Putting health care principles into practice.

• Position: YOUR LIFE

Pres. Barack Obama has released his guiding principles fur "Transforming and Medernizing America's Health Care System" Yet, what tactics will the President and his team use to fix a broken health care system where 16% of the nation's gross domestic product---more than two trillions dollars a year--is spent on health care and includes 47,000,000 uninsured U.S. residents?

The first--and perhaps most important-task is to define the proper role of government, maintains David Edman, managing partner of Wayne, Pa.-based Risk Management Partners, LLC. Should government be the single payer fur health care services, set the rates of payment to providers, and cut the checks? Examples include traditional Medicare (Parts A and B) in this country, and government-run health care in Canada and England.

"In Canada and England, government sets the rates, pays the providers, and limits the supply of services. Everyone is covered and costs are lower (per capita), but there are waiting lists for services, a dissatisfied public, and a growing system of private insurance. Traditional Medicare in this country is wasteful and inefficient--and since Medicare only covers 60% of costs on average--there remains a need fur private Medicare supplemental insurance to pay for health care services not paid for by Medicare."

Instead, should government manage (and pay into) a system of competing private insurers, establish the rules of engagement, be the referee, and promote competition based on quality and cost of care? Examples of this model include the Medicare Advantage Program (Part C) and the Federal Employees Health Benefits Program (FEHBP).

"The little-known Medicare Advantage Program is an example of the government paying into a system of competing private insurers,"' explains Edman. There are no waiting periods for...