President Obama’s principles for health care reform are choice, reduced cost and affordable health care for all. The people of this country want a better health care system that includes these principles. But that is not enough. In order to achieve reform, the new system must evolve from the old. Mandating universal coverage through a public plan will require a complex and costly transition. Conversely, a new system that is built on the President's principles and evolves from the present one will be simpler and more affordable and thus be welcomed by the American people.

Health insurance is just a part of that system. The people understand that there must be competition between providers, not just insurers, and that this is fundamental to controlling costs. Use of electronic health care records nationwide, establishing nationwide best practices, publishing physician outcomes, and publication of all fees for physician services, tests, and lab work will create competition by providing market transparency and true consumer choice.

Health care reform must also include:

• A federal health insurance option for all; “single payer” for those who want it.
• No exclusion or penalty for pre-existing medical conditions. Lower premiums will be permitted for those who follow physician prescribed plans.
• Portability. Insurance must become independent of employment. Therefore employer mandates must be phased out.
• Mandatory catastrophic insurance (integration of catastrophic health insurance with private non-health insurance policies permitted). The federal plan will offer only health insurance.
• Non-catastrophic insurance optional for adults, mandatory for children under 18.
• Premium subsidies for low income individuals and families.
• Consumer owned health records.

Paying for reform. Reform will be paid for by:

• The President’s identified savings in Medicare and Medicaid.
• Reduction in administrative overhead.
• Limited mandates except for children.
• Application of best practices and reduction of medical errors.
• Preventative care and the elimination of routine care in the emergency room.

Phase-out of employer contributions. Payments by employers for health benefits will be transferred to workers in direct compensation on a dollar for dollar basis. Employers will have one to five years to transition, based on employee group size.

Cooperatives. Small businesses and individuals in all states will have the choice to form private cooperatives.

Existing state plans. There will be flexibility in incorporating existing state reform into the federal system.

Penalties. Those who seek health care who are not enrolled in a health care plan will have the choice of paying in full for services or enrolling in a plan of their choice, paying the previous 12 months’ premiums for that plan and meeting any deductible or co-pay under that plan.

Pharmaceuticals. Government agencies will have the authority to negotiate drug prices. Individuals will have access to generic and imported drugs. The Medicare “donut hole” will be addressed in accordance with the President's June 22, 2009 agreement with the drug producing companies.

This country can no longer afford to wait to reform health care. My plan calls for an increase in choice and transparency. By increasing choice we will increase competition leading to reduced costs and putting us on a path toward affordable health care for all.