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IS HEALTH COVERAGE IN U.S. A RIGHT, OR SHOULD IT REMAIN A PRIVILEGE?

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QUESTION: Congress is apparently headed for a bitter debate over health-care reform that will last the whole summer and probably won't produce the kind of coverage President Clinton is advocating. Is the administration's desire for universal coverage a wise policy?

BONNIE ERBE: In theory, universal coverage sounds great. In actuality, it means higher costs for almost everyone. Clearly the Clintons are well-meaning. But they are ignoring that time-worn saying: "If it ain't broke, don't fix it."Let's start with the fact 37 million Americans have no health insurance and another 25 million are underinsured. That still means 85 percent of us have insurance.

A much more responsible (and less expensive) approach would be to require insurance companies to offer reasonable rates to all. Just because someone happens to work for a large corporation does not mean that person is a better insurance risk. And yet, under the present system, that person's premiums are cheaper. People who work for small employers or the self-employed should enjoy those same lower rates.

Second, Congress should ban the insurance practice of excluding or dropping people with "pre-existing" conditions or worse, dropping people after they contract horrible diseases even though they have paid premiums for years.

With those two simple adjustments, insurance would be available and affordable to all. And people without insurance, employed or unemployed, would have no one to blame but themselves.

BETSY HART: Just when I think my colleague is coming around to the "right" side of an issue, she veers off into outer space. She's right-on about universal coverage, but dead wrong on almost everything else.

If insurers must offer low rates to all Americans, they cannot stay in business and offer insurance to any American. And the idea of no exclusions for pre-existing conditions is ridiculous.

The point of insurance is to purchase protection before you need it, knowing you might never use it. Now if someone is dumb enough to risk not buying insurance when they are young and healthy, hoping they will never need it - well, government cannot save the fool from himself.

At least part of the answer to the health-insurance dilemma is to change the tax code. First, Americans should be encouraged to use health insurance only for real emergencies.

Paying for regular medical care out-of-pocket would put consumers in charge of their own health-care dollars for a change.

Second, individuals should be allowed to deduct their health-insurance costs from their taxes.

But the bottom line is that as long as health care is perceived as a right (as in other countries where everyone has access to lousy health care) instead of a privilege, then it will continue to create the dependency my colleague fears.