A clinic in how
to rip off taxpayers

Imagine a world in which everything we depend upon is subject to free-market competition.

Imagine, contrary to fact, that Hillsboro’s fire department sees an opportunity to expand. It seeks federal aid, buys more trucks, and stations them not in Hillsboro but in Marion.

In this imaginary world, it invests heavily in transforming an under-used Marion building into a new fire station. It ingratiates itself with Marion residents by contributing money to charitable projects. It hires a marketing manager to oversee a huge advertising and public relations budget.

Then, after Hillsboro taxpayers begin complaining that they don’t want their tax dollars spent in Marion, it suddenly decides to close its Marion station.

It doesn’t blame the closure on taxpayer concerns or even on the fact that it illegally went outside its operating boundaries. Rather, it blames what it calls unfair, retroactive limits on federal reimbursement for services it isn’t even authorized to provide and won’t be for months.

This couldn’t happen, of course. Hillsboro’s fire department has much better leadership than what these moves exhibit.

About the only way that could happen in reality would be if Hillsboro were to import a new chief from elsewhere — one deeply entrenched in the financial shell games that have dominated provision of privatized public services in rural areas.

To date, shell games haven’t reached into functions like police and fire protection. But they most assuredly have been trying to milk the nation’s biggest cash cow: health care.

All of us want to be able to select our own health care professionals. But the pressure such desires have created to keep health care firmly in the realm of private enterprise have created a system ripe for abuse.

Nationwide, billions that could go toward better health care for all are instead lining the pockets of shady, limited liability partnerships of speculators willing to play games with money intended to provide health care in rural areas.

Hillsboro has been the victim of this before. And while that’s not exactly what happened in the current brouhaha over Herington Hospital opening a clinic in Hillsboro, it’s the same type of behavior.

All of us can dream as much as we want about a rural health care system based on free-market principles. But truth is, Marion, Hillsboro, and Herington wouldn’t have hospitals if local governments hadn’t intervened. For one local government to suddenly decide to operate as if everything were an unregulated free market — albeit one totally dependent on federal aid — is what got us where we are today.

It’s time for all of us to take off our rose-colored glasses and begin viewing rural health care for what it is: a government operation, not free-market private enterprise.

We don’t have a lot of faith in bureaucrats to run any system — health care or otherwise. But when all the dollars involved seems to be coming from taxpayers at one level or another, it makes sense for taxpayers to have final say over how and where those dollars are spent.

Health care is too big and important a cookie jar to not have someone watching whose hands are reaching into it.

— ERIC MEYER