Editorial: Health care fix must be major

Friday, Feb. 14, 2003 | 3:58 a.m.

WEEKEND EDITION: Feb. 16, 2003

For at least the past three or four decades, with the advent of Medicare, Medicaid and health maintenance organizations being highlights, we as a nation have been fixing or attempting to fix only the component parts of the country's health-care system. Every cure impacts other sectors, which then need a cure of their own. It seems to us imperative that the federal government appoint a commission to thoroughly study the whole system before it deteriorates further. Fixing only the component parts has led us to where we are today.

Medical malpractice insurance is so high in many states that doctors are boycotting hospitals or shutting down their practices and moving, leaving patients without immediate access to care. The standard fix, tort reform, reduces pain and suffering awards for victims but is not reducing malpractice or lowering insurance rates. Prescription drugs, once the province of senior citizens and those affected with serious illness, are now dispensed throughout the population for every conceivable ache and pain. Pharmaceutical companies lobby to keep prices so high that many people who really need them must forgo other necessities. There's a chronic shortage of nurses. Public hospitals are running up steep losses. The Census Bureau reports that 41.2 million people have no health insurance. The profits of health insurance companies are tied to the stock market, ensuri ng that rates will jump drastically during volatile economic periods. HMOs have turned the administration of medicine into ! a complicated riddle while not improving access to care or stabilizing costs. Medicare and Medicaid reimbursements are so low that many doctors are reluctant to deal with them. Wait times can be hours in so-called "emergency" rooms.

A bipartisan national commission, with members representing state governments, consumers, and the medical, insurance and legal fields, could draft recommendations for congressional debate. We do not envision a national health-care system that would evolve into a massive tax burden. But we do envision a system where the component parts, having been examined as part of a whole, coordinate with each other.