The question of equality, or inequality, among states is a major reason President Obama's overhaul of the healthcare system, and the legislation in Congress to make it happen, seemed to reach the brink of collapse last week, writes David M. Herszenhorn in his Prescriptions" blog for the New York Times. And it is a reflection of one of the biggest challenges President Obama and Congressional leaders have faced since they began tackling healthcare last year: how to devise a national solution for a problem that varies sharply from state to state, he writes.