Two-Tier Health Care

Extrapolating from James Flanigan’s figure of $500 billion for this year’s U.S. health costs (Business, Nov. 22), we appreciate that this comes to roughly $2,000 for every man, woman and child in the nation.

That’s a great deal of money, especially when we consider that upwards of 100 million Americans have too little or no medical insurance. Medicaid, the Veterans’ Administration and socially responsible health organizations make up the difference.

It would be far better to have a two-tiered system of health care in this country. The first tier would be paid for by tax dollars and would guarantee an adequate level of medical assistance for all Americans, from prenatal care to infirm old age. Just what constitutes “adequate” would be a matter of ongoing debate, involving both medical advances and economics.

The second tier would be private insurance programs, which could provide more luxurious surroundings for the sick, and the more costly aspects of medical knowledge. The rich, and those who might sacrifice some day-to-day comforts in order to pay for an insurance policy, might get a slightly better quality of health care--and the ethical debate on that subject will also be ongoing.

The advent of a tax-financed public health program seems as inevitable as was the establishment of public education. We now have tax-supported schools, and the existence of successful private schools, all this based on the sensible notion that an educated citizen is more useful to the society that is an ignorant person. The same can be said of a sick citizen; let us create a national health policy which can minimize the amount of sickness our people must bear.

CLEMENT SALVADORI

Laguna Beach