The national debate over health care reform has ground to a halt, with both sides deadlocked over the scale and expense of potential government intervention.

However, we can all agree on at least a few things: Too many uninsured Americans are forced into bankruptcy by accidents and diseases; too many Americans are unable to purchase individual coverage due to pre-existing conditions; too many children are unfairly denied health care because their parents choose not to pay for insurance or sign up for government coverage; and the cost of health care is rising unsustainably.

The solutions to these problems don’t require trillions in taxpayer spending, nor do they require massive new bureaucracies making life or death decisions.

First of all, every American should be required to purchase catastrophic health insurance. We all get sick, so we should all have to pay our share of the cost. That doesn’t mean everyone would have to pay for gold-plated insurance; catastrophic care policies generally cost a fraction as much as regular plans, but they cover the prohibitively expensive costs of things like surgery, chemotherapy, or long-term hospitalization. Those who could not afford even that level of coverage would be eligible for government assistance. Since Medicaid already provides coverage for many of the poorest Americans, this subsidy would be relatively inexpensive overall.

Second, anyone denied individual private coverage due to a pre-existing condition should be allowed to buy into a catastrophic coverage Medicare plan. Medicare has its flaws, but if we are going to put more Americans into a government-administered health insurer, we don’t need to create a new one.
About two-thirds of Americans receive their health coverage through their employer, and for them the current system works well. But calls to force all employers to pay for health insurance are misguided: Not every company has a profit margin that can afford to pay those costs. Instead, we should mandate that all employers offer access to a group plan, without having to pay their employees’ premiums. That would let workers pool their risks without driving struggling businesses into bankruptcy.

To lower costs for individuals, a key first step is to allow people to purchase insurance across state lines. Today, some states only allow insurance that covers virtually any procedure, from acupuncture to baldness cures. That drives up costs for people who just want coverage for actual medical necessities. By allowing people to buy insurance from any state they wish, just as they can shop for cars or mortgages, we can expand choices and lower costs.
It’s deeply unfair for a child to go without health care just because his or her parents would rather spend the insurance money on a new iPod. We can end that unfairness by requiring all parents to provide coverage for their children, either through a group plan or via existing programs like S-CHIP and Medicaid.

Our public Medicare and Medicaid costs are unsustainable; the most recent estimates say Medicare will run out of money in less than a decade. A problem of that magnitude doesn’t have an easy solution, but we can begin by eliminating the $60 billion in fraudulent claims paid every year.
Experience shows that every $1 spent fighting Medicare fraud will end up saving $10.
These changes won’t solve every health care problem overnight, but they represent real progress – progress that doesn’t involve record-breaking tax hikes and crippling budget deficits. These are reforms that we can afford, and reforms that will work.

Rick Berman is executive director of the Employment Policies Institute, a Washington, D.C.-based nonprofit research organization dedicated to studying public policy issues surrounding entry-level employment.