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This issue of Health Care Matters goes to the printer a month late. Like many of our friends, in the aftermath of the September 11th attack on the World Trade Center and the Pentagon, we have thought long and hard about what we are doing, how we are spending the precious days of our lives, and what kind of a wake-up call the tragic events in New York and Washington may represent for us personally, for our families and communities, and for our nation.

Some say that things will never be the same again. Certainly we feel vulnerable as never before, and certainly we feel grief and anger over the senseless murder of thousands of innocent people. Yet a new spirit of unity and pride in our country has emerged. It is our fervent hope that this spirit will become a permanent one and that it will take the place of the cynicism and divisiveness which have characterized much of our public dialogue since the Vietnam war.

We hope that the spirit of Americans caring for each other, and feeling intense sympathy for others who are in pain, will continue and become a permanent part of the social compact of our society. In particular, we hope that the confidence in our government's handling of the crisis, demonstrated in the polls, will translate to confidence in government programs that work, such as Medicare and Social Security.

Suddenly the media have become aware of Public Health. Since the frightening anthrax stories have been on the six o'clock news every evening, people are hearing more about the role of Public Health in our lives. Perhaps when we see that we need to federalize airport security, and when we see that we need government to ensure that there are safeguards against bioterrorism, we will finally come to the conclusion that we also need government to ensure that all Americans have access to necessary health care services, and that no one should be left out. In the aftermath of the September 11th attacks, we rededicate our efforts to the cause of universal health insurance for all Americans, as part of a safer, saner world.

The timing of the terrorist attacks could hardly have been worse, coming on the heels of a serious economic downturn and a hugely expensive electricity deregulation disaster,. In California, currently studies are going forward regarding the feasibility of universal health insurance for all Californians. Nine proposals will be considered, but with all state funding about to take a 15% cut (except for Public Safety) and with motor vehicle license fees and sales tax revenues down, it appears that health care funding and state "realignment" funds will be scarce in the next fiscal year.

Yet if a universal health insurance program were to be initiated, covering all California residents, we are convinced that the cost would be lower than the cost of the current non-system. Almost any one of the models proposed, provided that it results in a risk-sharing pool containing all thirty million of us (most of whom are healthy), would be cheaper, fairer, and more efficient than the patchwork of plans and the millions who have no medical home and no coverage.

If the unthinkable happens and we are subjected to a smallpox epidemic or other bioterrorist horrors, there is no way the current health care providers could cope without government intervention and support, as well as control of the pharmaceutical industry production of prophylactic and therapeutic medications. How much better it would be if we were to access that support to fix the health care system without waiting for the crisis of a terrorist-caused epidemic!

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