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The harrowing tales of the uninsured explain why there is so much unease among working Americans even as the financial experts enthuse about how good things are.

The stock market soars to new levels, the deficit plunges and unemployment is lower than it's been in years.

Yet even in what's deemed the best of times -- at least on paper -- the number of Americans living in fear of getting sick because they have no health insurance continues to increase.

That is a national disgrace. And it raises a disturbing question: If America can't provide guaranteed health care for all its citizens when the economy is booming, when will it?

Yet the prospect of universal coverage isn't even on the public agenda anymore, after the insurance lobby spent big bucks to beat back a Clinton administration effort three years ago. Citizens seem willing to accept the contention that the nation can't afford universal coverage, even though virtually every other industrialized country has it.

Meanwhile, the politicians who say we can't afford universal coverage get top-shelf care themselves -- paid for by the public.

More than 40 million Americans lack health-care coverage at any given time. An estimated 100,000 of them are here in Western New York. They are like the North Buffalo woman who told of forgoing tests to determine the reason for numbness and tingling sensations because the tests cost $885 and neither she nor her husband had insurance. It wasn't until the symptoms got really bad that she had the tests and found she had multiple sclerosis.

Millions of others are like her, putting off health care until a problem gets so bad that it can't be ignored. By that time, of course, the problem also has become much more expensive to treat, driving up health-care costs while wreaking an unnecessary human toll.

Even after being diagnosed, many can't afford the medicine for chronic but treatable illnesses like diabetes or hypertension.

One Buffalo doctor tells of patients who survive on nothing but the free samples she's occasionally able to pass on. That's a story one expects to hear from doctors in a Third World country, not from physicians in Erie County.

Unlike the very poor, who get health care through Medicaid, most of the more than 40 million who lack coverage have jobs. But they are victims of an economy in which job-based coverage is increasingly rare.

Studies repeatedly document the decline in job-based coverage as more Americans work part time or in industries that don't offer coverage.

At the same time, with real wages stagnating and the premiums for health insurance high and rising, many can't afford to buy coverage on their own. A federal law last year gives them the option of paying to continue coverage when they change or lose jobs, but that's scant help to someone who can't make the payments.

An American Hospital Association study found that only 18 percent of workers who leave jobs are taking advantage of the new law.

That same study estimates that the number of uninsured Americans will continue to climb, surpassing 45 million by 2002.

Even if the economy continues humming along at its present pace -- something few expect -- it will do little for those 45 million people. They won't be helped unless the nation makes a conscious decision that health care for everyone is a necessity, not a frill.

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