Take time and do it right

Seemingly, there's one aspect of the health-care-reform debate that all can agree upon: It's time to move beyond the partisan bickering that has hijacked serious discussion on these complex issues.

Unless all Americans have health insurance, the uninsured will continue to seek primary care from emergency rooms or, worse, neglect their health to the point that they die prematurely. Without coverage or access to primary care, the government, private insurers and people who have insurance will continue to pay for the care of the uninsured. This track is unsustainable.

There is a deep divide on how to ensure that all Americans receive coverage, however. Some in Congress want to leave the issue solely up to the private sector. Still others want a public solution such as Medicare. Others believe a combination of strategies is needed.

We are not sold on the public option. Between the current level of spending on health care and the trillions of tax dollars spent on bailouts and stimulus packages, further expansion of the federal deficit would be perilous.

President Barack Obama insists that stripping waste and inefficiencies from Medicare would drive down costs. Even if some savings could be achieved, would it be sufficient to pay for another government health-care program? That's highly unlikely.

However, Obama said in his address to a joint session of Congress that any legislation he would sign would contain a provision that triggers spending cuts if the annual savings from reform efforts fall short, which seems a sensible approach.

Many questions remain. Does the nation need health-care reform as much as it needs health-insurance reform? Must medical insurance be employer-based? What if Americans could buy coverage the same way they do automobile insurance? Or what if, instead of creating another government program, people who meet certain income guidelines could be provided a health-benefits debit card they could use as a health-savings plan or to pay insurance premiums? This would require lawmakers to come up with a mechanism that does away with the exclusions of people with pre-existing conditions yet enables the entire marketplace to share the risk of insuring people who currently cannot afford insurance.

Seemingly, the entire debate boils to three issues: access to care, containing costs and ensuring quality. Each is a complex issue that needs to be addressed on the federal level, by the states and in the private sector.