The advice--demand, actually--from politicians and corporations who have made a disaster of U.S. health care could hardly be clearer. People who do get sick risk dying. Unless your illness is profitable to somebody, don't expect help.

There are few people in the U.S. who don't worry about what will happen if they fall ill--and not many who can afford the level of preventive care standard in other Western countries. But a little-noticed report, released (and given a one-day Congressional hearing) by the General Accounting Office, gave a scary glimpse into how bad it has gotten, when even the reformist triumphs ring hollow.

The report concerned 1996's "Health Insurance Portability and Accountability Act." It is the Clinton Administration's one actual constructive response to six years of escalating health industry crisis.

Well, never mind. The GAO sez the law ain't working; numerous loopholes allow insurance companies to jack up rates prohibitively or limit policies so as to foil lawmakers' intent.

The same market logic doomed Washington state's health care reform, even before its Republican caucus did. Not that the GOP hasn't helped; in Oly this year, they refused to allocate money to add 8,000 of the 600,000 on the waiting list for the state's Basic Health Plan. Or money for matching federal funds to cover indigent children's care.

The reason the U.S. has the developed world's most expensive health care, and the poorest public health statistics, is that we insist on putting private profit in the equation. Governments help by underwriting drug research, limiting competition, and winking at $100 billion a year in insurance-industry health care fraud (by GAO estimate). The byzantine payment rules are also rigged for private profit. As a tiny example of federal largesse, in 1995 Clinton's Dept. of Health and Human Services lifted the requirement of "reasonable pricing" on drugs developed in cooperation between the feds and private industry. Industries can now charge whatever for drugs developed with tax money--including charging Medicaid, Medicare, and other federal agencies that are, again, tax-funded. We pay to give them the drug, then we pay again to get it back. A recent study lists the American Medical Association--not the NRA or Christian Coalition (or Boeing)--as the biggest-spending lobbyist in D.C. Pharmaceuticals like Eli Lilly and Bristol-Myers are notoriously generous campaign donors.

A simple solution is out there for many such ills: abolish the private insurance industry except for elective procedures. It's worked in Canada, Europe, and Japan. Alas, its legislative champion, Seattle's Jim McDermott, has apparently decided he'd rather help Boeing make more of its planes in China. Absent organized public outcry, are we surprised?