Importance of Local Decision Making in Health Care Delivery and Access

While the current initiative on health care reform is being debated as a national policy, health care is mainly delivered locally. Considerations such as urban versus rural environment, variations in state and local laws, and participation by community organizations lead to discriminating the concepts of coverage versus access to health care. Even if universal coverage were affordable at this point in time, it is a much more expensive proposition than simply offering local access to the poor and homeless, to alleviate the free rider problem with emergency room medicine. Federalized altruism is poor substitute for local care by community and faith based organizations.

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Christopher Grell