At a time when nothing seems to stand between President Bush and soaring approval ratings, his one vulnerability may be a health care system on the verge of falling apart.

It is the creeping menace that will not be forgiven if too many Americans find themselves without coverage and up the tree of life absent the resources to save themselves. The case for a health care crisis does not require overstatement.

“Health insurance premiums are rising at double-digit rates,” writes Henry Aaron of the Brookings Institution in The Washington Post. “Drug prices are skyrocketing. Employers are curtailing health insurance benefits and boosting the share of cost employees must shoulder.

“Stunned by rising premiums, employees are foregoing coverage for themselves, their spouses and their children. As a result, the ranks of the uninsured rose to more than 41 million, a jump of 1.4 million in 2001 alone, and appear likely to continue expanding as rising costs hammer employers whose profits are depressed by a weak economy. No one should be surprised if 50 million people are uninsured by 2005.”

Aaron’s words suggest that if people aren’t hysterical, they should be. “A genuine mess is in the making, and no one is doing anything about it,” he writes.

A do-nothing attitude could even lead to a point where Americans punish Bush for leading them down a garden path to nowhere and to a health care system that lies in wreckage. What’s most depressing is that there is little evidence Bush has a plan for this impending crisis or a clue to its solution.

“The number of uninsured will continue to grow as long as health insurance premiums rise more rapidly than earnings, as they have for a decade,” says Drew Altman of the Henry J. Kaiser Family Foundation, which specializes in health care issues. “Losing health benefits is becoming a middle-class issue.”

Altman’s words are ominous because when a sense of insecurity creeps into the comfortable middle classes, it invariably touches raw nerves. These are not the same alarms sounded when the rich help themselves to a larger share of the nation’s income or when the poor get it in the neck again, as they always do.

“Only a plan that appeals to moderates of both political parties stands any chance of ending the deadly trend toward denial of financial access to medical care for tens of millions of Americans,” Aaron says.

This is almost like saying there is no hope, no solution because it would require Bush to do something liberal. The solution to the crisis was obvious even to an unregenerate Tory like Winston Churchill, who declared in 1944 that “disease must be attacked in the same way that a fire brigade will give its assistance to the humble cottage as readily as it will to the most important mansion.” Churchill’s reference to a fire brigade suggests that whether people can afford health care is no more relevant or pertinent than whether firefighters should fight fires, which everybody agrees they should.

In any event, it’s a problem that has already been settled in most of the civilized world, where the health care debate has been solved by universal coverage. It exists in Canada, in Europe, even in countries that can afford minimal health standards. It often creaks with inefficiencies and anomalies, but it still stands as the only sane answer to a compelling need.

The nightmare that still haunts the health care system is the experience of Hillary Clinton, who tried to solve the mess in 1993 and got nothing but grief and vilification for her efforts. She’s now a sitting senator from New York, which ought to tell us something, if only that people who try to solve problems instead of pretending they don’t exist sometimes get their just rewards.