Aside from war and death, Americans face few issues as immediate as access to health care, particularly during times of economic hardship and its accompanying stress. More than 47 million Americans under 65 lack health insurance.

All other major industrialized nations provide universal health care.

How many people do you know who are unemployed, self-employed, partially employed or retired who choose not to go to the doctor or emergency room when they need to because they cannot afford to go?

Advertisement

Two bills are now before the House and Senate that, if passed and reconciled, will be signed by President Barack Obama. They are not terribly different and reflect many compromises, so reconciliation is likely.

According to the Congressional Budget Office, they will both slightly reduce the national deficit over the next 10 years and, with luck, pay for themselves. Both bills would offer health care to more than 95 percent of Americans not already on Medicare. The proposals are actually LESS comprehensive as those made by President Nixon in the 1970s when bipartisanship was more of a reality. Democrats are often blamed for killing Nixon’s plan; Republicans will mostly be blamed if this reform fails.

Health care reform is on the brink of reality and for the first time in our nation’s history, this country has a chance to offer a health care safety net to the vast majority of Americans.

What won’t either of these bills do?

They will not take away the federal Medicare program. The Medicare Commission proposed in the more conservative Senate bill could, indeed, help stabilize it.

They will not force patients to go to some government-selected physician, although a public health option may be an insurance program the government underwrites and it may be efficient or not and it may prove to be more expensive or less expensive than private insurance. Neither program should impact the time patients wait to see a physician.

They will not force starving health insurance companies (exempt from anti-trust action unless House provisions changing that pass) into bankruptcy. For those who fear socialism, neither bill provides universal health care.

What WILL the law do? The public plan would negotiate payment rates for those who want to try it. In one bill, states can opt out of having a public plan, and the most conservative states will do so if that is the law.

Both bills will make it possible, through government subsidies, for lower- and lower-middle income families to pay for private or public insurance. Assisted living and nursing homes for the disabled become more possible than they are today for the disabled and elderly. And employers will have to provide health insurance.

There would be and should be a portability to insurers, which means those who have insurance cannot be without insurance even when they lose their job or move from one job to another.

Those who like their health insurance may keep it. The example for health reform is Massachusetts, where three years ago similar legislation passed, criticized as being clumsy and complicated. Today 79 percent of Massachusetts residents want to keep the state’s public plan and only 11 percent want it repealed. And 98 percent of the state’s residents have health insurance.

How would national reform be paid for? The Senate bill envisions charging a fee for very comprehensive coverage, thus making it something available only to those willing to subsidize giving everyone the opportunity to have decent, basic health insurance. The House wants to tax individuals earning $500,000 or more and couples earning $1 million or more. We are at a vital crossroads. We should call our senators and representatives and ask them to vote for the bills moving to the floors of both chambers, and for whatever comes out of each chamber.

If a reconciled bill becomes law, it will not be perfect. Unfortunately, given the political volatility of the United States, this opportunity to protect the health of our country may not come again.