My fear right now is that those decisions presently being made with regards to healthcare in this country are rooted in pure conservative fantasy about the way things ought to be from their view, rather than the way things actually are.

Sound public policy is often based upon the sum totals of our collective historical experiences. But sometimes those historical experiences can warp our perspective beyond all reason, and actually hinder our efforts to adapt to present-day and ever-changing circumstances. We ought to be able to respect our history and heed its lessons, without also being forever beholden to its ghosts.

U.S. healthcare policy is one such area where we've been hindered if not hamstrung. Per Victor Fuchs, PhD, one of the nation's foremost health economists, there are three fundamental characteristics in our U.S. political system -- driven by our country's own history -- that are making it very difficult for the U.S. to adopt a less costly government-financed health care system, such as exists in other developed nations.

First, there is our inherent distrust of large government, which first began when the original thirteen colonies broke away from an overbearing British Empire by force of arms. But while public skepticism is warranted and healthy to a point, it ceases being productive whenever it gives way to the paranoid delusions of a vocal and bullying minority.

Second, there is a reluctance to redistribute wealth across all citizens, in part because of the country's cultural diversity. I would go even further then Fuchs, and offer that this reluctance is based in substantial part on white American resistance to the idea that such diversity can define us without also dividing us.

White Americans need to accept the fact that policies to promote, protect and ensure the continued racial homogeneity and political predominance of the white race are the very antithesis of good governmental practices, and further represent a profound betrayal of our country's ideals and promise. We're not going to turn the clock back.

Finally, there are choke points in the U.S. political system -- such as the cost of election campaigns and the Senate filibuster -- that give deep-pocketed special interest groups an inordinate amount of influence in the crafting of federal policy, and gives those interests the upper hand in the prevention of the sort of sweeping reforms that our healthcare system needs.

And on that note, there's really no better example of that than the one offered today by the Senate's GOP majority leadership, which drafted their version of the AHCA entirely behind closed doors without any public input whatsoever, and is preparing to place it on the Senate floor for a vote as early as next week.

To bring this full circle back to Jeralyn's topic in this thread, which is our evolving views in HIV and AIDS in this country over the last three decades, I will close with a most appropriate quote from November 1977 by the late Sen. Hubert Humphrey, then facing the sunset of his own life due to advanced cancer, who nevertheless challenged us to strive always in our efforts to become a good and just society:

"The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped."