A sick system

June 10, 1991

There is hardly an adult in America who can't relate a horro story about the cost of health care -- from a serious illness that quickly runs into six figures, to a commonplace hospitalization that runs into five figures, to a routine emergency-room, first-aid visit that runs into three figures.

Given the pervasiveness of the impact of health-care costs throughout society, it is amazing that only now have our political leaders gotten serious about reforming the health-care delivery system in America. The moment of truth has come with a bill introduced by the congressional Democrats designed to extend either government-covered or insurance-covered health care to every American. At present there are 34 million Americans who ** have neither private health insurance nor government-paid health insurance, Medicare or Medicaid. These people are the major problem because they avoid medical treatment for diseases that can be cured if treated early but become enormously costly -- not just to the individuals but to the whole of society in the long run -- if neglected until hospitalization is required. It is a telling statistic that at any given moment, half the beds in Johns Hopkins Hospital in Baltimore are occupied by people suffering from illnesses or injuries which could have been prevented.

The Democrats' proposal would require all employers to provide health insurance or to contribute to a national fund for that purpose. The law would allow greater tax write-offs to marginal businesses in order to partially compensate for the new burden.

Whether that is the best plan or not, we can't say until the #F debate has begun. But the proposal at least has the virtue of starting that debate. Until the Democrats' measure was unveiled last week, the Bush administration had no plan at all for what is the overriding domestic issue to the vast majority of Americans. The president's chief fiscal officer, Budget Director Richard Darman, quickly promised that a Bush proposal would be forthcoming before the 1992 elections.

The need cannot be neglected any longer. Today Americans are spending more than 12 percent of total output of goods and services on health care. That figure is far, far more than any other developed country is spending and is more than double the amount being spent in Great Britain. The worst of it is, the graph line in this country is going straight up.

It is no exaggeration to say that the health-care economy in America is in the same state of disintegration as the general economy in the Soviet Union. If it is not brought under control, and very quickly, we may be certain that the 21st century will punish us with a substantially lower standard of living.

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