Code blue: the patient is ailing, the prognosis is poor. It's the nation's major medical emergency.

THERE IS AN EPIDEMIC RUNNING THROUGH THE nation's body politic that kills an estimated 18,000 Americans each year. It's called lack of health insurance. Those who have this illness already know its devastating effects. Those who don't have it, who believe that their employer-funded plan offers them all the protection they need, don't understand how vulnerable they are. If we could get the Centers for Disease Control and Prevention to formally recognize this epidemic, could we better track its pernicious outcomes? Would newspapers alert us to the new millions of fellow citizens afflicted by this disease each year? Could the federal government finally be forced to respond?

Back in 1992, when I was a cub reporter covering the social justice beat and Bill Clinton was a cub president getting beat up in Washington, I joined the editorial gang at Salt of the Earth (salt. claretianpubs.org) for a long-term planning meeting. Among the article ideas we kicked around was a comprehensive report on the state of the health care system. At that time 38.5 million Americans were without coverage, and we thought that was an outrage right up Salt's alley.

"But wait," I cautioned, "you know, Bill Clinton said health care was the first thing he planned to tackle. By the time we go to press on this, it may be a dead issue, and we'll look like idiots." Well, we didn't want to look like idiots. We shelved the article, then waited to see what kind of universal health care system would emerge from Hillary Clinton's marathon sessions with the nation's best and brightest.

Fifteen years later we're still waiting. It's astonishing to think that we are pretty much exactly as we were, only worse off as when the nation last seriously looked at this ongoing crisis. Now more than 47 million of us (including 9 million children) live in a constant state of uncertainty and with demonstrably poorer general health because they work for companies that do not offer health insurance. Conditions are worst among the nation's most vulnerable communities: 20 percent of African Americans, 33 percent of Hispanics, and 34 percent of immigrants do not have health insurance.

The Clinton health care debacle of 1992 may go down as the greatest missed opportunity of a generation. Now as major powerhouses like Ford and GM struggle with their employee coverage burdens and as the plight of the uninsured metastasizes across the country, Michael Moore's documentary Sicko (Dog Eat Dog Films), and the 2008 presidential election offer a slight hope that, finally, we may be ready to seriously treat our health care crisis.

While the rest of the economically advanced world tweaks systems that for a long time have been offering adequate coverage to all citizens, the United States flails about with the industrialized world's most expensive and, according to many measures, worst-performing health care system, treating it like an ideological football instead of a medical catastrophe.

It's important to remember that the moral imperative is that some form of adequate health care be provided to all citizens as a basic human right, not a privilege portioned out according to status or wealth. Communally sharing risks and rewards is one of the strategies humankind has used to help build societies. None of us knows the day nor the hour; we do not know when we may be the unlucky ones taken ill or injured, laid off, or otherwise dropped from health plans.

IN A MODERN, AFFLUENT NATION THAT HAS SOME CONCEPT of a common good and a judicious respect for human dignity, freedom from fear of health care crises is esteemed as a general social good worth achieving. Not so much in the United States, where the best health care is rationed to a diminishing group of people whose employers still offer plans, while the system's rewards are reserved for the for-profit insurance and pharmaceutical industries.

The U.S. Catholic Church does not offer a blueprint for a reformed system, but it does provide a framework of guiding principles. Among those principles: respect for life, preferential treatment of the poor, universal access, comprehensive benefits, quality care, and equitable financing. They are principles that could be put to good use as we diagnose this intensive care patient and create a treatment plan that will lead to a universal health care service that honors us all.

On the Web

Check out Kevin Clarke's blog at uscatholic.org.

By KEVIN CLARKE, senior editor at U.S. CATHOLIC and online content manager at Claretian Publications.