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Commentary: Fix health care now, fix warts at later time

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"Rome was not built in a day," Montana Democrat Max Baucus said with resignation after the Senate committee he heads voted to reject a "public option." A government-run health plan that would compete with private insurers' offerings, the public option is a means to curb spiraling health care costs.

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It's more than a little weird that something designed to ease the burdens of American business and contain federal deficits was opposed by supposedly conservative Republicans and moderate Democrats. Then again, the ruckus over the public option is more about ideology than reality and, in many cases, is merely payback to the medical-industrial complex.

The public option is "a Trojan horse for a single-payer system," Sen. Orrin Hatch warned after the Utah Republican voted against it. Funny, but a poll shows 69 percent of Utah small-business owners favoring a choice of private or public plans, with an additional 7 percent preferring a public option only. In a national poll of physicians, 51 percent of doctors in Utah backed both public and private options. Another 16 percent wanted a public option and no other! So exactly what Utah constituency is Hatch serving?

Well, Baucus was right about Rome. Another committee in the Senate and three in the House still have public options in their health care bills. And Maine Republican Sen. Olympia Snowe has proposed a backdoor approach -- activating a public option only if private insurers do not offer affordable coverage to 95 percent of residents in a given state.

Massachusetts is alone in accomplishing near-universal coverage, and its system remains a work in progress. Foes of the Democrats' plans point to Massachusetts as a state groaning under the costs of medical reforms similar to what's being proposed on a national level. True, the commonwealth has done a crummy job of putting the brake on health care spending.

But as a model for the rest of the country, the Massachusetts experience is not bad. A new survey shows that Bay State residents support their health care overhaul by a two-to-one margin. Only 11 percent want the 2006 law creating it repealed, according to the poll by the Harvard School of Public Health and The Boston Globe.

And it's not that these respondents are unaware of the state plan's price tag. They're getting hit with it. But rather than undo their hard-won reforms, most of those polled wanted the state to seriously address the spending side. A state commission is now working on that and will soon issue proposals for changing how doctors and hospitals are paid, key to moderating costs. So the lesson from Massachusetts may be to pass universal coverage first, then work on the most controversial parts.

The enemies of reform understand this. They know that once Americans get a taste of health care security, you'd have to call the National Guard to take it away. Thus, they must strangle this baby in the cradle before it starts walking.

That's why we are being bombarded with the crazy references to "socialized medicine" for plans far less socialistic than Medicare. It helps account for the melodramatic garment-rending over requirements that everybody obtain coverage or pay a penalty. (The Massachusetts plan instituted such mandates against similar whining. Everyone got over it really quick.)

Passing a national plan without adequate spending restraints is not the best way of going about this. But as Massachusetts has shown, the warts can be removed later.

Three-quarters of a century have elapsed since President Franklin D. Roosevelt first proposed national health care reform. If we need a few more months or another two years to get it right, so be it.

Froma Harrop's e-mail address is fharrop@wctrib.com.

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