With the insurance industry throwing out one last scare tactic salvo as Congress heads toward a decision on health care reform, it is useful to recall that several simple changes would accomplish significant cost savings immediately -- yet none of these proposals would be em-braced by the industry. All would be the target of vicious industry lobbying.

First, we could allow the government health insurance programs, Medicare, Medicaid, etc., to seek bids and purchase prescription drugs in bulk. Currently, this is barred, thanks to the Bush administration, which insisted on the ban during passage of the boondoggle Medicare Prescription Drug Modernization Act in 2003. Guess who that helped.

Yet, this one change would drive down the astronomical cost of drugs almost overnight and bring our costs more in line with the drugs that can be purchased in Canada.

Second, ban television advertising of prescription drugs, which once was the law before it was changed amid a flurry of "the marketplace knows best" monstrosities created under the Reagan, Bush & Bush administrations. Pharmaceutical companies claim the high cost of medicines stems from the cost of developing new wonder drugs, but much of that is underwritten by government. In addition, the outcome for many of these drugs proves less than wonderful, or they amount to a new brand name rather than a new, more effective medicine.

The truth is, these companies spend billions on ceaseless advertising on

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television. If none could do that, the drug costs would plummet -- and maybe doctors could begin to decide again which drugs patients should take, not patients themselves demanding the latest fad pill.

Third, have the federal government underwrite or directly provide malpractice insurance for doctors working at hospitals and at all but boutique health clinics for the wealthy. And underwrite or provide direct reimbursement for medical school tuition costs.

Fourth, provide basic care through clinics run directly by the government, providing free physical examinations, basic care and information on the further care and insurance coverage.

Fifth, tax the foods and beverages that are causing an epidemic of obesity and heart disease in this country and dedicate that money to Medicaid and Medicare.

Sixth, standardize the basic coverage a private insurer must offer -- with no precondition exclusion -- and standardize the insurance paperwork so that everyone can understand who pays what when.

That's enough for now. But what a great start these few changes would make, and what a different health care system we would have.