Health care - We must strive for national solution

By Gilbert Degenhardt

When it became apparent that addressing growing concerns about the adequacy of the ongoing heath-care delivery system, several basic needs surfaced: simplification, understandability, transportability and all-inclusiveness.

The current hodgepodge of systems serves only to complicate the situation and fails to address the foregoing concerns and needs. HMOs and managed care simply preserve at least two misconceptions embedded in our current conventional wisdom.

First: The mistaken long-standing assumption that health-care coverage should be attached to employment.

Health care is fundamentally a claim by members of the community on each other. It is a claim of human beings, not of workers. It is a citizenship claim, not an employment benefit.

In the origins of our current system, health care was presented as a benefit of employment. Companies used it as part of a compensation package that was negotiated with workers or simply instituted through corporate self-enlightenment.

From the first, however, health care has been a privilege and responsibility springing from our common life together, whether employed or unemployed, rich or poor.

It arises from our shared humanity and from the bonds between generations and among families, friends and communities.

Attaching this privilege and responsibility to employment misses the point. Servicing our current system has become a heavy burden to our nation's employers. Why saddle them with this in addition to their primary purpose of conducting their business?

Second: That private insurance carriers -- and their immense, overlapping bureaucracies with the resulting quagmire -- are somehow indispensable to the health-care delivery system.

Winston Churchill once said, "You can always count on Americans to do the right thing, but only after they have tried everything else." We're seeing this truism played out at this very time.

Insurers have created a system designed to maximize industry profits. For-profit managed care has proved so lucrative that it is offered by companies to do nothing else.

Former U.S. Surgeon General C. Everett Koop say recently, "Insurance companies are accumulating enormous power and wealth by taking over the ownership or management of entire health-care delivery systems, even some medical schools. ... All across America we see an accelerating trend of taking medical decisions away from doctors and patients and allowing them to be made by business."

Managed care is simply an arrangement to redistribute health-care dollars to industry administrative functions.

If we as a society cannot agree that health care must be addressed on an all-inclusive basis, we are accepting the present non-system with its stupefying panoply of programs to benefit corporate interests. To steamroll such programs, Americans are bludgeoned with the horrible specter of socialism and communism if a national health-care system is advanced.

If Americans fear government bureaucrats under such a program, wait and see what a taskmaster private-industry bureaucrats can become.

Following Churchill's assertions, all the fancy footwork and fragmented concepts to avoid what America must do to be true to itself are the only way stations on the road to a national, single-payer health-care delivery system.

Gilbert Degenhardt is a Cape Girardeau resident.