Tuesday, February 20, 2007

Specialty hospitals in Montana

In an issue of more acute interest to Great Falls because of the desire of the Great Falls Clinic to build a specialty hospital, a bill to extend the 2005 moratorium on such hospitals in Montana is prominent in the Great Falls Tribune today.

Proponents of specialty hospitals (and thus opponents of this bill) say that it will generate competition for hospitals like Benefis in Great Falls, causing them to "sharpen their pencils."

Opponents say that these specialty hospitals will kill "regular" hospitals because they will skim off the cream, so to speak.

While generally in favor of free-market competition, Montana Headlines tends to go with the hospitals on this one, at least on first glance. It seems that there would be an excessive duplication of services and expensive infrastructure.

We are not so sure that this issue needs to be painted as "doctor vs. hospital" either, wondering if the laws that, as we understand, banned doctors from having ownership in "regular" hospitals didn't help create this problem. There should be creative solutions available whereby doctors in Montana can have a direct stake in the financial success of their community hospitals, decreasing their interest in creating competing specialty hospitals.

Regardless of the size of the community, hospitals and medical corridors are large parts of the Montana economy. They need to be kept healthy. The debate will be interesting to follow.

Jore watch: home education and compulsory attendance

Rick Jore, C-Ronan, presented his bill to abolish compulsory education in Montana yesterday. Even if his bill gets out of committee and indeed out of the House, it has no chance of making it through the dual barriers of the Democratic-controlled Senate and the Governor's office.

But even with this likely failure, Jore has highlighted the relevant issues of personal liberty and family autonomy in a way that should help ward off bills like that sponsored by Don Ryan, D-Great Falls, to add additional regulations that parents educating their own children at home must comply with.

The only interest the state should have is whether truant troublemakers are supposed to be in school or whether their parents have assumed 24 hour direct responsibility for their behavior. Not having recently encountered gangs of destructive home-schooled children recently, Montana Headlines suspects that Sen. Ryan's concerns that truancy officers need these additional regulations are overblown.

Montana has a "leave us alone" libertarian streak that should be nurtured, not quashed. And it all starts with the children. Sen. Ryan's intrusive bill was voted down in committee 8-1, which is a good sign.

Small towns, rural areas, and war

An AP article in the Gazette today is entitled Small-town America pays high cost for war. In the course of the article, one gets the impression that there is some purposeful strategy behind this, as illustrated by this quotation.

There's a "basic unfairness" about the number of troops dying in Iraq who are from rural areas, said William O'Hare, senior visiting fellow at the University of New Hampshire's Carsey Institute, which examines rural issues.

One wonders if O'Hare is in favor of devising some sort of quota system whereby the country is divided up into various urban, rural, racial, geographical, economic, and educational groups -- and then constructing a draft designed to make sure that all are put in harm's way proportionately.

The article does mention the real reasons that this happens: rural areas and small towns are populated by people who tend not to be ashamed to be patriotic, having not yet learned that educated and sophisticated people think it rather gauche to have one's eyes tear up when one hears or sings "American the Beautiful," and that this patriotic bent leads to a willingness to overcome fears of the rigors and danger of military service.

The recently elected Sen. James Webb, in his excellent 2004 book Born Fighting, details at length the disproportionate numbers of Scots-Irish -- and specifically Scots-Irish from heavily rural Southern and border states -- who have served, fought, and died in the service of this country. The story of his people's military service is perhaps the most dramatic in our history, and had gone untold until Webb wrote his book. But it could be told, to one degree or another, by Americans of a variety of ethnic backgrounds from all over small-town and rural America.

Both parties today have members who have fought and served -- in fact, there are few ways to have a brighter political future than to be a combat veteran willing to run on the Democratic ticket as an anti-war candidate. As far as rank-and-file voters and party activists go, however, one suspects that Republicans are disproportionately populated by veterans and families of soldiers. The military certainly has traditionally voted heavily Republican -- roughly 90% in the officer core and 80% in the enlisted ranks during presidential elections since George McGovern's 1972 run.

The Republican party's dirty secret, though, is represented by what the left derisively calls our "chickenhawks." There probably has never been a time when the right's pundits and pontificators were so overwhelmingly filled with those who have never worn the uniform. Montana Headlines recently mentioned Jonah Goldberg of the National Review, but he is just the tip of the iceberg.

Perhaps the most significant part of the article is where it points out that support for the current war in rural areas has dropped from 73% in early 2004 to 39% now -- whereas the (more moderate) support for the war in urban areas has dropped considerably less -- 43% to 30%. The reason in the article is probably correct: they know more about war and the costs of war.

The generation that experienced World War II knew the cost of war, and both parties were generally filled with politicians who had served. They strenuously wanted to avoid war -- the argument was over how to avoid it: Peace through military strength and tough stances (think President Reagan or Sen. "Scoop" Jackson, D-Washington) or peace through more dovish approaches (think Sens. George McGovern or Frank Church.)

That generation of Republican "hawks" followed the long-standing tradition of being pro-defense but anti-war.

When Bob Dole was in the Vice-Presidential debates in 1976 against Walter Mondale, he (showing the penchant for quick-thinking barbed retorts that so often got him into trouble) pointed out the obvious when responding to charges that Republicans were war-mongers:

"I figured it up the other day: If we added up the killed and wounded in Democrat wars in this century, it would be about 1.6 million Americans-enough to fill the city of Detroit."

National Review called that "one of the great blunders of recent political history," and perhaps it was, but in retrospect it is also one of the more instructive episodes in recent American political history. While everyone at Montana Headlines voted for the Presidents Bush (and given the choices available would probably do so again, even knowing what we know now), it is interesting to note that since since their Presidencies, no Republican will be able to say anything of the sort for a very long time.

And it is remarkable to think that the Republican party is now full of members who would have no idea of what Dole was even talking about.

All of this is a long way of saying that rural America is probably going to remain more patriotic than their urban cousins and more eager to serve their country in uniform, but it will also probably return to being very suspicious of foreign wars and expeditions, as they once were.

This is a good thing, and if the Republican party returns to its roots, it will be able to keep their rural base. If not, look for more candidates like James Webb to be quietly knocking off Republicans throughout red country.