藏精阁

This article originally appeared in the The Washington Post, Sept. 21, 1993.

By: Jimmy Carter and Gerald R. Ford

American politicians and policy makers tend to overuse the word "crisis." Not every problem, not even every serious one, deserves that label. But the problems of our health care system do add up to a crisis -- and we need to attend to it with the urgency, and the willingness to put aside partisanship, that a real crisis warrants.

We have an extraordinary political opportunity, and we must move quickly to come together around a strategy for reforming the health care system. Never before has there been the degree of consensus that now exists -- about the importance of systemwide change and the general contours of what ought to be done -- in the business and labor communities, among the providers of health care and, perhaps most striking, on the part of the broader public. This is not to say that everybody agrees on details -- or that agreement on details will be easy to achieve. But we have never had a better chance to do so than now.

We need to move expeditiously, not only to pass reform but to implement it. The crisis of the health care system is intensifying. Every year, millions of Americans who have health coverage lose it. Children are born to mothers who were unable to get adequate prenatal care -- and these children in turn often go without basic preventive care, which they would receive in virtually any other industrialized nation in the world.

Every year, the costs of health care increase dramatically. In 1993, the United States is expected to spend more than $ 930 billion on health care -- $ 400 billion more than we spent just five years ago. This escalation of cost is draining off funds that could otherwise be used to expand businesses and create jobs, pursue other social goals (such as improvement of the educational system), improve the living standards of Americans, reduce the deficit and, for that matter, provide health coverage to those who are without it. And every year, far too many Americans suffer needlessly from care that is inappropriate or poorly delivered. We need to work hard, and soon, to improve the quality and the consistency of care.

Whatever strategy for health care reform we adopt needs to incorporate and reflect the urgency of our difficulties. We cannot afford the luxury of patience. Let us move quickly to decide what to do -- and then let us do it as quickly as we prudently can.

We are heartened both by President Clinton's recent call for a bipartisan effort on health care reform and by the reaction to it, from governors and congressional leaders in both parties. Ours is a nation that has flourished in part because of our willingness and ability to make necessary distinctions between those matters that were appropriately the subject of ideological and partisan debate and those that, because of their central importance, called for an extra measure of collaboration and resolve.

In the late 1940s, for example, Sen. Arthur Vandenberg, a Republican during the administration of a Democratic president, made an eloquent case for bipartisanship in foreign policy. The issues America needed to address, he said, were so crucial to our future and the world's future that politics should end at the water's edge.

It is time now to adapt the Vandenberg principle to health care reform. Politics should end at the hospital door.

We hope that the president, the governors and members of Congress in both parties will work together, not against each other, on health care reform. What matters is not who gets credit but that we get effective and workable reform. What matters is not who scores political points but who helps to secure the health of Americans, now and in the future.

We are optimistic about the prospects -- in large part because we have worked together for the past several years as honorary cochairmen of a huge alliance of businesses, unions, consumer groups and associations of health care providers that back tough, realistic reform. That alliance, the National Leadership Coalition for Health Care Reform, has operated on a purely nonpartisan basis from its inception.

Its members -- more than 100 varied groups -- have managed to reach consensus on a reform strategy that would control costs through expenditure targets and rate-setting, guarantee coverage to every American within three years of passage and launch a major effort to improve the quality of care. We know from this experience that the support for comprehensive reform is broad and deep -- and that if health care is approached as a genuine crisis rather than as just another issue, the force of common concerns will be able to overwhelm the inertia of parochialism.

Politics as usual may be good enough for usual matters. But the health care crisis is in a very special, highest-level category. It requires the exercise, by many people at once, of the most enlightened form of the political art: statesmanship.

Former Presidents Carter and Ford are the honorary co-chairmen of the National Leadership Coalition for Health Care Reform.