Regulation required

With the Obama administration showing signs of caving on some of its health care promises — such as affordable coverage for all Americans — it is important to note that one option already is within the president's power, with or without conservative or industry support.

If Congress still can't bring itself to do the right thing — and can't see the economic benefit of doing so (certainly a possible scenario) — there is much that could be done simply through tighter regulation of the health care industry and the use of relatively inexpensive incentives.

For instance, prescription drug costs are projected to be astronomical over the next decade or two, but that is primarily because of the Medicare drug program enacted during the Bush administration. It specifically barred the government from using the power of bulk purchasing to lower drug costs. That, however, could be changed overnight.

Secondly, ads for prescription drugs once were banned from television, but now they run nonstop. This leads to tremendous costs in the marketing of drugs and those costs are passed on to the consumer.

Likewise, drugs are marketed like the latest fashions or food fads, prompting viewers to "ask your doctor" for the latest miracle cure. Hint, there are very few miracles out there, but there are grotesque profit margins for some of the firms creating these supposedly new wonder drugs.

Taken in total,

though, how many drugs have proven a significant improvement over generic drugs that have been around for years — especially when the usually side-effects are taken into account? But the industry profits are always 100 percent healthy as a horse.

Removing this scourge from television would be difficult because of the amount of money and lobbying strength involved, but again, it could be done by a determined president and the Democratic majority in Congress with the voting numbers now in hand.

Other regulation to help contain soaring health care costs might focus on the private medical insurance industry, requiring standardized billing forms and practices and policy coverage minimums for everyone — as well as mandatory coverage regardless of a person's prior medical condition.

The best cost-control initiative might be to have a government-run or nonprofit cooperative with government support competing with the private firms, as has been proposed. But some medical expenses also might be subjected to government controls, such as for large equipment purchases by public institutions. This type of regulation has been used in a number of states and need not be reinvented at the federal level.

Many observers are already getting the impression health care reform could stall or be so compromised in the legislative process as to be next to useless. Even if this happens, a comprehensive strengthening of regulation could more slowly do the trick. It could do most of what the president promised during the 2008 campaign.