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Healthcare crisis countdown

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The healthcare system in the United States is eroding. Costs are rising too fast. More and more people lack health insurance. Companies are dumping or shrinking employee health plans. Deductibles and copayments on medical services are rising.

That's the widely agreed-upon scene.

Yet chances are slim that Americans will go for a far less expensive "single payer" health system, as in Canada, Britain, or Australia, anytime soon.

"The issue is not likely to be given a fair examination," says Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health, Boston. "There is a cultural resistance to even considering this very serious option."

Since the healthcare system is "sort of collapsing," Stephanie Woolhandler, co-founder of Physicians for a National Health Program (PNHP), expects "a lot more discussion" of a single-payer system after the congressional elections Tuesday, especially if the Democrats win at least one house in Congress. In such a system, the government pays the bills from hospitals and physicians.

Doctors Woolhandler and Blendon basically agree on why change is resisted.

Many Americans are cynical about government, distrusting its ability to provide a competent healthcare system. They prefer a market-based system with a high degree of individual choice.

Moreover, self-interested groups have political clout. Health insurance companies, pharmaceutical firms, private hospitals, and Wall Street investors in the healthcare industry "aren't going to go quietly into the night," says Blendon.

The drug industry usually ranks as the most profitable. In 2002, it made a 14 percent return on assets; the Fortune 500 made a median of 2.3 percent.

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