In an annual triumph of hope over experience, Cubs and Red Sox fans begin dreaming of the World Series each spring. And just about every fall, like this one, experience sends them into winter muttering, "Wait till next year."
Proponents of universal healthcare no doubt felt a spring-baseball heart flutter last week with the release of three reports. But if history is any guide, they should not start planning any victory celebrations.
An ABC News-Washington Post poll showed, among other things, that by an almost 2-to-1 ratio Americans said they preferred a universal system that would provide healthcare coverage to everyone under a government program, as opposed to the current employer-based system. Eight out of 10 poll respondents said it is more important to provide coverage for all Americans, even if it means higher taxes, than to hold down taxes but leave some people uncovered. Fifty-three percent of those who are insured said they worry about losing their insurance because of a job loss.
Then came a report from the Commonwealth Fund saying that one-third of the nation's workers without health insurance are employed by large companies, or those with more than 500 employees. Some 32% of uninsured workers in 2001 were employed by large companies, compared with 25% in 1987. Researchers attributed the rise to soaring healthcare costs, fewer manufacturing and union jobs, and the changing structure of large corporations and the benefits they offer.
A third report by the Center for Studying Health System Change disputed the widely held notion that uninsured Americans are the major cause of overcrowded emergency rooms. The center said capacity restraints experienced by office-based physicians combined with a loosening of managed-care restrictions might be fueling the rise in use. The researchers noted, however, that uninsured people's growing reliance on emergency care indicates decreased access to other sources of care, including physician offices. "Getting medical care outside of the emergency department is definitely becoming more difficult for uninsured people," said Peter Cunningham, the center's senior health researcher.
You might think all of this data and nearly 44 million uninsured Americans would spur an anxious nation to do something. Clearly, the employer-based healthcare system is wobbling under the strains of an economic downturn, layoffs, the outsourcing of jobs and skyrocketing medical costs. A new and comprehensive national program of public and private funding is needed. But the Cubs will play the Red Sox in the World Series long before this problem is solved. American politicians have been kicking around the idea of universal care since the last time the Cubs won the Series.
The last time anybody tried something beyond a Band-Aid for this ill, it was killed like the victim in "Murder on the Orient Express." Granted, President Clinton's Byzantine and bureaucratic plan was unlikable, but the repeated stabs by special-interest groups, including hospitals, insurers, pharmaceutical companies and physicians ensured that neither that proposal nor any other would survive a legislative debate. The next time around, whenever that may be, all of these groups will be joined by the ideologues on the left and the right who won't be satisfied with any compromise.
Probably nothing short of another Great Depression or a slew of healthcare providers going bankrupt caring for the uninsured will move the political system to serious action. Too many groups prefer the status quo, and too many voters are confused or apathetic. The advocates for universal access had better learn a new chant: Wait till the next century.
What do you think? Write us with your comments. Via e-mail, it's [email protected]; by fax, 312-280-3183.