A recent USAToday Gallup public opinion poll showed that President Bush’s main weaknesses are in the area of social policy, with his attitude toward health care in general and abortion high on the list. The polls also show broad support for a strengthened Medicare program with a strong prescription drug benefit.

These demands and the failure of the U.S. system to deliver decent health care are also becoming the focus of a number of national institutions able to exert a strong influence on the health care policy debate. This year’s congressional races are an opportunity to make some changes in the composition of both House and Senate and make these demands heard.

One of the most vocal critics of present policy is Dr. Arnold S. Relman, Professor Emeritus at Harvard and former editor of the prestigious New England Journal of Medicine, who told the U.S. Senate Committee on Social Affairs, Science and Technology that our present system is “expensive, inefficient and inequitable.”

An important aspect of Relman’s testimony is that he points to the quest for profits as the reason for this failure. “I am now at work on a book that surveys the present unhappy condition of the U.S. health care system, with particular attention to the role of private enterprise,” he told the senators, adding: “The U.S. may be a world leader in medical science and technology, and its major medical centers may provide some of the best and most sophisticated care available, but taken as a whole, our health care system is failing and will need major reform very soon.”

Relman said the U.S. had “tried private for-profit markets, first in hospitals, in ambulatory care facilities and services, and in nursing homes, and then more recently, in the ownership of insurance plans and the experiment has failed.”

Nor was Relman a lone voice crying in the wilderness. A recent study by the prestigious Commonwealth Fund based on a review of 150 studies and reports, found a “lack of preventive care, medical mistakes, substandard care for chronic conditions, disparities in care” and other major problems in the U.S. health system.

In another study, the National Academy of Sciences’ Institute of Medicine (IOM), found an obvious, but important, fact: “Being uninsured can be bad for your health,” the academy said.

“If you lack health insurance coverage you’re going to have a poor health status, greater chance of dying early and your quality of life is not going to be as good because of poor health care,” said Mary Sue Coleman, co-chair of the IOM committee that produced the report.

The report also found that people who have even a relatively short interruption in coverage tend to have a decline in their health.

This last fact is particularly important as the rolls of unemployed rise. Many, if not most, of the newly unemployed cannot afford the price – ranging from $600 per month and up – of continuing the health care benefits they are entitled to.

The only solution to this crisis is rejecting the for-profit ideology that Dr. Relman has documented as the culprit. The first step is to call for support of Universal Health Care Access Legislation, such as the concurrent resolution introduced by Rep. John Conyers (D-Mich.), and by making health care a priority in the upcoming election.

The author can be reached at pww@pww.org

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