The 'Price' of Health Care

FILE - In this Jan. 25, 2012 file photo, the U.S. Supreme Court Building is seen in Washington. The health insurance industry
FILE - In this Jan. 25, 2012 file photo, the U.S. Supreme Court Building is seen in Washington. The health insurance industry is spending millions to carry out President Barack Obama’s health care overhaul, essentially betting that the law or major parts of it will survive Supreme Court scrutiny. (AP Photo/J. Scott Applewhite, File)

If you never saw the 1993 film Indecent Proposal, you're in luck, because it's playing out in state legislatures and governor's mansions across the country as states decide how to pay for skyrocketing health care costs.

The film is not exactly appropriate material for my Sunday School class discussion. In short, Robert Redford offers $1 million for one evening with Woody Harrelson's wife, Demi Moore. You have to suspend disbelief that a guy with Redford's looks really ever had difficulty with the ladies.

The story revolves around the notion that everyone -- all of us -- has a price. A price by which we would choose to abandon our moral fiber to gain unimaginable riches.

Many of the great works of art throughout western civilization revolve around this theme of "choices of expediency." Shakespeare's Hamlet. Oscar Wilde's The Picture of Dorian Gray. Charlie Daniels' "The Devil Went Down to Georgia." The list goes on.

Conservatives are telling elected leaders that expansion of Medicaid comes at a moral -- or more overtly, a political -- price. At what price are they willing to go back on years of proclaiming "socialized medicine" as the slippery slope to "rationing of health care," "death panels" and other claims far too gruesome to mention in polite company?

Thankfully, many of the president's greatest critics have realized that accepting federal funds to expand Medicaid still allows them to uphold their solemn oath to preserve, protect and defend their state's constitution, without switching teams on Obamacare.

Ohio Gov. John Kasich has been one of the most vocal opponents of what he calls "government-run health care." Arizona Gov. Jan Brewer once literally shook her finger in President Obama's face to demonstrate her disgust with his health care plan. Last week, both governors approved their state's expansion of Medicaid. Brewer even launched two websites to drum up support for her conversion of conscience -- to extol the virtues of expanding Medicaid allowed under the same Obamacare she once filed a lawsuit to stop.

But, Kasich and Brewer are cheap dates. Florida Gov. Rick Scott once grandiosely exaggerated the state's costs associated with Medicaid expansion under Obamacare in an effort to stop it. But he has now decided to leave the door open to accepting $42 billion in federal funding to expand Medicaid.

Six governors that once excoriated Obamacare are now rethinking their options. But Ohio, Arizona and Florida are the big three that may break the dam.

Why? Well, if Kasich, Brewer and Scott -- three Tea Party darlings -- can't hold the line against what was once called "government takeover of medicine," who can?

What changed? The business community in all three states stood up to their governors, and demanded that expansion of Medicaid would not only be good for patients, it would be good for business, and was a critical need to help save struggling hospitals throughout their states.

These governors are demonstrating that many one-time critics of Obamacare can, and should, be willing to take another look at the impact Medicaid expansion will have on their state's budget -- and their constituents who may fall ill at some time in their lives -- in the face of a health care crisis.

Kasich and Brewer and Scott and the others don't deserve our scorn, because the choices they made were not part of some Faustian bargain. They made a principled decision -- for the betterment of their state -- even though it ran counter to their previously stated belief.

Leaders throughout state governments will review their options and look at the stakes involved. Hundreds of thousands of jobs could be created under Medicaid expansion. An untold number of hospital staff could be laid off if rural hospitals are forced to close.

Throughout the debate, this cannot become a game of "gotcha politics." We all, as Americans, understand these are difficult choices -- some would say moral choices.

But the moral choices should not revolve around a decision to backtrack on a previously made -- though heartfelt -- political statement. They should, and must, revolve around having the courage to take a new position when faced with overwhelming facts that improve the wellbeing of each state.

Enacting elements of the Affordable Care Act isn't backtracking on core principles, but rather understanding that new ways to help make health care affordable builds stronger businesses and saves struggling hospitals. And that is a very attractive offer.