HEALTH REFORM: A CHANCE TO RECONSIDER

Remember health reform?

President Clinton's No. 1 agenda item -- the one that was to be accomplished within months of taking office -- generated heated debate and brought special-interest groups out of the woodwork with millions of dollars to spend. But government-imposed health reform is over for this year.

Health reform isn't dead, however. It is in a coma. And Americans can bet their last hospital bill that reform fever will return next year. In anticipation of another attempt to make massive changes in the country's health care system, it is an opportune time to take a look at the rock-bottom issues while the heated rhetoric and the shrill lobbying have abated for the time being.

The real health issues are fairly simple.

-- Americans want insurance to be available to everyone, but they don't want mandatory insurance.

-- Those who have insurance want it to be portable. In a mobile society this is crucial to individuals and families who move from job to job, from city to city and from state to state.

-- Due to a variety of circumstances, those who want insurance also want uninterrupted coverage, even when they switch from one policy to another because of employment changes. Coverage for pre-existing conditions would eliminate a major gap in benefits.

Believe it or not, most legislators accept these three goals for health insurance reform. If the reform movement stopped there, members of Congress say, health reform would be a done deal. What concerns legislators -- and what genuinely scares the bejeebers out of taxpayers -- is the notion that national health reform ought to include letting the government run the health-care delivery system as well as oversee universal insurance coverage.

Curiously, a good deal of reform is occurring in spite of the lack of a federal takeover. Employers, insurers and health-care providers are constantly seeking new ways to contain costs, improve efficiency and upgrade drugs and medical procedures.

The notion that greedy providers have taken advantage of third-party payment systems is less significant in the overall tide of medical care in this country than the unbridled demand by virtually every American to use every medical innovation to sustain life, regardless of the quality of the results. The bald fact is that new drugs and new medical procedures are expensive, no matter who pays for them.

Real reform of health-care delivery must take into account that the biggest share of the cost is spent on patients who are dying and who don't survive the Herculean efforts to sustain life for a matter of hours or days. Meanwhile, too many Americans ignore preventative medical realities: sensible diet, weight control, no smoking, alcohol moderation, no drug abuse and exercise, to name a few. The cost of these good-health practices is a pittance compared to many heroic life-saving efforts.

Does it take a government mandate to change this? Absolutely not. While it may take Congress to level the playing field for insurance providers -- and it need not go beyond that, reform only takes a unified efforts by doctors, hospitals, companies that care about their employees, insurers who reward healthy lifestyles and preventative medical procedures, plus a reshaping of the national mentality that some doctor or hospital can and should cure everything for everybody.

It is time for everyone -- from the White House to the white house where you live -- to step back and take a look at what Congress nearly wrought this year at the insistence of an ill-begotten reform machine led by President Clinton and First Lady Hillary Rodham Clinton and financed by interests other than Americans in need of health care. Give Americans what they want, but leave the rest of reform to the marketplace.