Author Sebastian Junger wrote about the horrendous storm that hit North America's eastern seaboard in October 1991 in his best-selling book The Perfect Storm: A True Story of Men Against the Sea. Meteorologists called it a "perfect storm" because of the rare combination of factors that came together at the exact same time and pace to wreak havoc on all who were in it?s path.

Many voices are now in chorus trying desperately to warn us that the American healthcare system is in a crisis and if lawmakers do not respond soon the best healthcare system in the world might collapse. Five major factors are getting worse at the same time and many folks, like myself, fear the "perfect storm" is on the horizon that could destroy healthcare, as we know it.

Something must be done soon because these critical challenges are collectively creating pressure on our healthcare system, causing patients to suffer and healthcare to deteriorate. These factors include:

1) The number of healthcare personnel is shrinking in critical areas. In recent years, fewer students are deciding to choose the field of medicine. For the academic year 2000-2001, only 37,092 persons applied nationally for medical school enrollment. Only four years ago, 46,968 students applied to medical school. There is also a critical shortage of registered nurses. According to Health and Human Services Secretary Tommy Thompson, "the nation will face a shortage of half a million nurses by 2020." The bottom line is that we can not deliver healthcare without healthcare professionals. Incentives must be put in place to educate, train and retain medical professionals and their valuable expertise.

2) Healthcare policy decisions are NOT being made by people who give the care BUT by those who manage the cost. Control of healthcare has been turned over to Health Maintenance Organizations (HMOs) and Managed Care Organizations (MCOs), who almost by definition ration care and resources in order to generate a profit. Clearly, a strong Patient Bill of Rights is long overdue. Voters across the political spectrum should demand that the U.S. House of Representatives and the U.S. Senate work together to get a strong bill to President George W. Bush for his signature this year.

3) The cost of healthcare is rising much faster than the family budget. Consumers and employers cannot keep up with the skyrocketing cost of healthcare. A primary contributing factor to the rising cost of healthcare is the irresponsible gouging of profits by some in the pharmaceutical industry. From drug re-importation to restrictions on television advertising, the U.S. Congress needs to help bring down the cost of prescription drugs and break the strangle-hold the pharmaceutical industry has on consumers. Unfortunately the drug industry has powerful lobbyists who are in favor with Capitol Hill leaders from both parties.

4) Legal liability and medical malpractice insurance will not be available in the future unless we control frivolous lawsuits and limit certain "pain and suffering" awards (in non-economic damage claims) to a common-sense level. Many responsible lawyers favor some form of protection through "caps" and limited liability. Trauma centers are closing across the country and providers are leaving the healthcare profession because of liability. Tort reform should be a cornerstone issue in the next major healthcare bill to move through Congress.

5) Indigent care is overwhelming the entire industry. As unemployment rises, thousands of people are now included in the "indigent" category at exactly the wrong time. Just a few short years ago, hospitals had other revenues that they could use to take care of indigent patients. Unfortunately, "cost shifting" is now no longer an option because there is very little income to shift for most providers. The incentives are up-side-down forcing small business people, self-employed individuals and workers with limited benefits to opt for taxpayer funded healthcare.

The "perfect storm" that could destroy healthcare is closing in on us and Congress must act soon. As a concerned Member of the U.S. House of Representatives, I am disappointed that the 107th Congress has not adequately addressed these problems. Consumers should be worried that without timely action our private, fee-for-service healthcare system faces a potential "perfect storm" that will put families and small businesses in peril and ultimately cause the government to take over our healthcare system.