Capital Region residents should take steps to ensure that the presidential candidates’ current focus on the economy does not detract from a critically necessary national discussion about health care. The two are inexorably linked.

The connection between a sound American economy and health care was recognized as long ago as 1945, when President Truman observed that “millions do not have protection or security against the economic effects of sickness.” Moreover, he said the time had come to help them.

Six decades later, our market-driven approach to health care continues to fail 47 million Americans who lack health insurance, including an estimated 100,000 of our neighbors. It fails the health care industry, and all who are served by it, by increasing costs and depleting resources. And, it creates risks for our entire economy.

Provision of quality care at all levels, regardless of a patient’s ability to pay, is central to the mission of medical facilities throughout our region. And, provision of care in emergency situations, without concern for compensation, is mandated in law as well as by medical ethics.

But every day, Capital Region medical personnel care for people who may have been able to avoid the need for emergency or acute services if health insurance coverage had provided them with access to preventive and/or primary care.

If human compassion is not enough to inspire all of us to care about those who — because of lack of insurance, or access, or preventative education — suffer with conditions and complications that might be avoided, then economic and capacity issues should be.

As care providers, our approach is fundamentally driven by our compassion and commitment to serve all. Yet, increasingly, we feel the strain of inadequate resources. At Albany Med, we have experienced significant growth in the number of patients being transferred to our hospital by other community medical facilities that are challenged by stressed resources or the complexity of patient care needs. This reality, coupled with limitations in our own physical plant and resources, has necessitated the $360 million expansion project we recently announced.

New York, like other states, is trying to find solutions to the problems of the uninsured, as well as access, capacity and cost issues. But there are limits to what a state can accomplish. And, who among us would be satisfied with the potential result of 50 different approaches to care?

Do we really want health care that differs, perhaps fundamentally, based on state of residence?

That our individual states feel it necessary to undertake this patchwork approach underscores a glaring reality: Health care in the U.S. is not a “system” at all.

It is a loose and disorganized collection of costs and constituencies. Costs including labor, drugs and medical equipment are escalating at an unprecedented rate. Meanwhile, constituencies from the payers, managed care organizations and pharmaceutical firms, to hospitals, physicians and other care providers are struggling to control the supply and administration of health care. Interests are diverse, competing and, all too often, contradictory.

These complicated truths are both the reason that meaningful health care reform has remained elusive, and the reason all Americans should be advocating for true national reform.

As fuel costs extract more from our family budgets and increase prices of goods and services; as unprecedented numbers of Americans face loss of their homes; as more people become unemployed and potentially lose insurance coverage; and as an economic recession looms, the need continues to address our health care whether that be responding to disease or preventing it. And while we continue to procrastinate, the cost of meeting those needs, which already has priced too many out of the market, continues to increase at an unsustainable rate.

This is why it is incumbent upon all of us to learn about the presidential candidates’ health care reform proposals. The Kaiser Family Foundation offers a resource (http://www.health08.org/sidebyside.cfm).

Next, to be skeptical of simple solutions: Each of us should remind our candidates that we can’t have a healthy American economy without meaningful health care reform.

And, finally, when the election is completed, to hold the new administration accountable for reform.

None of us can afford complacency until all Americans have health insurance and access to the care they need from primary and preventive, to specialized and complex. Complacency and health care simply are not harmonious. Complacency and a sound economy are not harmonious.

Only true reform will lead to a healthy economy — and a healthy nation.

James J. Barba is president and CEO of Albany Medical Center. http://www.timesunion.com/AspStories/story.asp?storyID=685465&category=OPINION&newsdate=5/2/2008&TextPage=1