From the outset, let me make it clear that I believe that all Americans deserve health care. Children should not go without medical attention- no one should. Having said that one issue is how it will be financed and there has been the most attention on this. CNN’s Fareed Zakaria did an excellent segment on what we could learn from other countries about health care outlining their experiences. I will not explore health care financing. Enough has been said about it and I am hardly qualified to expound on this topic. What is missing, I think, is commentary about how ANY centralized form of health care could survive- being administered in a nation of our size.

Looking at models from Taiwan or Europe, for example, is most helpful, but, in the end they have nowhere near the logistic issues that we have here in the U.S. Our population is much more diverse from a religious base culturally, politically, financially, ethnically and racially. While English is our primary language, Spanish and many others are employed regionally. Our geography is immense and spans large cities, small towns and remote rural and mountain communities. We are, proudly I should say, a patchquilt. To attempt to manage the health of our diverse population centrally is utter madness. Centrally managed, Medicare’s success, I am sure, will not endure as our senior population expands with information age boomers who are much more independent and less prone to be herded or follow rules and regulations as today’s seniors do.

I am not sitting to the right or the left, but, as many Americans I am frightened what the future will portend with more central management. Bill Maher often summons up models of European success. My argument is NOT that we need universal care, but, in country of our diversity how do we make that happen? We can NOT replicate smaller countries. Central control of universal health care in America will be much more costly than promised. It will not allow creative administrators and doctors to reengineer medical care- consistent with THEIR regions needs, politics and requirements. It does not allow them to create the standards of care specific to their needs.

While the Affordable Health Care Act struggles to make concessions to regions, it is still a centralized, bureaucratic, regulation driven hodge podge. Here’s the thing, I do not want to get rid of the federal government. We can’t live without the Feds! I do not want to "go back in time" to when men were men and women were treated as if they all lived in AZ. I just want a more honest and more efficient Fed. That means less bureaucracy and more of my tax dollars spent on what was intended to do! It means a Congress that actually works for the people and not for lobbyists. It means that a health care system should be crafted with Federal support that assures all Americans health care, but allows regions that are bound by geography, culture, etc. to craft their own answer to assuring their populations will be cared for.

The Feds are like a meddling parent. There MUST be room to grow up and become independent. But, like most parents, they should not be demonized- they mean well and we all need parents. I know this is not easy but the democratization of our republic COULD be much easier because communications (computers, software, etc.) have made it much easier for us to talk to each other and express our interests. The Feds should facilitate a democratic and regional health system that extends from coast to coast and covers all Americans. Facilitation is not the same as forcing. Unlike Europe, what is good all over UK (a fraction of the size of the U.S.) or Switzerland or Cuba for that matter will not work in the U.S. We are not a one size fits all kind of society and I for one am proud of it. I respect the intent of our President. What I am questioning is his ability to manage what is an admittedly difficult concept to organize and get done. In the meanwhile, expect more "big" government, more wasted money and more useless politics and empty promises from both presidential candidates. Neither Obama nor Romney will ever want for the health care of their families. Mediocrity and hypocrisy are hard to take- deal with it!