ROANOKE TIMES

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, July 28, 1994                   TAG: 9407280054
SECTION: EDITORIAL                    PAGE: A14   EDITION: METRO 
SOURCE: By CRAIG V. VanSANDT
DATELINE:                                 LENGTH: Long


NO MORE DITHERING - PROVIDE UNIVERSAL HEALTH CARE NOW

I HAVE followed with great interest the debate over health-care reform in this country. As usually happens when large numbers of people, and especially politicians, get involved in a complex subject, the focus of the debate moves from the basic question to all sorts of side issues, some only remotely related.

So far, topics have included: How much of the population should be covered? Who should pay for the cost? Would government be more or less effective in setting policy than private insurance carriers? Should abortion be covered? What should the card look like? Will it really work or not? And so on.

My interpretation of most of the debate has been that no one is willing to state clearly what the true objection to health-care reform is. This reluctance has nothing to do with political correctness, nor with the noble search for the ``best'' answer, but everything to do with the shame of pettiness and greed.

The true objection goes like this: ``I don't want to take dollars out of my pocket to assure that adequate health care is available to all citizens of this country.''

This country's recent economic pressures have only added to the basic tenet of looking out for No. 1 (and maybe the immediate family). The idea of assisting those in need, whether derived from religious beliefs, brotherly love, or just caring about someone other than ourselves, has slowly eroded against the incessant tide of capitalism and materialism. I know very few, if any, who reject the concept of universal health-care coverage as a benefit to society. It's when cost is introduced that people blanch.

If added cost is the overriding concern, let's examine that. Do you know how much it would cost you to provide basic health-care coverage to everyone? I don't. I can't recall seeing any estimates along those lines. But if you'll allow me some guesswork, we could start with the sign at the corner of Campbell and Jefferson downtown.

This informs me that my portion of the federal government's accumulated deficit (notice that I'm using the collected liabilities since the beginning of this country, not annual figures) is something on the order of $17,000 to $18,000. Just pulling a number out of the air, let's say that the added annual cost of universal health-care coverage is 4 percent of that. (I hope this is way too high.) This would be about $700 each. I don't have much confidence in any of these figures, but let's use them just for argument's sake. If we're unwilling to spend an extra $700 each year to provide this coverage, what does that mean?

We would rather spend $700 on a new television or stereo than assure that poor women have adequate screening for breast cancer.

We would rather contribute $700 to anti-abortion campaigns than provide adequate prenatal care for all pregnant women.

We would rather save that $700 for a rainy day or retirement than see that all children receive a polio vaccine.

We would rather force a low-income, blue-collar employee of a small business to declare bankruptcy due to medical bills than require his employer to contribute to health-care coverage for him.

Maybe the real number is $1,136; maybe it's $378. I don't know. Regardless, the basic issue is the same.

Let's face it - health care is expensive. Much of the literature indicates that it's more expensive to fix big problems that could have been handled more cheaply and easily by routine and preventive care. But it's expensive, and someone (you and I) has to pay for it. If we're not willing to pay for it, then we must be willing to watch people suffer from ill health and even die because they didn't have access to health-care providers. Is that because we look at our checkbooks, savings accounts and stock portfolios everyday? We don't often have to look a poor or unemployed person in the eyes and say, ``I just don't care about you - you're not important to my life.''

The other thing Congress has done in this debate is to try to find a way to put off making the decision. Proposals now being discussed seek to delay covering everyone until some point in the future, and creating a ``hard'' or ``soft'' trigger by which small businesses may be required, sometime ahead, at some level, to contribute to the cost of health-care coverage. Sound sort of nebulous? That's the idea! That way, members of Congress can pat themselves on the back, just in time for the November elections, for passing health-care reform legislation while avoiding hard issues, and foisting them off on future senators and representatives.

I was on a Boy Scout camp-out recently with fathers from an affluent section of our town. Three happened to be doctors. The health-care reform topic came up, and was quickly dispatched. The consensus was that we would end up with no pre-existing conditions and portable benefits in the event of a job change. All agreed that was about all that's needed. There was no mention of the single most critical factor in reform - universal coverage for all, at least on a basic level.

We can debate the details of a reform package until no one needs health care anymore. Whatever plan is implemented, it will require extensive tinkering and refining. It's too complex an issue to get it ``right'' on the first try. If it's too expensive, then we can attack that issue. Certainly, there's no shortage of programs that cost too much or need cutting. But let's at least get the single most important issue resolved: Provide everyone with basic health-care coverage now!

Craig V. VanSandt of Bent Mountain is vice president at a regional bank in Roanoke.



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