Editorial: New ideas to reform health care

Friday, Nov. 22, 2002 | 4:09 a.m.

WEEKEND EDITION: Nov. 24, 2002

Shortly after he took office in 1992, President Clinton attempted to push through legislation that would provide universal health insurance coverage. In hindsight, the plan was overly ambitious and too far ahead of its time. So it never came close to getting off the ground. Of course, it's not as if the number of Americans without health insurance has gotten better -- it's gotten worse. Today more than 41 million Americans are uninsured, about 14 percent of the population. But if a Democratic president and a Democratic-controlled Congress were unable to deliver universal health care coverage in the early '90s, a Republican president and a GOP-controlled Congress aren't about to make it happen now.

The need to fix our medical system, however, has never been greater. We do have the best doctors and incredible high-tech medical equipment to treat illnesses and diseases, but what good is all of that if you don't have health insurance coverage and access to a doctor? And the recent medical malpractice insurance crisis, in which insurance companies have jacked up their rates for doctors and forced some of them to shut down their practices, is another signal that we're in trouble. Seniors with limited incomes also sometimes have to choose between food and medicine since the government-run Medicare program doesn't offer prescription drug benefits. States also have had to curtail their Medicaid health care programs because of fiscal woes. For those who do have health insurance coverage, double-digit percentage hikes annually are common and yet the insurance companies that run these plans keep curtailing benefits. It's a dismal situation.

If there is a glimmer of hope -- and that is a generous characterization -- it comes from a report issued last week by the National Academy of Sciences. The nationally renowned panel, which said the U.S. health care system is in a crisis, urged the Bush administration to let three to five states set up pilot projects to provide universal insurance coverage and no-fault payment for medical malpractice. The academy obviously is bowing to the political realities in Washington that have come to dominate health care. Even though the state of health care has reached a crisis stage, there is no way that dramatic reforms will occur on a nationwide scale in light of Republican opposition. It's not too surprising then that Health and Human Services Secretary Tommy Thompson indicated the Bush administration looked favorably upon the academy's report, whose recommenda tions are just baby steps on the way to genuine reforms.

Still, at the very least, Congress should adopt the recommendations of the National Academy of Sciences. While the states should have reasonable flexibility to implement these pilot projects, it also is essential that the states be required to provide universal insurance coverage. There should be no negotiating on that point. In addition, the federal government should provide the necessary funding to get these pilot projects off the ground. We've seen in Nevada, through our state prescription drug program for seniors, that the state doesn't have enough money to offer this benefit to all who need it. Although Nevada's prescription plan is better than nothing -- Congress' impasse on guaranteeing prescription drug benefits for those who are under Medicare has left it up to states to fill the gap -- it still leaves too many without prescription drugs. The st ates shouldn't be left holding the bag.

There aren't easy answers to solve the health care crisis, but Washington has irresponsibly walked away from this issue for a decade, a problem that didn't go away simply because the Clinton health plan was derailed. Maybe, if states show some success, Congress and the White House will be shamed into taking action so that all Americans will benefit. It is a sad commentary in this day and age that it can be considered a bold step when a scientific panel recommends that only a handful of states offer something as basic as universal health insurance.