The real health-care challenge: Get it done now - or miss the moment

AS BOTH THE U.S. SENATE and the House of Representatives start considering separate health-care-reform bills next week, beware of scam artists pouring old pills into new bottles and calling it a cure.

In this debate, almost no one says what he really means, using code words in place of plain language. So here's a guide to the action - and a call to action as well.

First, a glossary, courtesy of blogger Ezra Klein (www. ezraklein.com):

"Socialized medicine," like that found in Britain,

is a true "government-run system" in which doctors and hospital workers are employees of the government. Our VA hospitals are an example of "socialized medicine," but no one is suggesting the country as a whole adopt that system. (As a poll by Harvard University suggests, the term no longer holds the terror it once did: A plurality of Americans - 45 percent to 39 percent - say "socialized medicine" would make the health-care system better.)

"Single-payer" is a system in which the government provides health insurance (as it does with Medicare) that pays private doctors and hospitals. This route to reform also is "off the table,"

dismissed as politically impossible even though a sizable number of Americans continue to advocate it, loudly - and even though President Obama has admitted that it would be the best way to go if we were building a system from scratch.

But a "public option" is very much on the table, and it's an essential ingredient for meaningful reform. A "public option" is a government-financed insurance program like Medicare that would be offered as an alternative to private insurance, providing actual competition. Not surprisingly, health-insurance companies - and their agents in Congress - are dead set against it.

It's a testimony to how threatened they feel that private insurers are promising big concessions in exchange for killing a true "public option," or at least diluting it so much that it's worse than nothing. At a White House meeting last month, insurers promised to reduce health-care costs by $2 trillion, which raises the question of why they hadn't passed on even a fraction of the savings already. One answer is found in a recent report by Health Care for America Now (HCAN), an umbrella organization of about 1,000 progressive groups:

"Extreme consolidation" of private insurers in local markets - including Pennsylvania, where Blue Cross controls the market - has concentrated the power to control premium levels and provider payments. And so they skyrocket - 86 percent in the commonwealth in six years.

But beware of impostors claiming to be a "public option" - for example, if it's only regional or if it has a trigger - that is, delaying it unless it's "triggered" by a failure of private insurers to meet certain benchmarks, which then are set so low that the trigger is never pulled. That would be the ultimate in health-care-reform snake oil.

Which leads us to the ultimate code word in this debate: "bipartisan." Most congressional Republicans strongly oppose a "public option," so a bill they do support should bear special scrutiny.

IF EVER THERE was a time for ordinary Americans to act, it's now. The HCAN Web site - www.healthcareforamericanow.org - includes a wealth of background information, and ways to get involved, including joining at least 1,000 Pennsylvanians going to Washington on June 25 to lobby members of Congress. Make it plain that there will be severe political consequences for those who stand in the way of true health-care reform.

It's now - or not in our lifetimes. *