Health debate rages on.

After remaining silent on the issue for almost a year, President George Bush joined the debate over national health care in February when he announced a $100 billion proposal to use tax incentives and other changes in the law to make quality medical care available to all Americans. Bush's acknowledgement of the health care crisis has turned up the heat on Congress to enact some kind of health care legislation soon. It has also] spawned health care proposals by the National Medical Association (NMA) and other groups.

"There are [more than] 30 million Americans who have no health insurance and another 20 million who have inadequate health insurance," says Rep. Louis Stokes (D0Ohio), chairman of the Congressional Black Caucus Health Brain Trust. "It is mandatory that we begin to try and give Americans--particularly minorities--adequate health care as a right."

The Bush plan would give people not covered by Medicaid tax credits, and families making less than $80,000 a year tax deductions to pay for medical costs. He would also pass laws to ensure that even chronically ill patients could receive health insurance. The plan has received a cool reception on Capitol Hill, and alternate proposals, including a full-scale, government-paid national health insurance plan, are under development.

But what does America really want for its health care system? The views are many.

The Congress of National Black Churches (CNBC) and the NMA have proposed a national health care plan specifically for blacks. "We're hoping that through the local churches, we might be able to set up some sort of health care plan," says Dr. Charles W. Butler, former CNBC chairman and pastor of New Calvary Baptist Church in Detroit. Butler says doctors would refer patients to participating hospitals, and the health maintenance organization would pay the costs. He hoped pilot programs for the NMA/CNBC plan could be tested in several cities this year.

However, Health and Human Services Secretary Dr. Louis W. Sullivan believes that the high level of bureaucracy in a national health care system would make it unmanageable (see "The CEO Of Health," September 1991). "We should keep our health care system primarily in the private sectors--with insurance, hospitals, physicians and other health professionals--but] work harder at streamlining the system and controlling costs," says Sullivan.

Dr. Joseph Clift, president of the California chapter of the American Society of Internal Medicine (ASIM), says the Washington-based physicians organization rejects a national health care plan as well. "Our philosophy is to build on and improve the foundation of our existing health care system," says Clift. "We want to bring as many Americans as possible into employer-based health care, because it works well for most Americans and can be improved with modest changes."

Clift says ASIM opposes a national health care plan because health care could then become politicized and possibly lose out to competing budget priorities. Furthermore, he says the organization projects that a national plan could cost more than $250 billion, which will cost the public increased taxes to support.

LeRoy Robinson Jr., executive director of the Minority Health Association, doesn't accept the argument that national health care will cost too much.

"Any time a society like ours spends over $600 billion a year on health care, there's certainly enough funds in the system to do whatever we want," he asserts.

Robinson says no price is too high to pay because of the approximately 60,000 unnecessary deaths each year due to the lack of health care in this country. "It has to be the will of the people and the leadership of this country to do something about not only the cost, but the delivery, access and availability of health care."