When you strip off the rhetoric and the partisan politics and remove the fear factor, the health care legislation working its way to President Barack Obama's desk is, for most Americans, the healthiest medicine ever offered.
Sure, there are missing pieces and probably things that should not be there. Instead of trying to produce perfect reform legislation, which has failed in the past, the Democrats in Congress, under pressure from Obama, have made a good start.
The legislation provides a basic structure that will, in time, shelter almost all Americans from the high cost, selective availability, inefficiency and injustice of American medical care as it is today. When implemented and tweaked, the new medical care system will bring the United States more in line with the other industrialized nations. Being at the bottom of the list, as we are today, is a disgrace.
We need to focus on both our short- and long-range health-care goals. In the long term, our nation needs medical care to be affordable for all. We want medical care to be competent and cost efficient, preferably given by the doctor and the hospital of our choice. We would like to feel secure knowing that no matter how sick we get, we won't go broke trying to save our lives or quality of life. Medical care must be available for those with a pre-existing condition or a genetic high-risk factor, or those who lose their jobs, or whose employers go out of business.
And wouldn't it be nice if medical care was seen as a right, rather than a source of enormous profit to others? Insurance companies shouldn't force us to bet against the odds on our health. If we can't afford the drugs, even the best diagnosis is of no benefit.
Although the vast majority of Americans, including physicians, nurses and hospital administrators, embrace these goals, none really exist in this country -- except for the wealthy. Does the pending legislation head us toward these goals? And is this enough? Do we have to score the very first time we get the ball? Let's look at the short term.
The legislation imposes on a free-enterprise, for-profit medical delivery system a new and important objective: access for all. The United States is at long last on the road to having regulated medical care, not only for the older citizens who now enjoy Medicare, or the indigent, who have some access to Medicaid, but for everyone.
Just take the ability to get insurance as an example. Currently, whether you can even get insurance is entirely up to the insurance companies and they can exclude "pre-existing conditions." Sure, the company may let you buy insurance and pay a standard premium, but they exclude from coverage the one risk for which you really need to be insured: a disease or ailment to which you seem vulnerable.
Insurance coverage limits are another example. Currently there are ceilings on the obligation of the insurance company to pay your medical bills. You may think you're insured against ruinous medical costs, when in fact you're not. The insurance company walks away from coverage at just the time when your medical bills become ruinous. Those limitations will be outlawed in all insurance policies.
Unfortunately, it seems the final legislation won't do much to achieve the other key objective of systemic cost reduction. Health-care industry lobbyists won that round. But what we're getting is a foundation on which an informed public and a responsible Congress can build long-term goals of affordable health-care rights for all.
So let's not quibble about how the structure isn't the way we personally want it, that it seems unfinished, perhaps not big enough, or short of certain features. It's not that the glass is half-full or half-empty; it's that there is finally a glass at all.
John Steel is a lawyer and the former mayor of Telluride, Colo.