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MOLLY IVINS Health Care in a Great Nation When a poor, black boy like Michael Jackson can grow up to be a rich, white woman who marries Elvis Presley’s daughter, you know we live in a great nation. And now, on to the outrage du jour concerning health-care reform. Enough alreadyenough that they’re letting the private insurance industry keep $100 billion a year for doing a rotten job, enough that the big five insurance companies and the big HMOs are writing the bill, enough that we can’t get doctors for rural areas or family practitionersnow the damn fools in Congress are caving in to Pepsico \(owner of Pizza Hut, which won’t pay for health insurance for American workers but does for other big corporations on the point of letting individual states set up their own single-payer systems if they want to. Where are the conservatives, who say they’re federalists on this one? Where are all those Republicans who like to blather about how states are the “workshops of democracy”? Aux armes! Victory or death, as Col. Travis once put it. How dare they prevent some intelligent, forward-thinking state from starting its own single-payer system? If the politicians in some Shangri-La like Oregon, lions of courage backed by the overwhelming majority of their people, want a single-payer system, who is Washington to tell them they can’t have it? If Oregon pols are willing to pass the taxes and take the heat, why should Congress, just because it is so wretchedly gutless, say them nay? The big multinational corporations, such as Coca-Cola, finagled a provision into the House bill that allows them to opt out of state single-payer systems and avoid paying taxes to support them, and that guts the state single-payer option. To hell with ’em: Let the people drink Dr Pepper! You know what they’re really afraid of, of course. They’re afraid the people of every state will see how well single-payer works in one state and demand it for themselves. It’s like Hawaii already having mandates that require employers to insure all full-time workers. Hawaii has the lowest uninsured rate of any state at 8.12 percent. Texas has 25.7 percent uninsured, compared with the national average of 17.4 percent. Sam Kinch’s newsletter, the Texas Weekly, ran some interesting stats recently. The original Clinton health-care plan would Molly Ivins, a former Observer editor, is now a Fort Worth Star-Telegram columnist. have cost larger Texas employers $657 million a year by the year 2000, but smaller employers would get lots more than that in subsidies; employees at companies that now provide health insurance would save four times that much in family-coverage preiniums; state employee health-care coverage would be down. by $600 million a year; and the state would save about the same amount through lower costs for Medicaid. So how many of the pinheads in our delegation supported the plan that would have saved Texas and Texans millions? Ha ha. For Texas families covered by health insurance at a parent’s workplace, employees pay an average of $5,169 in out-of-pocket while employers pay an average of $2,378. Like to see that turned around, wouldn’t we? Among Texas employees with health insurance on the job, one-fourth lost their coverage at some time between February 1990 and September 1992. So, do you ever get the feeling our elected representatives aren’t exactly considering our best interests here? What we are now looking at in Congress is not a bill written for the people of this country; it’s a bill written for MetLife. If there is any saving grace to come out of the mess Congress has made out of the Clinton bill \(which was no great prize to Leader George Mitchell’s insistence that we get health insurance for kids. For that much, let us be grateful. HEALTH CARE Follies contin ues to put on display everything that’s wrong with the American political system in gruesome detailand still manages to come up with new twists every day. Right now, the House and Senate have revived the old running gag about a couple of Frogs who hit the door at the same time: “After you, Alphonse.” “No, after you, Gaston.” “No, no, after you, mon cher Alphonse.” “Mais non, I insist, after you, mon cher Gaston.” Like kids playing “I get to go last,” the House has now cleverly postponed its vote on health-care reform until the Senate votes. The Senate, in turn, has crafted a remarkable piece of legislation under which employer mandates \(that’s the sticky bit until 2002 or later, by which time all incumbents presumably will be out of office or safely dead so they won’t have to face anyone’s ire. Besides, it doesn’t sing as an election issue: “And my opponent voted for something that will make a lot of rich peo ple mad sometime in the 21st century.” My favorite new developmentand this is an original startis that Newt Gingrich and 50 other Republicans have sent letters to all the delegates in the policy-making body of the American Medical Association. Now, normally we count on special-interest groups to take their complaints and pleas to the politicians and try to get the pols to vote their way. Now we have pols approaching a special-interest groupto wit, the doctors of the nationand telling them what they should be saying about health care. It’s new, it’s novel, it’s fresh! “We are dismayed by the actions of the leadership of the AMA,” wrote Gingrich & Co., who said the AMA’s position supports the Clinton plan \(which, as followers of this AMA’s sin was to join the AFL-CIO urged Congress to support a health-care plan that will provide universal health care insurance. The AMA has supported universal coverage for many years, but Gingrich felt entitled to scold them for supporting this radical notion. So the AMA obligingly noted that it was not supporting any particular health-care bill. How nice that Newt Gingrich feels entitled to tell the AMA what to think about health-care reform. 01′ Newt’s not a doctor, but maybe he could play one on TV. SADDEST NOTE of the past fortnight. An invitation to a 75th birthday party at the Officers Club of the Pensacola Naval Air Station: “We are going to celebrate this milestone with a party to beat all parties.” The party didn’t take place. Instead, there was a memorial service for James H. Barrett, who was shot to death by an anti-choice terrorist outside a clinic in Pensacola. James Barrett was a career military man and later a teacher who survived three warshe flew missions in North Africa in World War II, in Korea and in Vietnam. Barrett was still on duty, still protecting freedom, when he was shot to death by an American terrorist. Barrett was so angered by the murder of Dr. David Gunn last year that he volunteered to serve as an escort to Dr. John Britton, another doctor who performed abortions in Pensacola and who was also killed by the terrorist.Last year, Barrett told a local newspaper, “I’ve spent my life doing my best for the security of my country and the people who live in it. Why should I stop now?” I don’t know if there is a medal that covers James Barrett’ s kind of heroism and sense of duty. But there should be. 14 AUGUST 19, 1994