When the Clinton health care reform initiative died in 1994, the problems it promised to address didn't disappear with it; they grew worse.
More than a decade later, the United States' population has reached 300 million, a large percentage lacking adequate--or any--health care. Figures vary, but approximately 45 million Americans have no health insurance at all and another 20 to 30 million are underinsured, while many more are at risk of losing what little they have.
A new collection of essays, Health Care Reform: Ethics and Politics (University of Rochester Press), questions the ethics of having so many citizens without basic health care--the middle aged who have lost their jobs and benefits, children of uninsured parents--and proposes ways of moving beyond the standard ideological roadblocks.
The anthology, edited by Timothy Engstrm and Wade Robison, professors of philosophy at Rochester Institute of Technology, call for a renewed national dialogue committed to revamping the U.S. health care model guided by moral principles in balance with political and economical realities.
Health Care Reform grew from a conference held at RIT in 1995 and shows how little has improved since the failed Clinton initiative. Essayists include Howard Brody, a former consultant with the Clinton administration's Health Care Reform Task Force; Norman Daniels, from Harvard School of Public Health; and Uwe Reinhardt, who sat on the National Advisory Council for Health Care Policy, among others.
"The message throughout the book is that moral clarity comes first and that clear policies can and must follow," says Robison.
The escalating costs of health care force companies to cut benefits and transfer costs to employees to remain profitable or, paradoxically, to move abroad to countries with a national health care system--all decisions that compromise individuals' and the nation's economic health.