Like it or not, the U.S. has reached a historic juncture for its healthcare system.

We have long accepted that our complex public and private approach to healthcare financing is unsustainable. We devote nearly 18% of our total output for goods and services to healthcare and spend 50% more than the next highest spender among all the countries on the globe. Yet we don't live longer than the citizens of many industrialized countries. We don't live healthier lives, and we allow 40 million of our residents to live without healthcare insurance.

Even those with insurance are not assured access to the type of advanced medical services that radiologists proudly developed and provide. Many of us live in fear of illness, not because it may threaten our lives, but because it may ruin our financial well-being.

Think of the injustice of paying thousands of dollars annually for insurance coverage, deductibles, and copayments and still being denied an opportunity to choose one's physician, hospital, and medical clinic. Thirty years ago, that situation would have been considered socialized medicine. Today it is called managed care.

Beyond that, insured people still face the probability of financial ruin when they, or a direct family member, become seriously ill. The status of healthcare as the leading cause of bankruptcy shows that there are no assurances in its method of insurance.

The economic picture is also bleak for employers, who cover 60% of the nation's healthcare bill. The fact that General Motors spent more on employee healthcare than on steel epitomized the U.S. healthcare problem for decades. We have been repeatedly warned that the U.S. was losing its edge to international competition because of healthcare spending obligations.

That butcher's bill has come due. GM is bankrupt, and controlling interest of Chrysler has been turned over to Fiat, an Italian company whose workers are covered by a national health service financed by payroll taxes.

The problems with the U.S. healthcare system are clear, but the optimal solution remains a matter for debate. The Obama administration has proposed a plan involving private insurance and a new public coverage alternative. It has committed $635 billion as a down payment for its plan, and the president has challenged the healthcare industry to find $300 billion of wasteful and unnecessary costs to eliminate.

With opening salvos sounding in June, this summer will be a time when federal legislation will be introduced and debated. As with the Clinton administration's attempt at comprehensive reform in 1993, this effort is bound to turn into a bare-fisted legislative brawl.

A warning is in order for those who would shout down thoughtful, yet necessarily painful, solutions to our healthcare woes. The status quo is not an option because the current system cannot be sustained.