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Curing Health Care

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If there is one subject that the stressed-out, angry, and polarized population of the U.S. of A. agrees on, it is this: that, for all the outdated palaver about ours being the "finest health-care system in the world," it is nothing of the kind. It is, in fact, as Dr. J. Edward Hill, a Tupelo physician who is past president of the American Medical Association, put it to the downtown Rotary Club on Monday, "a tragically disordered mechanism."

Hill quoted some disquieting statistics -- that almost 47 million Americans have no medical insurance and, thus, no access to any kind of health-care system. Another 20 million have "inadequate" medical coverage. Altogether, almost a fifth of the nation is under-served medically -- including nearly a million Tennesseans.

The remedy? Hill's prescription tilted heavily to what he called "the leverage of free-market economics" and regulatory reform. He sees the national Medicare system and the American health-insurance industry locked in an unholy alliance that has prevented the "price" of medical care (he found the term "costs" too ambiguous) from settling into a self-regulating system that could be both affordable and universal.

As it happens, one of the subjects that is now the subject of a stalemated debate in the Tennessee General Assembly is that of medical tort reform. One or two proposed solutions have barely failed becoming the basis for a bipartisan compromise. While it's frustrating that agreement hasn't yet been reached, it's encouraging that the two sides -- consumer interests and trial lawyers on one hand, doctors and economic conservatives on the other -- have come this close. (It's also encouraging, we have to say, that the contentious issue of caps on malpractice awards has apparently been shelved for the time being.) The fact is, everybody knows something has to be done.

Another sign of the gathering synchronicity on the issue was that the first major presidential forum, held over the weekend in Las Vegas, was devoted exclusively to the subject of health-care reform. Disappointingly, Republican candidates, though invited, did not attend. But all of the well-known Democrats did, and between them they constructed useful signposts for the journey ahead. Former North Carolina senator John Edwards suggested an elaborate system that offered incentives to insurance companies and employers, side by side with a Medicare-for-all alternative. Ohio congressman Dennis Kucinich (yes, he's running again and, "viable" or not, deserves to be heard) was all for dispensing with the "subsidized" insurance industry's role altogether, calling for a national single-payer system. And former senator Mike Gravel of Alaska proposed a national "voucher" system that, in effect, did the same thing.

Whatever we end up with, there is a growing national consensus, linking all the political corners, that our system is outmoded and that something new must take its place. Hill, in his remarks on Monday, cited an epigram by the late Nobel Prize philosopher Milton Friedman: "Only a crisis -- real or perceived -- produces change."

Few of us need to be told that we are at crisis point now, and change has got to come.

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