There is a health care crisis in this county. Everyone who has to pay for health care premiums, whether by writing a check or having all or a portion deducted from a paycheck, knows it. Everyone who faces the uncertainty of life without health care coverage knows it. Every employer who provides health care benefits to workers knows it. The cost goes up and up and the availability of care and medicines does down and down.

With stubborn tenacity the President clings tightly to the proposition that the cost of medical care and pharmaceuticals must be left to the providers and drug companies to determine. He claims to be introducing “competition” into the health care delivery system by privatizing parts of Medicare and Medicaid and forcing beneficiaries into private HMOs and PPOs to obtain the care covered by those programs. The “competition” between institutions seeking to administer the care provided to beneficiaries has no effect upon the cost that the providers charge for their goods and services. When the system makes the patient to select among managed care providers the system is takes away the patient’s right to select his or her doctor and gives it to the administrator, whether that choice is based on cost or quality of care. When the system is restrained from negotiating for lower prescription drug prices with the companies who enjoy a patent protected domestic market and forbids acquisition of the identical drugs from the cost controlled international market then the system encourages increased cost to the patient.

Neither the Kerry proposals nor the Bush pushed privatization scheme will control runaway medical costs. Neither will restraint of a patient’s right to recover for injury caused by negligent providers. Doctors and patients together face the crisis in medical malpractice premiums as an element of the cost of medical care. But the increase in premiums is not cause by trail lawyers prosecuting malpractice claims. It is caused by investment losses in premium reserves in a market that fell again today. That is a “market force” that impacts both malpractice insurers and health care insurers alike.

Neither the cost of health care nor the cost imposed on the system by negligent providers can be controlled by excluding any element of cost control from the system. Neither party is ready to propose realistic medical negligence reform or realistic health care programs. America is the only industrialized nation without a tax paid single payer health care delivery system. Those are the economies with which American industry must compete while directly shouldering the cost of health care. Meaningful medical negligence reform that would promise real cost savings would be modeled upon the Workmen’s Compensation systems by which we provide for people disabled by industrial accidents. By standardizing compensation and taking fault out of the equation costs can be controlled and predicted. That reform and a single payer administrative system is the way to heal our ailing health care system