Is It in the Stars?

Health and Human Services Secretary Kathleen Sebelius puts the odds of the nation adopting a health care reform plan this year at 75 percent. President Barack Obama says reform must happen this year. "We don't have any excuses," he said this week. "The stars are aligned."

Maybe.

The House and Senate both plan to advance bills aimed at reforming the gigantic system within a month or so with the goal of passing a final package of reforms by the end of the year.

There are hopeful signs. Some of the same industry groups that scuttled Hillary Clinton's stab at health care reform in the 1990s want to be part of the discussions. Obama met with industry leaders this week, and they pledged to work to cut cost increases in the health care system by $2 trillion over the next decade.

But there are miles to go, and so far, there are real concerns that the plans don't do enough to hold down costs in the gluttonous system.

The United States trails almost every other developed country in the way it approaches health care. About 45 million Americans have no health insurance, which inevitably leads to higher costs when they finally do get care.

The American system, an envy of the world for its quality, is also costly and inefficient.

Any reform plan should aim to cover everyone, inject real competition into the system, encourage preventive care, offer a choice of plans and preserve the ability of individuals to select their own doctors. And, as Obama repeatedly has said, it must hold down costs.

To get there, some form of hybrid is likely — a public-private model in which the government subsidizes care for those who cannot afford insurance. It's notable that no one on Capitol Hill is talking about a single-payer system. That's a non-starter. But the insurance industry is worried that a government-run plan competing with private insurers inevitably would crowd them out. That isn't necessarily so, and in many cases, a new government plan would offer individuals more choice than they have now. Also discussed: mandating that everyone have coverage, which seems sensible.

Perhaps Obama's right. Perhaps the stars are aligned this time. Let's hope so. America's health care system, with its runaway costs and uncovered citizens, is unsustainable.

REPRINTED FROM THE MILWAUKEE JOURNAL SENTINEL.

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