America is interested in health; you might say we are a little preoccupied by it. In a sense, this is an encouraging sign because it means that the man on the street has realized that his future health depends upon important decisions regarding lifestyle and choices. The public interest goes beyond that though; it goes to the delivery of health care in the United States. Our government's role regarding health care is vital, considering something has to be don about the health care of the lower class and the poor of the United States. We also have to acknowledge that there is a terrible problem when you have a system of health care that spends more and more money but seems to serve fewer and fewer. It looks like our government is going to have to open its' eyes and focus on a little health care for awhile.

What can we do about the worries and "prices" of health care? The Bush adminis- tration acknowledges the crisis, and is pushing for dramatic changes. Chief of Staff, John Sununu, argues that fixing the system means new taxes and no-win battles with many constituents, and that reform should be set back until after the 1992 elections. Every day that ticks by without reform not only punishes the poor and uninsured, but also pushes much of American business towards financial ruin.

An important question that needs to be answered is why the $750 billion health care system functions so inefficiently. To understand why, imagine that America's car market worked the same way. Whatever the car the basic American chose to buy, the company insurance would pick up 80 percent or more of the tab. There would be no need for tuneups and no fear of costly bodywork since insurance would pay for the repairs. Most Americans would therefore be driving elaborate expensive Cadillacs whose prices skyrocketed each year. Automakers, dealers, and repairmen would be filthy rich. Instead of shrinking GNP, as it has since 1986, the car industry would be booming.

Rising cost is due largely to lack of information too. Without MD degrees, most people do not know what care they need, leaving the decisions to doctors and hospitals. Yet advances in medical technology means that providers do not always know the most effective, or which one, treatment to use. Thus, they have powerful incentives to over-treat patients--their profits ever increasing with each blood test.

One sensible solution to the medical price spiral is more regulation. A plan would be for the government to set a standard price schedule for all hospitals. This would eliminate the problem of "cost shifting," which occurs when providers offset fee constraints imposed by the government for Medicare (or Medicaid) by hiking prices for the private sector.

Another solution to the problem would be to make health care function more like a market. An approach favored by Budget Director, Darman, would overhaul the current system, under which 70 percent of Americans below 65 get health coverage as a tax-free benefit. Instead, most consumers would receive fixed tax credits from the government based on income, using their proceeds to buy health insurance through companies or on their own. Forced to make decisions about spending their own tax dollars, shoppers might think a little, settling for a good value from the Wal-mart health care instead of buying from Tiffany. There are clearly limits to how well these charges would work. Consumers are ignorant of medicine and can be influenced by doctors and hospitals. On the other hand, regulators lack perfection in setting prices and shrewd providers can find their way around. The problem with health care is that there are no foolproof ways to rationalize the use of resources or control costs.

In health care, there are plenty of precious commodities, ranging from public education to careful testing of new medical technologies. If business cannot provide them, who can? The government must do it, and make no mistake, the government is us! Our responsibility is to make certain that every American understands his own personal role in solving this crisis. More than two-thirds of Americans who die each year are stricken by only four conditions: heart disease, cancer, traumatic injuries, and strokes. Great progress can be made through the simplest measures: eating balanced diets, exercising, driving safely, and quitting smoking. We have direct evidence that promoting good self-care can be cost effective.

Clearly there is no way that all of the principles of reform can be carried out without upsetting the status quo. In the words of Democratic Senator, Jay Rockefeller, of West Virginia, a leading reform proponent, the process will be like orchestrating a "symphony of unhappiness." The government cannot and is not doing a great deal to revise health care. America has to come together and make some sacrifices also. If the government cannot handle it, then may be we should put a little more pressure on the subject to make health care in America a little better and a lot less "flaky."