Who killed health reform?

• Position: Editorial

Perhaps it's presumptuous to declare health-care reform dead before the body is even cold--when there is, in fact, still a chance, technically speaking, that some sort of meaningful legislation will emerge from the tangled mess of Congressional- committee jurisdictions that have been wrangling over the Clinton Administration's proposal and a host of alternatives. Conceivably, the sundry Senatorial satraps who figure prominently in the debate- -Dole and Moynihan, Chafee and Breaux, Mitchell and Packwood, among others--will resolve their differences with each other, with the House of Representatives, and with the White House, and will agree on a measure that meets at least a minimal standard of real reform.

But as these words are written early in July, there seems to be every reason to conclude that once again, after half a century of failed attempts to institute a rational and humane health-care system in the United States, we've missed the boat--for this year and, it seems depressingly likely, for years to come.

Some sort of bill may emerge from the Congressional committees, survive votes in both houses, and be rendered acceptable to each in conference. Some sort of bill may be signed by the President, who will undoubtedly put the best possible face on it. But it will fall so far short of what was supposed to be achieved this year that it may occur to many Americans, on sober reflection, that no bill at all would have been preferable, since the current fiasco may well foreclose the possibility of genuine reform for a long time.

That is so because the argument will be made--is, indeed, already being made--that whatever feeble measure may be enacted this year, it must be "given a chance to work" before any new effort is made to overhaul the system. That argument alone can be stretched into a decade of temporizing and delay.

Let's try to remember, if we can, what has been all but totally obscured in the recent health-care debate--the major shortcomings in the U.S. system that were supposed to be remedied this year:

[paragraph] Adequate health care is simply unavailable to more than thirty-five million Americans who have no access to insurance they can afford to buy.

[paragraph] Those enrolled in employer-financed insurance plans live in fear that their coverage will lapse if they change jobs or become unemployed.

[paragraph] Even those who are securely enrolled in health- insurance systems are at the mercy of insurance companies which may drop...