It is hard to believe that the national debate over health-care reform has become so nasty. Our invasion of Iraq didn't create such a stir _ as if that, too, didn't affect everybody in some way.
Dinner-table chats that stray to the health-care issue become heated arguments from both sides, as the disappointment about what might not occur clashes with the anger over what could happen.
President Obama wrote in The New York Times this week that `` much of the media attention has been focused on the loudest voices. What we haven't heard are the voices of the millions upon millions of Americans who quietly struggle every day with a system that often works better for the health-insurance companies than it does for them.''
But people like you and me are hearing from a few of those millions of voices _ and they, too, can get pretty loud. Some of them have health insurance that works fine for them and they're afraid they might lose out with real reform.
Or, they're afraid they'll have to start paying more so that others have access to the same kind of coverage they have.
On the other hand, an Oxford woman, 39, died earlier this week because she had liver cancer. According to her aunt, months ago doctors told the woman she needed a transplant to survive, but that her insurance company wouldn't pay for it. Only after appeals did the insurer relent.
Was our health-care system working better for the woman or her insurer?
What does reform mean, anyway? Certainly not what could be applied to the meager proposals being advanced some days by the president and other leaders concerning health care.
Naturally, as with any major opportunity for positive change, power politics holds sway. While compromise may be the result of politics, backing off and watering down are what happens when the power of the status quo is flexed.
The battle in Washington _ and on Main Street _ now is about whether we should move immediately to a Medicare-like ``public option'' system that would eliminate the need for most private insurers.
Or, whether we should take a small step or two that would at least provide health-care coverage for the 40 million people who don't have insurance _ mostly because they can't afford it. That would be an improvement, since some say that 60 people die every day because they lack access to health care.
Or, do nothing, which, not surprisingly, is favored by whoever or whatever is making money off the current system, and by many of those for whom affording coverage is not an issue.
A recent Health and Human Services survey showed that 36 percent of non-elderly adults who sought private health insurance in the past three years were ruled ineligible because of a pre-existing condition, charged a higher premium, or their condition was refused coverage.
Is this system working better for the insurer or the people? What kind of country _ what kind of health-care system, would deny coverage to people because they have a disease or some other serious condition?
The ``small step'' option this week was described as the creation of federally funded health-insurance co-ops to operate alongside private insurers, but which would cover anybody who can't afford the privates.
Some have derided the idea as ``Obamacare,'' and suggested the co-op plan would cost $1 trillion over the first decade. Now, that is scary, especially because the private insurers would still be around raking in millions.
Is this system, which has the taxpayers picking up the health-care tab for all the people the private insurers refuse to cover, working better for the insurer or the people?
About 75 percent of New Yorkers surveyed don't believe what we have now is working and that reform is long overdue, according to the Siena Research Institute this week. And, to be sure, all those people are not uninsured.
That leaves the ``public option'' as the only system that accomplishes both universal coverage and fiscal responsibility. By eliminating most of the private insurance sector, the option would save $4 trillion in administrative costs and corporate insurer profits over 10 years.
Those who wish can still have private insurance; if the demand is there, the for-profit insurer will supply.
For everyone else, there will be single-payer, Medicare-style, universal health care administered by the government.
Of course, having the government ``administer'' anything can be a scary thought, too. Can we do it better than some programs have been managed in the past? That will be the challenge for our nation.
But will this system work better for the insurer or the people? It is the only option that has a chance to place the health care of the people first.
Meanwhile, we better add health-care reform to politics and religion on the list of taboo dinner-table conversation topics.
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Cary Brunswick is managing editor of The Daily Star and can be reached at cary@thedailystar.com or 432-1000, ext 217.
