Pass reforms we can agree on

September has arrived, and Congress is returning to Washington to continue its debate on health care reform and other weighty matters. While members of Congress were on vacation or canvassing their home districts, my household received an intriguing piece of mail. The colorful 7-inch by 10-inch flier on heavy paper was personally addressed to the two registered voters in our household. Its veiled message either lauded or lobbied Sen. Kay Hagan on the health care issue. "Sen. Kay Hagan is working to lower health care costs ..." one side of the flier said. "Kay Hagan Is Working To Pass Consensus Bipartisan Health Care Reform That Will Make Sure People Can Get Quality Health Care Today And In The Future," the other side said, concluding "Call Kay Hagan Today ... Tell her thanks for fighting for health care reforms we need ... ."

My reaction was "What's this all about?" Hagan, the freshman Democratic senator from North Carolina, is seen as a key vote on the health care issue. The fancy flier I received was paid for (according to the fine print on the flier) by Pharmaceutical Research and Manufacturers of America and Families USA. PhRMA, which represents major prescription drug companies, has fought some of the proposed reforms now before Congress. Families USA has pushed for reforms that would make health insurance more affordable. It's an interesting alliance, if nothing else. Is this coalition attempting to bolster Hagan's standing and keep her from getting cold feet on reforms, or is it trying to embarrass Hagan into following its lead? The vague praise of Hagan on the mailed flier carefully avoids addressing any of the divisive issues in the health care reform proposals.

After a month among "the people," members of Congress may be no closer to agreeing on reform proposals than they were in July. Perhaps instead of a 1,000-page comprehensive reform bill, they should concentrate on passing legislation that could garner majority, perhaps even bipartisan, support. For instance:

• Make it illegal for insurance companies to cancel coverage when someone contracts a chronic or fatal illness.

• Make it illegal for insurance companies to refuse coverage for "pre-existing conditions."

• Ban all prescription drug advertising aimed at consumers, including ads for Viagra, Cialis and all the rest. Only physicians can write the prescriptions, so they should be the ones to decide what prescription best suits a patient. This would save many millions of dollars.

• Allow multi-state, interstate insurance groups, expanding the group population and spreading risk, thereby reducing costs.

• Find a way to gradually wean American consumers from employer-paid health insurance. This accidental system is illogical. You don't expect your employer to pay your homeowner's insurance or your car insurance, and you shouldn't expect employers to pay your health insurance. Involving the consumer directly in health insurance decisions would reduce costs and waste.

• Use mandates, subsidies or whatever other means that is necessary to extend health care coverage to all Americans. This can be done by federal subsidies for low-income individuals and families or by allowing the uninsured to "buy into" Medicare by paying a premium equivalent to the government's costs for providing health care for the elderly.

• Agree on a simple principle: Health care is not an inalienable right (it's not in the Constitution), but universal health care is an economic necessity. America's competitiveness against other industrialized nations is hurt by the burden of health insurance and the inordinate costs of American health care. A Benson M.D. recently made this point.

• Medicare costs can be reduced by imposing sensible limits on reimbursements. When the Bush administration proposed this, Democrats in Congress killed it. Now Democrats are proposing to pay for health care reform, in part, by trimming Medicare expenses, and Republicans are whining. A pox on both your houses.

• Health care reform cannot ignore the impact on federal spending. The national debt, driven by anti-recession spending, is soaring. That debt must be brought under control. The nation's fiscal health is as important as its medical health.

Reform is needed. Simplify the debate; pass what's possible now and remove the specter of financial ruin that can easily result from a single accident or illness.