From testing to treatment, there has been much angst over the federal response to the COVID-19 crisis. I get it insofar as the growing concern over the rising exposure and death toll numbers nationally, for everyone has every reason to be concerned about maintaining public safety, especially for family, friends, and themselves. However, what seems to be lacking is a fuller appreciation, understanding of, and respect for the belief that "all healthcare is local". This is because New Deal era thinking has shifted the modern mindset to expect the federal government to be the great savior whenever catastrophe arises. Hence, pervasive in American political thought is what I have termed the "Fed Saviour Complex", and it is alive and well during today's COVID-19 pandemic. While similar to and different from the oft cited "White Savior Complex", what exactly does this Fed Savior Complex mean?
Psychology Today gives a very good working definition of the "savior complex" and details the mentality that's associated with this behavior or mental state. Psychology Today writes, "According to the blog PeopleSkillsDecoded.com, the savior complex can be best defined as “A psychological construct which makes a person feel the need to save other people. This person has a strong tendency to seek people who desperately need help and to assist them, often sacrificing their own needs for these people.” While this is a common condition that rears itself in relationships of all types, it is regarded as disordered and destructive to healthy human relations. But, what exactly is its connection to government, healthcare, and today's Coronavirus crisis?
Well, as I alluded to in the opening paragraph, it has become convenient and quite common-place to look to the federal government when local communities are confronted with crises and catastrophes that capture national interest. In fact, it is more of an obsession or "givenness" to look to the federal government for THE solution rather than form collaborative partnerships inter-governmentally for a shared or allied approach. In so doing, the federal government has become society's de facto savior no matter what, and this is why we have a Fed Savior Complex mindset every time chaos occurs. This is a serious problem in the public square, particularly because a one-size-fits-all approach (i.e. the federal government) is inefficient, ineffective, and in contradiction to the ideas and ideals expressed by our Constitution and its framers. As it relates to healthcare, a July 17, 2013 commentary at www.clintonfoundation.org makes this connection crystal clear. The article Healthcare is Local states the following:
The challenge we face is as great as ever. In 2010 the United States spent nearly a fifth of its GDP on healthcare, higher than any other developed nation. With childhood obesity, an aging population and the prevalence of chronic diseases, cost pressures are entrenched as part of the health care equation. When you add the fact that in this country, on average, there are only 25 physicians for every 10,000 patients, you begin to get an even clearer picture of a system that remains overwhelmed and threatens US competitiveness. One study found that, “ballooning dollar figures place a heavy burden on companies doing business in the United States and can put them at a substantial competitive disadvantage.”
While the national story is compelling, the truth is communities feel the real burden. In Harris County, close to 30 percent remain uninsured, surpassing the national average. The rising rate of obesity in Houston– the conditions it exacerbates and the diseases it causes — remains the single biggest threat to the health of the city and its families. To paraphrase, all healthcare is local.
That may be the answer, too. Because all healthcare is delivered locally, the healthcare system should be designed locally. It is at the local, community level where we are most likely to innovate and implement new healthcare delivery solutions. By piloting healthcare programs in specific markets we will be able to determine what works best in that particular city or region. Doing that while driving results, however, requires a systems approach and effective collaboration among multiple stakeholders — including policy-makers, providers (physicians and hospitals), purchasers (large-scale employers, etc.), and health plans (insurers). We are already seeing this approach working in cities around the country.
The quote above, despite being several years old, is timeless, persuasive, and refreshing in its relevance and application to a national healthcare crisis that today threatens our very existence. If only we could better appreciate the role state and local healthcare systems play in the delivery of quality healthcare outcomes, crises like COVID-19 could potentially be resolved in a much more unifying, responsive, and reliable manner than anything wished for from a cumbersome and overly bureaucratic federal government system.
In closing, If history is to be our guide, we would be well served to recapture and reapply the words of Thomas Jefferson if we hope to avoid undermining and compromising state and local government due to the Fed Savior Complex obsession. As an obsession, for it truly is, I'd classify it as disordered because the thinking and subsequent behavior is destructive and subversive to the separation of powers between government systems in our republican form of government. This the framers opposed in both spirit and practice. We must be reverse this trend now more than ever in order to preserve the integrity of our Union.
Our country is too large to have all its affairs directed by a single government. Public servants at such a distance and from under the eye of their constituents . . . will invite the public agents to corruption, plunder, and waste. . . . What an augmentation of the field for jobbing, speculating, plundering, office-building, and office-hunting would be produced by an assumption of all the state powers into the hands of the federal government! (1)
The states can best govern our home concerns, and the [federal] government our foreign ones. (2)
1. See Healthcare and the Constitution at www.wallbuilders.com, footnote 11. Thomas Jefferson,The Writings of Thomas Jefferson, Andrew A. Lipscomb, editor (Washington, D. C.: The Thomas Jefferson Memorial Association, 1903), Vol. X, pp. 167-168, Thomas Jefferson to Gideon Granger, August 13, 1800.
2. See Healthcare and the Constitution at www.wallbuilders.com, footnote 12. Thomas Jefferson, The Writings of Thomas Jefferson, Andrew A. Lipscomb, editor (Washington, D. C.: The Thomas Jefferson Memorial Association, 1904), Vol. XV, pp. 450, Thomas Jefferson to Judge William Johnson, June 12, 1823.