thoughts on health care in america

In the immediate aftermath of yesterday's controversial court decision, saying that the health care plan requires unconstitutional control over private citizens' pocketbooks, there seems a very widespread sense that the single payer plan would have circumvented this legal problem. However that alternative falls afoul of the reactionary impulse toward smaller government at all costs. It seems to me that this is less a case of the white house and congress kowtowing to industry, but another in a series of poor but necessary compromises with a strong right wing. This is part of the larger breakdown in american political life between what I would call modernists and antiquarians. It is simply not feasible or realistic to have a 'small' federal government in a huge highly industrialized country. Our system of checks and balances is still the best way to control the excesses of power, even when it works poorly or slowly. The alternatives, too much central power or too little, lead separately to police states or to gross economic inequity. I suspect that hundreds of years from now when historians consider the 21st century, that is the major conflict that they will see.