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Unless policymakers move quickly to enact comprehensive health-insurance reform, the nation's health-care system is poised for a "meltdown,'' an editorial in the Journal of the American Medical Association states.

The editorial, which appears in the May 13 issue, marks the one-year anniversary of a special edition of the journal that was entirely devoted to health-care reform.

In the year since the special issue, there has been a lot of discussion--but no action--at the federal level about health care, Dr. George D. Lundberg, the editor in chief of scientific publications for the American Medical Association, writes in his editorial.

"We are now poised near the brink of what I call the 1990's health-care-system meltdown,'' he writes.

Unless physicians, insurers, and policymakers can work together and come to some consensus, health-care costs will continue to spiral upward, he writes. If the status quo continues, he predicts, the government is likely to panic and socialize medicine by 1996.

And this, he notes, would be "tragic, catastrophic, and certain to fail over time.''

Another article in the issue notes that there is little consensus about many of the key points in the health-care debate, including whether coverage should be universal and who should pay for expanded benefits.

Over the next several weeks, a series of public-service television announcements will encourage women to seek proper prenatal care.

Johnson & Johnson last week unveiled the first of a series of televised public-awareness commercials that encourage women to avoid alcohol, tobacco, and other drugs during pregnancy.

The drug- and baby-products conglomerate has paid to show the 30-second spot during a number of popular television shows this month, including "Murphy Brown,'' "Beverly Hills 90210,'' and nine soap operas.

The advertisement tells women that, "from the moment you get pregnant, everything you do to your body, you do to your baby.''

The company says the advertisements are part of a five-year, $15-million effort to improve maternal and child health.

At the same time, the Advertising Council, which coordinates public-service campaigns for the advertising industry, has produced three commercials promoting the need for adequate prenatal care.

One spot will emphasize the importance of prenatal care as a public-health issue. Another will stress that men have a particular responsibility to help pregnant women, and a third will be aimed specifically at women.--E.F.

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