Think I’m dying,

Got to go;

Must convince

My HMO.

Americans are fond of magic cures. We relish weight-loss pills, hair restorers, herbal remedies, and, in the old days, snake oil. We prefer to avoid the unpleasant disciplines of diet, exercise, and staying out of the sun.

These personal preferences are not so different from our approach to health insurance. We’re happy to delegate the whole business to hospitals, private doctors, HMOs and pharmaceutical companies. We’re also eager to avoid the unpleasantness of taxes, such as we have to pay for schools, Social Security, and Medicare. Nor do we relish mucking around in the messy pit of deciding which treatments should be free, which should be paid for by the patient, and which should be avoided altogether.

By leaving such health decisions to private business and to non-profit hospitals, most unpleasantries get taken care of by someone else.

At least they do for those of us with money and good genes. As long as our employer pays our premium, or we can readily afford it ourselves, and as long as we lack expensive chronic afflictions, HMOs are happy to enroll us. They provide world-class care, more or less, and frankly, we wonder what all the big fuss is about.

If we were Hispanic we might have a better idea. Around 40 percent of Latinos are uninsured. The same is true of the poor in general. In particular, part-time workers and those families who were squeezed off welfare are perhaps the most common sufferers. In all, around 18 percent of Americans, growing steadily, lack coverage, with all the trauma that entails for their families.

And some folks suffer plenty even if they are covered. The two biggest groups are the mentally ill and those on Medicare. Psychiatric treatment is severely limited for the one, and Medicare doesn’t buy prescriptions for the other. Many of our own families know these truths all too well. And so far our sainted free-enterprise system has failed to develop a solution.

That’s hardly a surprise. Free enterprise hasn’t found a solution for health care elsewhere in the world, either.

As with schools, pensions, and armies, and in some instances utilities, most nations have concluded that health is too important to be left to the stock market, lobbyists, and campaign contributors. As a result, in those lands either the care itself, or the insurance to pay for it, is provided through the government. Like Social Security and Medicare, citizens pay a tax, but pay no premiums and get no bills.

The advantages of such a public system are plain. First, everyone is covered, rich and poor alike. Second, costs drop because there is no more massive marketing expense, no more huge salaries, and no more duplication of corporate bureaucracies.

Third, drug prices plummet because the government is the only buyer, and pharmaceutical companies can no longer rip each of us off individually. Fourth, all employers, both large and small, are taxed to pay their fair share. This kind of public insurance system is sometimes called "single-payer," because the government becomes the only insurer, rather than all those individual HMOs.

In short, the whole system, if imported here, would work much like Medicare. It’s not perfect, but it’s cheap. And everyone would be included. Yes, Congress might get more involved in personal health decisions, but at least it would no longer be influenced by expensive lobbyists or pernicious campaign contributions.

As a nation devoted to private enterprise and the enjoyment of competition, we should only turn to government as a last resort. But a last resort is exactly where we are right now. We already turned our schools and retirement systems over to government because education and late-life survival are too precious to leave up to profit. So is health. he outside world is ahead of us on this one, and it’s time we caught up.

William A. Collins is a former state representative and a former mayor of Norwalk, Connecticut.