Mercy on us all!

Russell Baker

September 15, 1993|By Russell Baker

HERE'S a country with 90 million grown-ups who can't write a coherent letter or do simple arithmetic. It's a country where "Everything I Need to Know I Learned in Kindergarten" inevitably becomes a huge best-seller.

It's a country where 40 million people actually learn everything they know not in kindergarten but from television. Television! At best, on PBS, that means they are under the delusion that bugs mate to the strains of Mozart. At worst --

Well, never mind worst, we are here to talk about President Clinton's health-care program. The president's people last week started serious leaking about what kind of program they would like to install.

The immediate impulse is to smite the forehead with flat of hand and cry, "What country do these dreamers think they live in?"

It is obvious they haven't heard of the 90 million who are helpless when confronted with the simplest intellectual demands, since coping with the health-care program they have in mind would test the ingenuity of corporate lawyers, tax accountants and Las Vegas bookmakers.

First of all, everything seems to be about insurance. Say "insurance" to an American, even one who can write a coherent letter and grasp Euclid's rules for proving the congruence of triangles, and you evoke a moan from the depths of the soul.

Insurance means "fine print" you didn't read, did you, dummy? It means a demented profusion of numbers, of legal terms composed to make non-lawyers feel humiliated, of preposterous mathematical gabble about actuarial tables and estate law.

It means morbid evenings of listening to people wise about post-funeral finance debate about which of the Union's 50 states is the best to die in.

It also means all those insurance companies that quit paying Aunt Zell's hospital bills after her first three-day illness and refused to cover Cousin Sam at all because their inspectors said he had the quinsy and croup too often and might come down with something even costlier in a year or two.

The Clinton planners say they won't let insurance companies do that anymore, yet why, when hearing promises like that, do we persist in remembering about the fine print?

The 37 million now without health insurance obviously include a good percentage of the 90 million who can't read much or figure shrewdly, and some of whom can't read or figure at all.

Such are inevitably the people at the bottom end of the health scale, the people whose ailments go untreated until they are out of control and extremely expensive to treat, hence the people whom any sensible health-care program should be designed to accommodate.

Such people are the ones most likely to be repelled by elaborate schemes devised by governments to accommodate the private insurance industry. John Gielgud, playing the butler to a rich idiot in the movie "Arthur," makes the trenchant observation that being poor in today's culture requires such immense experience that people unpracticed in the arts of dealing with the social-welfare bureaucracy cannot survive.

It took generations for today's poor to accumulate the necessary skills. Can we expect them to master the arcane tricks of a new insurance-oriented health-care system in less than a generation or two?

Even for the unpoor, which is to say people who can afford a mortgage, the Clinton plan is packed with promise of bureaucratic frustration. Does everybody here really know what is implied by the initials HMO? And what about those regional health-care alliances that are going to dicker with insurance companies to hold down prices?

Suppose you are self-employed: a carpenter or plumber or painter, say. You go to the regional health alliance to get your coverage, then you pay the full cost of the basic premium, but never fear because you can deduct the cost of the standard package from your taxes.

Mercy on us all! They are designing another nightmare as complicated as the tax law, with the same kind of opportunities for finagling and corruption.

Bill, Hillary: Why not just have everybody send his medical bill to Uncle Sam and let Uncle, who understands these things better than we do, negotiate a fair price with the creditors?

Russell Baker is a New York Times columnist and public television host.

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