TO YOUR GOVERNMENT-DETERMINED MINIMAL HEALTH - AT 8:05 P.M. ET:  It may be symbolic, but the president is in Moscow just as his legions in Congress are trying to introduce a brand of socialism to the American health-care system.  Ah, maybe Barack and Michelle can visit some of those healthy Muscovites, and ask how they like government control of their livers.  Or, maybe Mr. Obama can fly on to Britain and symbolically put his name on a waiting list for an operation.  Should be available a bit before the end of his term.  Or, even more tingling to the legs of the left wing of his party, he can jet into Cuba and see the marvels of free medical care.  Just don't ask about any other freedoms.  This new administration "understands" other cultures.

What chills us is that we're having a debate without information.  What precisely is the problem in our health-care system?  Does it need an overhaul?  Or patches?  Why should the government be involved?  If saving money is the goal, when has the government ever saved any health-care dollars?  And perhaps most important, does independent research, including good journalism, support the claims made by the administration or its critics?

The press has been next to shameful.  There is little depth to the reporting on health care.  There are anecdotes and claims, but the kind of three-column story that would set the record straight is lacking.  Even the cable news operations, which have plenty of time, have only dealt with the facts of health care superficially.

Also lacking is plain common sense, a phrase that often panics the educated elite, who believe that all knowledge is contained in their sheepskins.  (Truth in packaging:  I actually qualify as part of that club, but I refuse to apply for a membership card.)  Often, especially when something as personal as health care is concerned, simple observation can tell us a great deal.

Example:  I recall, many years ago, that there were campaigns to get operations for children whose families couldn't afford the care.  The press loved them, often sponsored them.  "Get Johnny cured!"  "A new life for Annie!"  In a grim way, we were fascinated by these campaigns.  Write a check, save a kid.

But I haven't seen a campaign like that in decades.  Why? What does that tell us about our system?  And when is the last time you saw a story of anyone being denied medical care because he or she couldn't pay a bill?  I don't remember the last time.

What do these observations say about American health care?  The fact is, there are many programs available for people who can't pay medical bills.  Hospitals, often by law, are set up to handle cases where payment is in doubt.  It's far from a perfect system, and improvement is indicated.  But people do get care.  We do not see bodies in the streets.  Question:  Shouldn't we improve on this system rather than overhaul the entire medical delivery mechanism?  And is government the proper party to do this?  If there's a leak in one pipe in your home, you don't normally rip out all the plumbing.  You patch the broken pipe.

Some years ago I attended a seminar run by Public Broadcasting System (PBS) in New York.  They were thinking of putting on a medical information program.  The purpose was to encourage members of minority groups to seek medical care, which was amply available to them.  The dirty little secret of the health care system is that many people who don't receive care don't get it because they don't want it - either because they don't want to spend the money and think they can beat the odds, or because their culture doesn't put much emphasis on things like preventive care. 

And there's another point that requires mention:  Sometimes the tragedies that some commentators attribute to a defective medical system have nothing to do with medicine at all.  A few years ago I was commenting to a writer friend of mine, who lives in another part of the country, how few members of my high school class were deceased.  It was about five percent.  My friend replied that in his class, which was even younger, the number was closer to 35%.  I asked him what possibly could cause that disparity.  He answered, "You have to realize where we live.  It's guns, cars, and alcohol."  Lifestyle plays a role, sometimes a dramatic role. 

We need more facts, better reporting, more details, before we overhaul a medical system that, for most Americans, delivers quality service.  Here is where the press can excel.  It hasn't excelled.  But you can be sure that, if you tune in tonight, you'll get five more stories on the death of Michael Jackson.

July 6, 2009