The Democratic majority in the Congress, pressed by the President, is getting ready for a health care reform that essentially cannot work.

Most of us Poles have experienced the benefits of ZUS (Zaklad Ubezpieczen Spolecznych – Social Insurance Institute) in the flesh. Americans, it seems, want to experience it on their own.

In fact, it is hard to assess at this point what will come out of the reform now being prepared. The discussions resemble convulsions rather than a systematic progression along a concrete plan. The outlines of the reform are swelling, the concepts are changing  and the so-called public option once is and then is not taken into consideration.

Democrats seem to be willing to pass anything so that they can claim victory and finally give the President something to sign. Unfortunately, we will all suffer the consequences. Well, maybe not necessarily all of us, because no one from the political and business establishment will join the new plan, although it is unanimously hailed by them. Senators and members of the House of Representatives will still use their special insurance options. 

Nobody questions the need to reform the health care system. We need to reduce costs and eliminate the monopoly possessed by insurance companies, as well as give a greater number of Americans the opportunity to obtain health coverage. Unfortunately, what has emerged from the reform prepared in Congress cannot possibly satisfy these needs.

The costs are to be reduced by the introduction of a new government plan (the widely understood public option), which is to function like a non-profit. Then private providers, in danger of losing customers who will be lured by a new and cheaper plan, will have to lower prices. According to the initial estimates, the prices would fall by as much as 10 percent.

However, the basic problem with that idea is that it runs counter to the market economy, which assigns no such place for nonprofit structures – ultimately somebody has to pay for something that does not bring in a profit. In this case, it would be the state, or, in other words, the taxpayers. In the next 10 years the reform may cost in excess of a trillion dollars, which, as we know, the federal budget does not have. The administration will have to deepen the already horrendous deficit in order to finance the reform.

The idea of creating competition in order to lower prices is generally a reasonable one. It seems, however, that instead of building and financing an artificial structure that will be managed by an army of federal clerks the same results could be achieved by allowing for competition among the insurance companies that are already present in the market. Allowing an individual to choose from insurance plans operating in the entire country as opposed to, as it is now, only in the state of residency, would create such an opportunity. This option, nevertheless, is taken into account in neither the Senate bill nor in the one prepared by the House of Representatives. It is true that such arrangement would require more complicated and time consuming changes. But, who says that the reform has to be conducted in a rush?

Medical treatment costs are currently kept high the by hundreds of medical tests prescribed by doctors – just in case, although mostly to protect themselves from possible law suits. The health care reform in discussion does not address this problem. The legal lobby clearly has appeared to be too powerful here. 

Want to lower costs? Let's deregulate the market, do away with barriers, and import cheaper medicines from abroad. Let's not create artificial structures and a costly bureaucracy.

A final point. Apart from the need to lower health care costs, at the basis of the reform is the notion that all Americans should be insured. This raises questions: Is it possible? And more importantly, is it reasonable? Does it make sense to threaten a healthy young man with a penalty in order to force him to purchase health insurance when he would rather spend his money in some other way?

A mandatory payment for ZUS always was one of the biggest obstacles to the growth of entrepreneurship in Poland. Whoever could shun paying these dues did so, knowing that, when in need, he would pay for a private doctor and avoid waiting in line to see a specialist from the "free health care network." That's why we should pray to stay healthy in the event that "Obamacare" passes.