Question Number Eight: President Bush and Sen. Kerry have unveiled their health-care plans. How would you structure a health-care plan? Would it be universal, or only for indigents? Would you feature privatized health-related savings accounts? What would you do about malpractice lawsuits?


These are very serious issues and Americans deserve a thoughtful, nonpartisan solution that will be fair to the majority of people. America has to decide what we mean by "health care" - i.e., is it 10 or 12 heart catheterizations for an undocumented worker? Is it prenatal care/delivery/PICU care for a premature undocumented baby whose mother comes the United States only to deliver? What about those who come here for health care and return home?

Is "health care" mandatory coverage for every single worker, whether they want coverage or not? Is it mandatory coverage for every single American? The homeless who choose not to work? Is it mandatory coverage for those who have enough money stashed away (there are more than you think) who do not want to pay for health insurance under the notion that "I'm not sick now, why pay?"

America has difficulty identifying the number or distribution of uninsured Americans. Demographic data available include:

* In the first half of 2001, 16.7 percent of the noninstitutionalized civilian population of the United States were uninsured meaning that nearly 80 percent of the entire population did have insurance.

* Among the U.S. civilian noninstitutionalized population under 65, more than a third of Hispanics (37.7 percent) and 20.2 percent of black non-Hispanics were uninsured during the first half of 2001, compared with 14.9 percent of white non-Hispanics.

* Among people under 65, Hispanics accounted for one-fourth (26.3 percent) of the uninsured civilian noninstitutionalized population - even though they represented only 13.1 percent of the overall population this age. (http://www.meps.ahrq.gov/papers/st4/stat04.htm#DefUninsr)

What we know is that the largest numbers of uninsured are Hispanic, and this raises the question of how many of those are undocumented workers. Nobody seems to know.

Canada and England have socialized medicine, and I do not know whether, if I entered either country illegally, they would provide me with medical treatment.

I do know that a large part of our health-care crisis is related to medical care for undocumented workers and that Hispanics are now the majority minority population in America. Many members of this group do not speak English so that providing health care becomes even more costly with translators and such.

The Federation for American Immigration Reform's estimate of the national cost incurred by undocumented workers for Medicare and Medicaid is $3.7 billion. The federation cites cases in which individuals come here just for the health care, and then return home. Again, no one knows how many people do this, but undoubtedly whenever it happens, the rest of us incur the cost.

I have yet to see either candidate, or wither major party, address the problem of an estimated 3 million (and that may be low) undocumented workers crossing our porous borders every year. I personally believe this to be the most important domestic issue this election - but you'd never know it by the content of the political speeches from both sides. Maybe we can ask Dan Rather to investigate.

As long as either party politicizes the health-care crisis, nothing will be done to solve the problem. We need a task force, madeup of experts in medicine and the health-care industry who have not now nor ever will be elected to office, to examine this issue seriously. Outside of Washington, behind closed doors, with no media, much the way the Founding Fathers developed the structure of our government. There is nothing worse than preening, egocentric politicians "solving" a problem.

I hear Republicans and Democrats alike whining about people choosing between food and medicine and I know there are some people who must make those difficult decisions. But I know more who are choosing between health insurance and cigarettes, beers, widescreen TVs, DVD players, and other non-necessities. They do not want to pay $300 a month for health insurance but think nothing of smoking two packs a day at nearly $200 a month, paying $100 a month for digital cable or satellite, and trading in their cars every three years.

If, as we say, health care is a "right," then health insurance is a responsibility of the individual. Our problem - or the issue, depending on how one looks at it - is that many Americans want free health care. The 50 percent of American "taxpayers" who do not actually pay taxes are more than willing for those who do pick up the tax tab to pay more for everyone to have health care.

I know that the high costs of lawsuits is a real problem, and the malpractice premiums are very high, but I also see medical doctors with million-dollar homes, six-figure cars and beach homes/vacation condos on the beach. Practicing medicine today in America is a license to print money. I do not begrudge a physician his or her income except that now we may have to take my health care choices away to pay for all to have health care to maintain the physicians' lifestyle. I know a lot of doctors who would like some type of socialized medical coverage but not if it impacts their lifestyles.

My grandfather was a physician. I can clearly remember the day he purchased a Buick - a big day for them. Not a Caddy, not a Benz - a Buick. My grandmother told me he would take chickens and vegetables from folks' gardens for payments. I know physicians today who practice "boutique" medicine so that people can pay a yearly fee and pay their doctor cash - no sitting in the waiting room (Dante's 7th Circle of medical hell) with the unwashed masses of folks on Medicare/Medicaid and (gasp!) Blue Cross/Blue Shield.

We cannot craft a health care policy until we decide what we believe our responsibilities are, as Americans, for our own health care and the health care of others. We cannot propose sweeping changes in the health-care system without making sweeping changes to programs such as Medicare/Medicaid, and we have to address the undocumented worker issues. We cannot make sweeping changes to health care unless we address the compensation to physicians.

Socialized or universal medical coverage would affect all of us, not just those paying the taxes, and not just the patients. It woulld affect physicians and their income, nurses, drug companies - everybody. A governmental board will decide if you really need a pain clinic, or if you should just cowboy up because everybody hurts sometimes.

I think everybody who wants socialized universal healthcare ought to call his or her local Social Security and IRS offices. After all, socialized medicine can't be worse than that, can it?