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LAME EFFORTS OF CONGRESS, CLINTON ADMINISTRATION HAVE LEFT HEALTH CARE IN SHAMBLES

The physicians of this nation are barking again. Some of them are howling. They're telling patients they can't make ends meet; that insurance companies are cutting back on reimbursements.

Doctors are saying they can't remain in independent practice much longer. Others are talking about retirement.

All their complaining might be coincidence. It might also be the kind of concerted moaning they indulged in a half a century ago to help kill President Harry S. Truman's attempt to get the nation in the mood to create a system of national health insurance.

The doctors were so successful then, calling the Truman plan "socialized medicine," that nobody seriously brought it up for another 40 years -- until Hillary Rodham Clinton came up with an insurance-based universal program in 1994.

The insurance industry lied about what the Clintons were trying to do, and the business lobbies, led by the National Federation of Independent Business, piled on.

Those physicians who didn't stand on the sidelines in that fight bought into the industry fabrication that the complex Clinton program would nationalize health care.

Employers, drug manufacturers, insurance companies and some doctors spent millions promoting this monstrous falsehood. Left for dead on the battlefield were the uninsured young, the poor, the elderly and these self-same physicians.

The killing of Clintoncare was the first big firecracker to fizzle out in this decade. The impeachment trial was the most recent. These frustration games do nasty things to a country's politics.

Democrats did their own share of fomenting mistrust. The first lady, as we observed long ago, undercut her own campaign because she held her hearings in abject secrecy when she might have used them to educate the nation.

Years later, Sen. Daniel Patrick Moynihan, D-N.Y., revealed he spiked the Clintons' guns because the plan threatened the state's dominance in graduate medical education.

What we are left with now is "a mess," to quote Dr. Michael Bernardino, vice president for health affairs at the University at Buffalo. There are literally thousands of formulas the federal and state governments use to pay for services, support medical education and the rest.

Only a handful of nerds understand these formulas, people who run the big computers at the White House, Congress and in the warrens of the health-care and insurance industries.

It's so confusing that Bernardino said UB and a big hospital combine in Buffalo had to hire consultants to find out whether the teaching hospitals made money or lost money on graduate medical education.

Special interests toy with these numbers to manipulate the argument in order to protect their nest egg. Meanwhile, the White House and Congress nickel and dime the elderly, the poor, the hospitals and the universities.

Three years ago, the Republican Congress and the Democratic White House decided to put a cast-iron grid around the health-care industry called the Balanced Budget Act. They made it too tight, cutting federal funding by unnecessary tens of billions a year.

This pressure set all the segments of the health-care profession against each other. Hospitals against insurance companies, hospitals against nurses, doctors against insurers. Layoffs, the demoralization of a lot of wonderful doctors, hospital consolidations, disruption, the wholesale undermining of medical education and of the nursing profession are among the results of the lame efforts of Congress and the Clinton administration to get its arms around this patchwork system.

Every few months a senator or a member of Congress will get up and brag about what he or she did to keep the government from twisting the knife they carelessly plunged into the belly of health care.

They'll spew out numbers that nobody really understands, or has any reason to believe.

Their heroic comments obscure their role in one of the great political failures of this century -- their failure. It damages the nation much more than the refusal of Congress to reform campaign finance. Campaign laws indirectly influence everything here, but they directly affect only the politicians.

The mess in health care influences everybody, touches their very lives. We remain the only industrialized nation in the world without an integrated health-care program.

Some visionary Republican president may lead the country out of this wilderness. Apparently, the Democrats have lost their stomach for the fight.

Rep. Eliot Engel, D-Bronx, thinks his party's role in trying to fix health care in 1994 may have cost it the majority in the House. Engel has a universal health-care bill, but in this environment he's keeping it under wraps as though it were some kind of Bolshevik plot.

It might help if the doctors stopped their whining and got their act together.

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