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The right to health

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At present, the offices of the N.C. Committee to Defend Health Care consists of a spare room in Dr. Carol Kirschenbaum's house in Durham. Meetings are in the parlor and may adjourn to the dining room table when there's a mailing to get out. The group's objective: to make decent health care the constitutional right of everyone in North Carolina.

It's a goal so simple and direct that when I hear it, I have to smile at its audacity. It seems unlikely that the General Assembly, which has never seriously considered enacting universal health care coverage, would let the people of this state order them to do so. But that's what the Kirschenbaum group is after. House Bill 1396, if approved by both houses of the legislature (by three-fifths majorities), would ask the voters to approve the following amendment to the N.C. Constitution: "Health care is an essential safeguard of human life, and there is an obligation for the State to ensure that every resident is able to obtain this fundamental right."

If approved, the amendment would also impose a 2004 deadline for the General Assembly to pass legislation "that permits everyone in the State to obtain decent health care on a regular basis."

If HB 1396 is a long shot, though, does either political party want to be the one seen stopping decent health care--and stopping the public from voting on it? It's an issue ready for the taking by the Democrats or the Republicans, and they wouldn't need to concern themselves about the legislative details for another four years.

According to Kirschenbaum, there are 1 million people in North Carolina without health insurance. Most work. Most aren't poor (many of the poor are covered by Medicaid), but their jobs don't provide health coverage as a benefit, and they can't afford to buy it themselves. So their care is spotty. There may be a nonprofit clinic for them, or the emergency room at the hospital will take them if they're really hurting. "But there's lots of evidence that they delay treatment too long and get less than they need," Kirschenbaum says, "and much less than people with insurance."

Meanwhile, for-profit HMOs and hospital chains, the fastest-growing elements of the health care system, take in profit as much as 33 percent of the premiums they're paid.

Kirschenbaum´s group, about two dozen "core" members and another 600 supporters, is asking health care professionals to endorse HB 1396 and to help get the professional and medical organizations to which they belong behind it as well. They´re also recruiting people to testify on the need for reform at a legislative hearing on the bill sometime in the spring. For more information, call 919-402-0133, visit the Web site at www.defendhealthcare.org/regions/nc (e-mail: ckirsch@acpub. duke.edu).

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