Once upon a time, so the legend goes, if the king of Siam (modern day Thailand) had a courtier, or subordinate, with whom he was well and truly displeased, he would bestow upon that person a very special gift.

That gift was a white elephant.

The albino elephant was sacred. Because it was sacred, it could not be put to any gainful employment.

Because the elephant was a gift from the king, the “much-favored” new owner couldn’t give away the elephant because this would be an unforgivable affront to the king. Since it was sacred, it couldn’t very well be sent where all good elephants go eventually – but maybe sooner rather than later.

The object of the king’s largess would be stuck with a very large and very sacred animal, with no useful purpose, the upkeep of which would eventually drive the recipient into abject poverty.

Which brings us to a little discussed aspect of the Republican health care proposals.

Proponents of the current House and Senate versions suggest that under their plans, responsibility for some aspects of health care would devolve back to the individual states. This, we are told would allow states to tailor health coverage to meet each state’s unique needs rather than a national one-size-fits-all approach.

Federal funds would be made available to help ease the transition from national to state responsibility.

On the face of it, such a move would seem consistent with the GOP’s fascination with downsizing the federal government by sending some of its functions back to the states. If you dig a bit deeper, however, you begin to uncover some, shall we say, “white elephant” issues.

First of all, there is the issue of funding the expanded state role in health care.

Even if there initially are federal dollars to ease in a transition from national to state responsibility, is there really anyone out there who dismisses the possibility (or likelihood) that such funding could be cut, or capped, or eliminated, at some time in the future in the name of fiscal responsibility?

If, and when, that happens, states will be faced with a tough choice. Do they pony up more state money for health care … or do they reduce health care benefits?

Another consideration: States do not have equal resources. What may be affordable in California may not be affordable in North Dakota … or Indiana. Should the level of health care depend upon the state in which someone gets sick or injured?

Do I migrate to a state with more generous benefits? Will that state accept me, or attempt to deny coverage?

Finally, what mischief is likely to take place as state legislatures “tailor” their coverage?

Does it sound out of bounds to deny coverage to undocumented individuals?

How about access to birth control products?

Do we resist tinkering with prohibitions on denying coverage for pre-existing conditions, or do we make the cost of coverage cost prohibitive for someone with a pre-existing condition?

Do we reinstate lifetime caps on coverage?

What about self-induced medical emergencies? There is already a city councilman in Ohio advocating that if you have overdosed twice, on the third strike, the ambulance will not come to save you. (If you find yourself agreeing with this approach, you might want to refer to Matthew 18:21-22 KJV for guidance on how often forgiveness should be extended.)

What about coverage for medical issues unique to specific groups within the general population – such as sickle cell anemia, found primarily in the African-American population, or issues more common in the LGBT community?

Do we really want to fund another generation of lawyers to fight yet another round of the social wars, because in your heart you know that a multiplicity of plans will lead to a multiplicity of lawsuits which will only serve to further divide the body politic?

Do we really want a crazy quilt of 50 different health care plans?

National health care requires a national health care plan that is uniform across the board, albeit with provision in the enabling legislation made for reasonable flexibility.

Let me suggest that if you prefer a state-by-state solution, you must also be ready to take responsibility for the care of the white elephant that comes with it.