Hailed as a very smart man who knows the tenor of the public, President Obama has not acted

on the one thing the people have asked for in health care reform &#8212 to bring its

geometrically escalating costs down.

Instead, he has thrown his weight behind an expensive collection of entitlements, mandates

and regulations that will only raise the deficit again. And he has turned away from some

obvious steps that would reduce costs.

Increased competition between health insurance companies, by allowing them to sell

nationwide, is the traditional American way to bring costs down. Medical malpractice reform

must be addressed with reasonable caps on damages, so that doctors and hospitals will make

costly diagnostic and care decisions based less on fears over lawsuits.

And as the debates rage despite the Democrats&#8217 intent simply to push through the plan

they want, it remains puzzling that so little attention is being paid to the health reform

plan &#8212 as opposed to the health reform rhetoric &#8212 advanced by Republicans. The

Common Sense Health Care Reform and Affordability Act has a lot of the things that the public

is asking for and could lower costs as well.

Included in that plan are items worthy of actual debate instead of political posturing.

Among them are provisions that would allow children to stay on their parents&#8217 policies

longer, guarantee that people with pre-existing health problems will be able to get insurance

and not allow insurance companies to drop people if they get sick.

While those provisions also are in the Democrats&#8217 plan, so are a slew of others &#8212

all costing a lot of dollars, which the Democrats say would be covered by an unlikely

combination of scenarios including future congressional cuts in popular programs. The

Republican proposal is contained in 219 pages. There are 2,000 pages in the Democrats&#8217

bill.

Experts have been stunned at the skyrocketing cost of health insurance, and the government

has not found a way to bring those costs down. With health care already tied to a sixth of the

American economy and heading higher, that cost control is essential. The difference

essentially is that the Republicans first want to control costs and Democrats first want to

expand entitlements. In this case, expansion should follow cost control &#8212 not undermine

it.

It is unclear whether the president is willing to get to the heart of the matter. Already,

he has consumed 13 months on aggressively pushing health care as a top priority when the

public, during a difficult recession, is concerned first about jobs. This is neither good

political thinking nor good decision making.

Starting over and presenting a sound bill for passage need not take 13 months. Both the

Congress and the president have been chastised by the public for some of the mistakes they

have made in back-room dealing. They don&#8217t have to repeat those mistakes. If the sound

economic approach in a time of huge federal debts and deficits demands health care cost

control, do that first. And do it without saddling a new bill with a thousand pages that

crushes real reform by expanding entitlements without really figuring out how to pay for them.

Finally, there is a difference between health insurance and health care. The latter is

important not only from a cost standpoint, but also from the standpoint of quality delivery of

medical care in this country. The president loves to talk about how excellent the care is and

how low-cost the price is at the Cleveland Clinic and other such superior medical facilities.

If that is the future he aspires to, where is the action to get there?

This obviously is no simple task, but if the president and the Congress would accomplish

this improvement along with cost reduction, they will have advanced the public&#8217s well

being far beyond what has been presented so far.