Health bill comes due; Wal-Mart diagnoses America's ailing, out-of-control health care system.

CHECK CHUTZPAH IN YOUR NEXT EDITION OF WEBSTER's. It may have to be updated to include a sketch of Wal-Mart CEO H. Lee Scott. Speaking at a recent meeting of the National Governors' Association, Scott informed the assembled dignitaries that government needs to do more to help Wal-Mart get health care to its low-wage, benefit-challenged employees. That's a tough message to hear from the CEO of the world's largest retailer, a behemoth that last year generated more than $285 billion in revenue and $10 billion in profit.

Once media-shy, Wal-Mart is struggling to improve its unpleasant public image and derail legislative efforts to force it to assume a greater share of the cost of its employees' health care, so Mr. Scott's altar call at the governors' meeting may have been self-serving and disingenuous. But that doesn't mean he was wrong to make it.

Wal-Mart has been expanding the health coverage it offers, and last year confronted health care costs that rose more than 19 percent. Despite its improved efforts, the company is not even close to covering all its 1.7 million employees.

Wal-Mart's dissed associates join millions of other U.S. workers in the growing national pool of full-time employees who are no longer offered health coverage or who cannot afford to pay into their companies' increasingly expensive plans. It could just be that our 60-year experiment with employer-provided health care is grinding down to a dismal and dangerous conclusion with no viable alternative on the cultural horizon.

The United States maintains the world's costliest health care system with per capita expenses that are two to three times higher than what other advanced Western economies pay for more humane systems that are at least equal--arguably superior--to the U.S. And our industrialized peers manage to provide something the U.S. system shockingly has failed to offer despite decades of political hand-wringing: dependable, universal care to all citizens.

Many U.S. business leaders, like Scott, are surely aware by now that the nation's health care delivery system no longer functions and that with annual increases that are often triple or more over the rate of inflation, health coverage will increasingly be out of reach of more businesses and workers. Most know that the cost of this system is dulling America's competitive edge at a time of intense global industrial competition. Most simply plan on shifting more health care costs to their employees or dumping coverage altogether.

Major industrial powers like General Motors are stumbling under the weight of their health care burden, which according to one GM vice president adds almost $2,000 to the price of every car sold by GM. Does it make any sense to persist in a health care model that relies on private businesses to address this social burden, a model that already leaves out 45 million citizens completely and inadequately "covers" millions more, a system that rations care based on the ability to pay and the likelihood of a good return on investment, a system that has repeatedly failed to respond to free market cost controls?

Defenders of the status quo sputter over malpractice insurance and space-age medical breakthroughs, but one need look no further than the annual reports of the nation's for-profit health care and insurance providers and pharmaceutical conglomerates to understand that tort and technology have little to do with the breathtaking cost escalations of the existing system. The bloated executive salaries and bonuses and rich shareholder dividends you'll find spelled out in those reports offer a more credible explanation for the system's spiraling costs.

THE FREE MARKET MODEL OF HEALTH CARE DELIVERY HAS long endangered lives among the nation's 60 to 90 million un- and underinsured. Confronting a near-term future when employee co-pays on a company's family plan could run as high as $300 to $500 a month, it increasingly threatens the long-term viability of America's beleaguered middle class. It is time to devise a joint public-private project on health care that will remove the for-profits from a system that should be about providing a human right based on need, not running a service industry bent on maximizing profit.

Scott had the chutzpah and the power to speak up on this important matter. Let's hope some other unlikely voices challenging the health care status quo join him--soon. USC 

By KEVIN CLARKE, senior editor at U.S. CATHOLIC and managing editor of online products at Claretian Publications.