A Harvard University study found that in 1984 roughly 100,000 Americans died because of a lack of health benefits coverage -three times the number of people who died of AIDS that year.

There is an epidemic in the United States that grows year by year and now affects 43.4 million people. Each month, another 100,000 people are afflicted. In Maryland alone, 677,000 people suffer from this condition - 13 percent of the state's population.

The condition is being without health insurance, and it can kill. Each year, millions of Americans do not get necessary treatment because they cannot afford it, and many of them die as a consequence. A Harvard University study published in the New England Journal of Medicine found that in 1984 roughly 100,000 Americans died because of a lack of health benefits coverage - three times the number of people who died of AIDS that year.

Since then, the problem has become worse. Between 1989 and 1998, the U.S. population in-creased by 9 percent, from 248 million to 271 million, but the number of children without health insurance jumped 25 percent, from 8.5 million to 10.7 million. This, despite congressional efforts to correct the problem, including the Children's Health Insurance Plan and the Kennedy-Kassebaum Insurance Portability Act.

Even those who have some health insurance feel the effects of this crisis. More and more people are finding out from their own experiences what census reports tell us: For most Americans, health care benefits are declining. Many people are discovering that their insurance does not cover their specific needs or that they are responsible for higher co-payments than they had expected.

Americans are aware of the problems. A recent health insurance survey of people in the industrialized countries, conducted by Harvard researchers, showed that Americans were the least pleased with their health care coverage. While most Americans were satisfied with their own doctors and hospitals, only 10 percent were satisfied with the way in which their health care was funded and organized. In Canada, the figure was 60 percent.

Congressional efforts to ad-dress the problem have been insufficient Despite the Insurance Portability Act, few workers keep their health insurance between jobs. And efforts to protect children have come up short.

In 1992, President Clinton promised a major overhaul in the system of funding of health care. This effort failed, partly because of the enormous power exerted over Congress by insurance companies and other lobbyists. In the last election, these interest groups spent $12 million to atop health care reforms.

Change is possible, however. Most other industrialized nations spend less on health care than we do, while providing health benefits and comprehensive coverage for their populations

Canada, for instance, once had a system of health care funding like ours. Then in the 1960s it passed a law guaranteeing all citizens access to health care in time of need through government funded health benefits coverage. In Canada, the government contracts with the private sector for the delivery of services, offering a full choice of physicians and other providers. Neither physicians nor patients are constrained by the strict limitations that for-profit managed care imposes on providers and patients in this country.

Other countries have developed other ways of guaranteeing access to health care. All the industrialized nations except the United States guarantee their citizens comprehensive health coverage. Access to health care is listed as a human right in the United Nations Declaration of human Rights. The U. S. government, a signatory to this declaration, never implemented this right on its own soil.

It is paradoxical, to say the least, that the United States presents itself as the great defender of human rights while denying this basic human right to its citizens.

Vicente Navarro
Baltimore

The writer is professor of health policy at the Johns Hopkins University School of Hygiene and Public Health and was a member of the White House Health Reform Task Force in 1993.

The Sun: Saturday, May 1 1999