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We all know that the members of the greed-is-good club, otherwise known as Missouri GOP legislators, have done nothing but stamp their little feet and scream “nooooo” when it comes to federal health care reform. As it seems more and more likely that there will be some type of reform package despite their obstructionist tactics, some of the junior members in the State legislature have even promised to bring to bear the mythical powers putatively adhering to the tenth amendment of the U.S. Constitution in order to zap the federal legislation – although, as Hotflash has noted, there is little constitutional meat in their proposed magical exercises.

Apart from all the ideological wailing and gnashing of teeth, fantasies about an imminent socialist takeover and evocations of an imaginary constitution, the real issue always seems to come down to defending Missourians, particularly wealthy Missourians, from taxes. In general, this stance is characterized as being fiscally conservative – which, in spite of common usage, is not really the same thing as being fiscally responsible.

While these folks are seriously exercised over the financial burden that they think Missourians will bear come the health care apocalypse, none of them, to my knowledge have referenced the relative costs and benefits to the particular states. Not to worry though, in the Health Affairs Blog, Claudia Schur and Marc Berk have done some (admittedly quick and dirty) analysis  to show the relative winners and losers.

Turns out that once again, those in red states who agitate the loudest about those socialists who want to redistribute their precious income to lazy, no-account lumpen stand to realize greater benefits than those in blue states who, as usual, will foot the bill.  And guess what? In at least one scenario, that in which premium insurance packages are taxed, Missouri is likely to be one of the top winners in terms of taxes spent vs. benefits realized.

While this consideration need not dictate policy decisions for responsible legislators, I agree with the Schur and Berk that:

… legislators should at least be cognizant of the relative advantages and disadvantages to their state under alternative financing scenarios. The press has legitimately noted the deals demanded by Lieberman, Nelson, and Landrieu for their support. It is more surprising, however, that most legislators have decided their position on reform without any consideration of the relative costs and benefits to their states.