Health Care Priorities

The prospects for genuine reform of the nation's broken health care system will likely turn on how Congress deals with two nettlesome questions: How will the government pay for reform? Is it wise to also offer a plan run by the federal government?

We already know, of course, that President Barack Obama favors a public plan. And this idea just might work with the proper safeguards. But there is legitimate concern from Republicans and Democrats alike that a government plan would crowd out private health insurers.

The question of paying for whatever Congress devises is even dicier and probably will have to include some sort of unpopular new tax — possibly on at least a portion of individual health benefits.

But any plan first should include incentives to wring efficiencies from the system, which should result in significant savings. A recent article in The New Yorker examined why health care costs so much more in McAllen, Texas — one of the most expensive markets in the United States — than in El Paso.

It concluded that doctors in McAllen were much more likely to prescribe treatments of all kinds.

Any reform plan must get a grip on runaway costs. Health spending accounts for about 18 percent of gross domestic product today but is expected to rise to nearly a third of national economic output by 2040 without action.

Any plan must cover everyone — including young, healthy adults — which argues for mandatory insurance. About 46 million people in the U.S are uninsured, an abomination.

Participants should be able to keep the plan they have now, but there should be a menu of options. Choice, in other words.

Insurers shouldn't be allowed to cherry-pick the healthiest people based on age or pre-existing conditions.

Prevention should be a priority.

This is the best opportunity for real reform in years, but the window for political action won't stay open for long. Congress should act — and act prudently — to ensure that every American is covered.

But lawmakers should not simply create a new entitlement without fully addressing costs.

REPRINTED FROM THE MILWAUKEE JOURNAL SENTINEL.

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