Universal Access

WASHINGTON -- The nation has a severe shortage of general physicians and a surplus of specialists, a trend that must be reversed soon if major repairs are going to be made to the ailing health-care system, a federal advisory panel has warned in a report to be made public soon.The study is expected to be taken seriously by the Clinton administration, because it has set health-care reform as an early goal, because the head of the panel, Dr. David Satcher, is said to be on the short list for the job of secretary of health and human services in the new administration, and because Democrats and Republicans have indicated that health-care reform will be at the top of the priority list for Congress next year.

WASHINGTON -- At the close of the winter meeting of the nation's governors here, Republican Gov. Carroll Campbell of South Carolina, the group's chairman, was asked whether in the conversations they had with President Clinton on health-care reform, the president had ever reiterated his State of the Union veto threat to Congress."

President-elect Clinton's vow to halve the deficit within fou years may yet prove to be as elusive a pledge as President Bush's promise of no new taxes. If the recession drags on as leading indicators suggest it will, there is almost no chance he will achieve that goal with the economic program he offered during the campaign. Indeed, Mr. Clinton's greatest nightmare might be a federal deficit doubling rather than halving this year's $290 billion figure in the fourth year of his term.Given this danger, the president-elect would be well advised to make an attack on the deficit his top priority in the revised budget he will offer in January for the 1994 fiscal year starting next October.

Amid modern furors about insulating state from church, it is comfortable to ignore the immense role that faith played in the evolution of democracy. I know no book that has ever more fascinatingly traced that historic phenomenon than "Wide as the Waters: The Story of the English Bible and the Revolution It Inspired," by Benson Bobrick (Simon & Schuster, 384 pages, $26). Much of the concept of individual rights, of course, occurred in England, where the principal conventions of Western democratic values grew.

There has been a lot of conflicting information in the local and national press recently about pre-kindergarten. As longtime practitioners of the art of early childhood education, the Maryland Family Network would like to offer some perspective and broaden the conversation. First, publicly funded pre-K is just one piece of a much larger system of early care and education. This system consists of child care centers, family child care, Head Start and a range of other early learning settings, such as private nursery school.

Does your house have good night lighting in place, or do you risk a fall moving through it in the dark? In the kitchen, do you find yourself dealing with an inconvenient layout that has you walking from sink to refrigerator to stove, carrying heavy bowls and cartons of milk? If you burn the toast and need to open a window for air, do you just about throw your back out trying to raise a clumsy, old-fashioned sash window?In the bathroom, is the shower faucet inconveniently high? Does getting in and out of the tub seem perilous at times?

U.S. Sen. Barbara A. Mikulski said Thursday that she will introduce an amendment to the Senate health reform bill guaranteeing women universal access to mammograms beginning at age 40. The move is a response to new recommendations from an advisory panel, the U.S. Preventive Services Task Force, which said most woman do not need mammograms until they are 50, and only every two years after that. The mammograms result in too many false positives for women ages 40 to 49 and don't save many lives, the panel said.

U.S. Sen. Barbara A. Mikulski said Thursday that she will introduce an amendment to the Senate health reform bill guaranteeing women universal access to mammograms beginning at age 40. The move is a response to new recommendations from an advisory panel, the U.S. Preventive Services Task Force, which said most woman do not need mammograms until they are 50, and only every two years after that. The mammograms result in too many false positives for women ages 40 to 49 and don't save many lives, the panel said.

President Clinton's latest trial balloon -- increased federal cigarette taxes to pay for health care reforms -- looks like it will stay aloft but in no way can it begin to finance the costs of extending universal access to all citizens and extending coverage to include long-term nursing care.According to a study just released by the Congressional Budget Office, a doubling of the current 24-cents-a-pack federal tax to 48 cents would raise just $17.9 billion over the next five fiscal years.

ANNAPOLIS -- The House of Delegates unanimously passed a bill yesterday to help small companies with the rising costs of health care.If it passes the Senate, the measure, known as "small group market reform," is likely to become the broadest health care reform effort to pass the General Assembly this year.House Bill 374 was sponsored by the entire Economic Matters Committee. Its chairman, Del. Casper R. Taylor Jr., D-Allegany, has conceded that the legislature will not be able to enact a fundamental reform this year that provides universal access to health care.