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Time to deliver on healthcare promises

Given the nation's deepening economic crisis, some are cautioning President-elect Obama to postpone comprehensive health-insurance reform until things settle down. For reasons both substantive and political, it's crucial that he ignore them. Fortunately, the incoming Obama administration gives every indication it intends to deliver on its promises.

In practical terms, there's nothing better the new administration could do for millions of Americans living through hard times than removing the fear that losing your job means losing access to healthcare. New York Times reporter Robert Pear recently chronicled the hardships endured by former employees of a closed cookie factory in Ashland, Ohio.

Unemployed workers are canceling medical and dental appointments, postponing surgery, and not filling drug prescriptions for themselves and their children. Pear interviewed an Ashland woman who, notified that her medical benefits were about to expire, persuaded a midwife to induce labor and rushed to the hospital to have her baby delivered by Caesarean section. The infant did fine; alas, her insurance company denied the claim, leaving her with a $17,000 hospital bill she cannot pay.

Hospitals are also feeling the pinch, forced to write off millions to charity while revenues are dropping, although operating expenses are not. An administrator at Ashland's Samaritan Hospital told Pear, "We've seen a huge decrease in MRIs, CAT scans, stress tests, cardiac catheterization tests, knee and hip replacements, and other elective surgery."

There's nothing unique about Ashland, Ohio. Shamefully, such stories are becoming increasingly common all across what we're so often assured is the nation with the finest medical care on Earth. The difference is that most uninsured Americans suffer more or less in silence. Uninsured medical costs remain the single largest cause of personal bankruptcy in the United States.

In terms of medical outcomes, of course, the United States has nowhere near the best healthcare in the world. There's hardly a country in Europe that doesn't show far superior health statistics while providing universal health insurance to its citizens at a fraction of the cost. Nations such as Canada, Australia and New Zealand also manage to do a much better job.

What's more, for all the fear-mongering about "socialized medicine" on the American right, doing away with universal health insurance isn't a significant political issue anywhere. Even former British Tory Prime Minister Margaret Thatcher, much revered by American conservatives, never really tried. Like "socialized" water, sewage treatment and fire departments, once achieved, universal health insurance becomes a permanent fixture.

Two things you can be sure of about individuals warning the Obama administration to go slowly: They have excellent health insurance of their own, and their real motive is to prevent meaningful reform entirely. Their arguments tend to be deceptive at best, downright hysterical at worst.

A recent Washington Times column by Rep. Michael Burgess, R-Texas, was sadly typical. "The idea of government-run healthcare sounds appealing to many Americans," he wrote. "Really what that means is limiting freedom -- the freedom to choose a doctor, to take your healthcare with you when you switch jobs, to make personal medical decisions. ... As a Republican and a physician, it is critical for us to offer a clear and credible alternative to a one-size-fits-all system that puts bureaucrats in charge of healthcare decision-making."

Because, as everyone knows, "bureaucrats" ruin everything. Except insurance-company bureaucrats, of course, who devote their energies to writing incomprehensible contracts, enabling them to ditch policyholders who actually get sick, and engaging in perpetual conflict with rival bureaucrats in hospitals and doctor's offices seeking to get paid. It's the maddening inefficiency of our current Rube Goldberg system of healthcare financing that makes it so ruinously expensive.

Either Burgess doesn't understand or he chose to misrepresent healthcare legislation proposed by Democrats such as Montana Sen. Max Baucus, whose most salient feature is the choice to stick with employer-based insurance, or to buy coverage through a public Health Insurance Exchange. Apart from providing federal subsidies for individuals unable to afford it, Baucus' plan would also forbid private insurers from denying coverage to persons with "pre-existing conditions."

Policies purchased through the Health Insurance Exchange would also be completely portable. Changing or losing your job wouldn't affect healthcare. As Sen. Baucus, a relatively conservative Democrat, pointed out in announcing it, far from competing with attempts to improve the U.S. economy "health reform is an essential part of restoring America's economy and maintaining our competitiveness."

During his primary campaign against Hillary Clinton, Obama did some shameless pandering on the topic of mandated universal health insurance. In accepting the Democratic nomination, however, he movingly recalled watching "my mother argue with insurance companies while she lay in bed dying of cancer." He vowed "affordable, accessible healthcare for every single American."

The need's immense; the time is now. Odds are that President Obama will never be politically stronger than on the day he takes office.

-- Arkansas Democrat-Gazette columnist Lyons is a National

Magazine Award winner and co-author of "The Hunting of the President."