President Obama joined the lengthy parade of American policymakers who've gamely attempted over the years to fix the nation's health delivery system with a somewhat wooden attempt last night to clarify his plans for health reform. Thank God we can now finally put the debate to bed and get to work on fixing health care! (Just kidding)

Obama began a minor offensive against health care reform's antagonists who've trotted out a snorting stable of familiar rhetorical devices aimed at scaring citizens away from reforming a system that has enriched a handul while driving many of us to exasperation and the most unlucky of us into personal bankruptcy and an early grave.

Critics say Obama's reforms (any reforms really) will mean care rationing as if our system were not already rationed by employment, ability to pay, or an insurer's whim. They glumly intone that reform means civil servants will be making health care decisions for us as if A.) that were true (it isn't) or that B.) that were somehow worse than for-profit bureaucrats making decisions for us when all their professional and market incentives push toward coverage denials.

The rhetorical gelding (see stable metaphor above) of "health care crisis, what health care crisis?" has also been trotted out by a few glib politicians. These guys are apparently unable to imagine that because they have good health plans (via their gov't jobs) other people might not. Many apparently are also girded by the Bushian faith that when all else fails "there's always emergency rooms open to anyone."

True. They're open and full of people who should be going to a GP's office. Instead while real medical emergency cases wait on line to be treated (been there, done that), our uninsured brethren endure 4 to 8 hour waits to receive the least efficient and costliest health care delivery mechanism in the world. 

Add to that the Glenn Beckers out there shrieking "no one is dying in the streets" when something in the area of 22,000 are actually dying pretty darn close to the streets (maybe not on his street) because of lack of access to reasonable care and you've got a cultural denial overflowingsitsbanks aimed at . . . hoping to . . . achieve . . . what exactly? This is what puzzles me. Are these folks truly content with the status quo?

How can anyone regard a system that is twice to three times more costly as any comparable health care delivery in the OECD (but mind the gap!), that is threatening to consume 25 percent of our nation's GDP, that is consuming $14k or so of an individual worker's potential income annually (if he or she is lucky enough to work for someone who provides health coverage), and that still manages to leave out or underinsure a jaw-dropping 50 to 90 million of us each year and argue that it remains likable just the way it is (sorry bridget's diary fans everywhere)? Yeah, beats me, too.

A handful of reform resistors have now dragged the abortion debate into the mix by arguing that Obama's reforms are a secret pro-choice bomb even though there is no language in the proposed legislation calling for government funding for abortion procedures. Aha! But neither is abortion explicitly denied coverage in the proposed legislation, they say (not sure they say the Aha! part). Fair enough.

Assuming these guys really do care about being on the prolife side of the pro-reform contingent and are not just trying to find any reason they can to shut down or slow down health care reform with an eye toward weakening the Obama administration in a thinly veiled attempt to get back in the game for 2012, here's hoping the Obama-squad is ready to write out any chance that health care reform packages could be construed as a legal opening to government funding for abortion.

The U.S. bishops, long supporters of a comprehemsive health care reform, are apparently concerned enough about the above possibility that even as they issued another letter in support of reform, they've felt obliged to remind policymakers about their overarching pro-life concerns.

“Genuine health care reform that protects the life and dignity of all is a moral imperative and a vital national obligation,” said Bishop William F. Murphy of Rockville Centre, N.Y. in a July 17 letter to Congress.

“All people need and should have access to comprehensive, quality health care that they can afford, and it should not depend on their stage of life, where or whether they or their parents work, how much they earn, where they live, or where they were born. The Bishops’ Conference believes health care reform should be truly universal and it should be genuinely affordable.”

But, Murphy adds, “No health care reform plan should compel us or others to pay for the destruction of human life, whether through government funding or mandatory coverage of abortion. Any such action would be morally wrong . . . . Health care reform cannot be a vehicle for abandoning this consensus which respects freedom of conscience and honors our best American traditions. Any legislation should reflect longstanding and widely supported current policies on abortion funding, mandates and conscience protections because they represent sound morality, wise policy and political reality.”

The bishops want to get the church behind Obama's plans. He needs to show some evidence that's he's listening on abortion. Let's hope he really is or we may as a nation miss another, odiously rare opportunity when the obvious need and the public mood on health care are so well aligned  we actually have a chance to overcome some powerful political and corporate interests—and their portfolio managers—who have no desire to see any alteration in what to them is a personally enriching national health care delivery complex.

If we blow it now, we may be revisiting this mess again in another generation but not before falling farther behind industrual confreres who long ago rationalized their health care systems and needlessly diminishing the health of the natiion economically, culturally, and personally.