Impending Health-Care crisis.(COMMENTARY)

The Washington Times (Washington, DC), November 24, 2002 | Go to article overview

Impending Health-Care crisis.(COMMENTARY)


The threatened reneging of some industries to cover retired employees with health insurance, and the loss of employer-based coverage due to rising unemployment, are only the latest blows to a health care system whose brain waves are flattening. Indeed, columnist David Broder hardly overstated the case when he recently concluded, "The American system of medicine is threatened with meltdown."

"The health of the people is really the foundation upon which all their happiness and all their powers as a state depend." This expression of a nation's strength voiced a century and a half ago by the brilliant British statesman, Benjamin Disraeli, is perhaps even more apropos today. For modern medicine has probably done more to mitigate the misery and suffering that plagues so much of mankind than all economic theories, political ideologies and religious persuasions combined. The triumphs of modern medicine are marred, however, by the failure of medical socioeconomics to keep pace with the remarkable progress of medical science and technology. A resultant double standard of health care has evolved in our country.

Most Americans are medically well-insured and have ready access to a health-care system that has appreciably lengthened life expectancy and dramatically improved its quality. But many Americans do not fully share these health benefits, largely because they are medically uninsured and have limited access to the health-care system. That the medically uninsured have poorer health outcomes than the fully insured has been well documented. Indeed, there are wards in our nation's capital whose health statistics are more akin to those of a Third World country than of a world superpower.

The socioeconomic problem has its roots in the unanticipated nature of accidents and disease. The answer to preventing a medical calamity from becoming a financial catastrophe is budgeting in advance through insurance, as we do for a possible auto accident or fire in the home. But unique among Western industrialized societies, we do not provide coverage of our entire citizenry through either private or public medical insurance.

It was with high hopes, therefore, that we elected a president in 1992 who had made universal health insurance (UHI) the centerpiece of his pre-election campaign. UHI was initially endorsed by such influential voices as the American Medical Association, American Hospital Association, American Nurses Association, American Association of Retired Persons (AARP), League of Women Voters, corporate America and labor unions. With public polls also indicating overwhelming support. Bill Clinton apparently had a sure winner.

What followed, however, was an incredibly inept White House performance. The president appointed the first lady (those were the two-for-one days) and Ira Magaziner, a troubleshooter from industry, to midwife UHI through Congress. Neither had a track record of health-care expertise, and it soon became apparent they were in over their heads. Instead of narrowly focusing on UHI, they attempted to remake the entire health care system during one session of Congress.

The Health Security Act that emerged was an indigestible 1,400-page tome of tenuous assumptions, untested theories, top-heavy bureaucracies and government intrusion into medical education, training and practice. This mishmash could not compete with an insurance industry-sponsored $19 million "Harry and Louise" TV blitz that, without rebuttal from the White House team, confused the public by equating national health insurance (e.g., Medicare) with socialized "government medicine." The bill never even came to a vote.

Mr. Clinton's vision of UHI came a cropper mainly because he erred in his choice of messengers to deliver his message. With the demise of UHI, senior White House adviser George Stephanopoulos acknowledged that "we bit off more than we could chew" and the recruiting Hillary Clinton to pilot the program was "a mistake. …

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