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The House took the first swing Saturday at passing a plan to overhaul the nation's health care system. The bill includes some long-needed reforms, such as preventing insurers from turning down patients with preexisting conditions.

But it misses the mark in numerous other ways, including the risk the proposal poses to the deficit over the next two decades. The House plan will not be the final bill, of course, and that's a good thing. The more liberal House really didn't need to worry about its moderates to pass a plan. Fortunately, the Senate can't afford to take that course. Its more powerful moderates will have a broader say over that chamber's bill, which is why Senate Majority Leader Harry Reid is still struggling to get the 60 votes to offset a filibuster of the Senate proposal. Reid almost surely will get his 60 votes. But before he does, we all should hope that moderate Democratic senators like Evan Bayh of Indiana and Blanche Lincoln of Arkansas amend the final product so that it can better contain health costs. The Peter G. Peterson Foundation recently analyzed the Senate's bill and concluded that it falls way short in curbing medical expenses.

Change how doctors and hospitals are paid. Like the House bill, the Senate plan still relies on limiting payments to doctors and hospitals to curb health spending. Such payment limits have not worked in the past. Doctors have balked at Congress for limiting their Medicare reductions, and, generally, Congress has suspended the reductions. There's no reason to think things will be different in the future. Instead of repeating that mistake, Congress should create a Medicare payment system that rewards doctors and hospitals for using data, patterns and evidence that point to the best way to treat their patients. So-called "evidence-based medicine" will never be perfect, but it could improve the quality of care patients receive by regularly tracking patient outcomes. Instead of just rewarding medical providers for the volume of services they provide, which we do today, the feds - and private insurers  should reward them based on their results. A change like this can't happen overnight. But the Senate can move us further toward this goal. For example, the Senate needs to create more pilot programs that reward doctors and hospitals for keeping patients healthy, not just giving them treatments.

There are hospitals trying to think anew about how they deliver care. The New York Times' David Leonhardt profiled Utah's Intermountain HealthCare Sunday, citing how it is using "evidence-based" medicine to change practices, such as how the hospital treats early births. But we still have a system that is built upon fee-for-service medicine. And that's a big part of our problem. As Leonhardt wrote: "The fee-for-service" payment system encourages ever more testing and treatments. We're not sure which ones make a difference, but we keep on getting them, and costs keep rising. Millions of people cannot afford insurance as a result. Millions more have had their incomes pinched by rising insurance premiums. Medicare is on a long-term path to insolvency. The American health care system is vastly more expensive than any other country's, but our results are not vastly better.

Source: The Dallas Morning News

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