One Step at a Time

To address the growing health care crisis, President Obama needs to pull back and refocus health care reform on the fundamental issue of rising health care costs, instead of forcing costly and unwieldy health care reform through the Democratic-controlled Congress. We cannot provide full access to every American -- something I favor -- without simultaneously addressing the issues of cost and quality.

With a substantial portion of disease resulting from lifestyle issues, the U.S. needs to address rising costs by focusing on wellness and prevention to enable Americans to stay healthy by taking responsibility for their health. Reimbursement should be focused on keeping them healthy, not just on disease management.

With regard to access, insurance cooperatives should be set up that provide coverage to the uninsured, portability for workers changing jobs and elimination of pre-existing conditions. These government-supervised -- not government-run -- coops would provide low-premium, high-deductible catastrophic coverage for all Americans and offer competition to private health insurers.

Finally, a major effort to improve health care quality should be launched, with reimbursement based on outcomes, not inputs.

In this stepwise approach, the U.S. will move steadily toward full access at reduced costs and improved quality.