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Published: Monday, 6/29/2009

U.S. can ill afford for health-care reform to derail now

THE battle for health-care reform has begun in earnest in Washington. President Obama has been reiterating his campaign promises, echoed in his inaugural remarks, to overhaul our health- care system. It is a $2 trillion dollar business and players who are determined to maintain the status quo are reluctant to help kill the fat goose that has been laying the proverbial golden eggs for them.

The debate on health-care reform has ignored a fundamental human rights principle that has been the touchstone of health care in other industrialized countries. Is health care a right or a privilege? The rest of the world thinks it is a fundamental right. In this country, we have relegated it to the realm of privilege.

Much has been written, and often in emotional, self-serving tones, about health care in other industrialized countries and particularly in Canada and Great Britain. To put President Obama's efforts to reform health care in proper context, let us look at the genesis of the National Health Service in Great Britain and try to find some common threads between post-World War II Great Britain and the present economic woes in this country.

NHS began in 1948 in when Great Britain could ill afford a massive, publicly funded program. The country was in the depths of economic depression and severe rationing was part of daily life. Food was not only rationed, but meager rations were being further reduced. Here is the preamble outlining the premise and the promise of the drastic change government was about to undertake.

It told people that the NHS "will provide you with all medical, dental, and nursing care. Everyone, rich or poor, man, woman or child can use it. There are no charges. There are no insurance qualifications. But it is not a 'charity.' You are all paying for it."

NHS has been criticized by its detractors - all of them are outsiders - as an inefficient and archaic monolith where people wait years to get elective operations and where disease does the patient in long before the patient is called for surgery or other vital procedures. While it is tempting to succumb to such overgeneralization, it is far from true.

Sir Bruce Keogh, the chief medical officer for NHS in England, was recently here to give the commencement address at the University of Toledo college of medicine. The address touched on the journey NHS has traveled. While some of the criticism of NHS has a measure of truth, it does not reflect the current retooled health system in that country.

A large investment in NHS in recent years has reduced the much-discussed waiting period for elective surgery from 11 months to a few weeks. Investment in new facilities and empowering regional governing bodies for health care have been greatly successful.

Success of any system is measured not only in patient satisfaction but also in the results of scientific scrutiny. That said, the so-called archaic British system, as all other systems in the industrialized countries, surpasses us. They spend half as much and obtain superior health-care results.

The common denominator in all those systems is public financing, or a combination of private and public financing of health care. While most health-care players in America are resigned to the idea of meaningful reforms, they remain adamantly opposed to any government role in the final scheme.

President Obama, to his credit, still wants to offer a government-sponsored insurance option, along with private plans.

The important question is not whether the country can afford such a drastic change, but whether it can afford not to. In an eloquent op-ed in The Blade on Tuesday, Dr. Jeffrey Gold, dean of the UT college of medicine, argued that a reformed, quality-driven, easily accessible, and affordable health-care system is vital to the long-term fiscal health of our country.

At the current rate of unchecked growth, within several years we will be straddled with an annual expenditure of 4.1 trillion dollars. That is unsustainable and unaffordable.

In 1993, an earnest effort by former President Clinton to reform health care was sabotaged by the status quo. Even though a consensus is emerging between government and key health-care players, there is always a possibility that the process could be derailed.

It would be tragedy if that were allowed to happen.



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