The whole world is in recession. But the United States is the only wealthy country in which the economic catastrophe will also be a health care catastrophe  in which millions of people will lose their health insurance along with their jobs, and therefore lose access to essential care.

Which raises a question: Why has the Obama administration been silent, at least so far, about one of President Obama’s key promises during last year’s campaign  the promise of guaranteed health care for all Americans?

Let’s talk about the magnitude of the looming health care disaster.

Just about all economic forecasts, including those of the Obama administration’s own economists, say that we’re in for a prolonged period of very high unemployment. And high unemployment means a sharp rise in the number of Americans without health insurance.

After the economy slumped at the beginning of this decade, five million people joined the ranks of the uninsured  and that was with the unemployment rate peaking at only 6.3 percent. This time the Obama administration says that even with its stimulus plan, unemployment will reach 8 percent, and that it will stay above 6 percent until 2012. Many independent forecasts are even more pessimistic.