A Diagnosis That Requires Attention : The nation’s doctors are right: We can’t wait for a health-care consensus

The Bush Administration’s chief health officer says health-care reforms are hopeless without a “common vision” of what they should be.

A spokesman for the American Medical Assn., the country’s biggest organization of practicing physicians, said Monday reform can’t wait for consensus. In an unprecedented attack by the generally conservative medical association, Dr. George Lundberg called the existing patchwork of programs that finance health care unacceptable--”morally, ethically or economically.”

The most basic flaw in the system, Lundberg said, is that somewhere between 31 million and 37 million Americans have no health insurance. That means they either pay out of their own pockets, rely on diminishing government programs--or, more and more often, do without care.

Lundberg is editor of the Journal of the American Medical Assn. The Journal’s new issue unveils a range of proposals for expanding the benefits of American medicine. In another first, the new issue covers only one subject--health-care reform.

Dr. Louis W. Sullivan, secretary of health and human services, was right about one thing in calling for consensus. The ideas in the AMA Journal’s special issue--as in most public debate on reform--are all over the lot.

--One simply called for importing Canada’s health system, in which the government would pay all medical costs virtually without paperwork. It also would keep hospital staffs lean, limit purchases of new medical diagnostic technology to curb costs and provide treatment first to the most seriously ill. That can lead to long waits for people with serious, but not advanced, illnesses. Or:

--Employers could be required to provide health insurance for workers and their families, and states to create risk pools for others.

A smaller group of doctors could create a single national insurance program to replace private insurers.

But the mere fact that the AMA has joined think tanks, politicians, academics and others in denouncing the nation’s health system is an important step toward consensus--at least on the fact that there is no great need for further study. It is well established that something is terribly wrong and that fixing it cannot wait.

Lundberg doesn’t know precisely what the fix will be, but says the answer lies somewhere in his journal’s special edition. He and others also suggest that President Bush must lead the search. As one doctor said, the President can make sure the right questions are asked. It’s hard to argue with that--as it is with the AMA’s dim view of the health-care system. Maybe physicians can now push the nation to heal itself.