Dennis G. Smith, a top federal official, said the parties involved were using "complex, creative financing schemes" and exploiting loopholes in federal laws and regulations to shift financial burdens off themselves.

Something to do with Enron-style bookkeeping at corporations? Finally a run at the offshore tax havens of the rich? My gosh, has the Bush administration gained its mind?

Not to worry, all is as it should be. The parties being targeted are the states and the issue is Medicaid. Simply put, the Bushites, who think the DOD is a bargain at twice the price, want to spend less on health care for poor people and are accusing the states of trying to look like they're spending more than they are in order to increase the federal matching funds they get.

Now, in fairness there may be some truth to the charge. After all, this is a time when

states, struggling with severe fiscal problems, are cutting benefits and restricting eligibility for the program, which serves 50 million low-income people each year.

The states are certainly desperate for the cash. But if it's true, it simply would show that truth (states are being slippery with their accounting) and justice (they're doing it to provide health care to their poor citizens) are not, in fact, the same thing.

Our national health care system is a disgrace before the world, something of which we as a people should be ashamed. You will hear the rebuttal that "we have the finest health care in the world," but that's not a defense, it's a diversion. The issue is not the quality of health care available to those who can afford it, it's the availability of health care to those who need it. A nation whose only cars were Lamborghinis and whose only airplanes were 767s might claim it had the finest transportation in the world (please, no arguments about fuel efficiency or air pollution, you know the point I'm making) - but most people would still be unable to afford to ride.

But here again, I'll ask again: Do you think President Anybody But Bush will be pushing for single payer national health care? Do you think that Mr. ABB (there ain't gonna be a Ms. ABB this year) will stand up to corporate interests, the insurance industry, the pharmaceutical companies, on behalf of the politically-irrelevant, non-campaign-contributing poor?

Do you really think we can afford to not start looking beyond November to be ready for the fights that will come? Or would we rather spend the ensuing four years feeling betrayed, like we did with Jimmy Carter, like we did with Bill Clinton?

I've obviously gone somewhat astray from my original topic, but no matter. If justice is - as it should be - our goal, then we have to realize that changing the face in the White House (as valid a goal as that might be) is simply not near enough. You know the phrase "act locally but think globally." A corollary to that could well be "act tactically but think strategically."

Consider it our version of "the vision thing."