* Tort reform. Obstetricians and neurosurgeons in some states pay malpractice insurance premiums in the hundreds of thousands of dollars, costs that are passed on to the patient and insurers - and limit access to those physicians.
* Bringing market forces to bear on health care purchases. Americans are used to making price/value judgments in their purchases. Health care purchases shouldn't be treated any differently. Patients should know the cost of services. (How many people know what an MRI actually costs?) Provider quality information should be made readily available to patients (consumers). Any reform should encourage price and quality transparency.
* Providing tax deductibility for all health insurance purchased, not just that provided by employers. This, combined with health care exchanges, will bring down the out-of-pocket cost to those who have to buy their own insurance, such as farmers, sole proprietors and small businesses. For those who still couldn't afford even the most basic plans, tax credit subsidies can be made available.
* Expanding the availability of high-deductible ("catastrophic") plans combined with roll-over health savings accounts. These products could substantially reduce the cost of everyday health care expenses, with those savings passed on to patients. They could be designed to encourage wellness programs that could save even more in the long run.
* Encouraging use of technology to provide higher quality with lower cost. Everyone should have an electronic copy of their entire medical record. That would not only save costs of duplication when going from one physician to the next, but it would avoid errors in hand-written records and prescriptions.
* Denying any new health care entitlements to illegal immigrants. The costs of providing care to needy Americans through Medicaid is already threatening to bankrupt state governments as well as the federal government. We have to provide everyone care in true emergencies, but that's where we should draw the line.
These reforms would address the demand for portability, personal ownership, affordability and accessibility. They protect patients' rights, preserve the doctor-patient relationship and focus on putting patients and their families first. Our nation still enjoys the finest health care in the world. Let's make necessary changes, but let's take the time to get it right.
Dr. Andy Harris, a Republican, represents District 7 in the Maryland state Senate. His e-mail is andrew.harris@senate.state.md.us.
