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The county executive is correct that Medicaid costs are creating a crisis for the county and that there must be some relief from these costs. However, those who represent the state tell us that they are not fiscally able to offer relief. Both are likely correct.

I believe the crisis of health care and Medicaid cannot be resolved at either the county or state level. Health care represents a national crisis that is reaching catastrophic proportions. An increasing number of Americans are uninsured and underinsured. Costs are escalating beyond control.

This can only be resolved through a comprehensive approach that is universal and national in scope. County and state representatives need to demand a national effort to address health care in a way that will prove adequate. Certainly there are problems with national plans, such as we see in Canada. Nevertheless, we should not run away from what is necessary because of such problems, but carefully address them and initiate a national plan that will work. A comprehensive approach would include parity for both mental and physical illnesses.

It is painful watching county and state representatives fighting and blaming one another as they address this issue of Medicaid. I believe their view of the problem is too narrow. Their solutions will only prove temporary. The problem of health care is national in scope and demands a national and comprehensive effort.

Charles J. Sabatino