By Carl Stahl

Yes, there are things about the present health care insurance system that need to be adjusted or changed. Unfortunately, without the support of the vast majority of Americans none of us will get the kind of effective and acceptable health care legislation we deserve.

A major part of the problem is the distrust of the president and our legislators by large segments of the voting public. Statements the president has made and Congressman Jim Himes has repeated are directly responsible for this distrust.

First, it is misleading to say that 46 million Americans are without health care insurance without acknowledging that many of those are people who have voluntarily decided not to purchase health care insurance, usually the younger people in our society, and illegal aliens.

Second, the president and our congressman have said that more than half of personal bankruptcies are caused by excessive and unexpected health care expenses. This is truly misleading since it exaggerates the facts. According to the American Bankers Institute, there were a little more than 1.2 million personal bankruptcies in 2008, which means if the president and Congressman Himes are correct a little more than 600,000 were caused by health care expenses. Advocating changing the entire health care system serving more than 300 million Americans because there were 600,000 personal bankruptcies is ludicrous.

Third, they claim that health insurance costs have risen dramatically. That is true, but the increase can be directly correlated with the number and costs of medical malpractice lawsuits. This raises the cost of liability insurance coverage for doctors, hospitals and clinics that we all end up paying for in our medical insurance premiums. Another reason for rising health care costs is the absence of interstate pricing competition. Rising health care costs are clearly not the result of insurance company or doctors' greed as the president has often intimated. Unfortunately, the president's health care plans contain nothing to correct these real causes of increasing health care premiums.

Fourth, it is common knowledge that government programs like Social Security, Medicare and Medicaid are on the verge of bankruptcy as a result of bureaucratic ineptitude and inefficiencies. These programs are on the verge of complete failure but cannot be discontinued because they are too ingrained in our society. But we certainly do not need any more programs like them.

Here are some steps that I feel most Americans will accept:

- Make sure health insurance is available on an interstate basis.

- Make health insurance follows the employee from job to job.

- Provide the poor who cannot buy insurance with vouchers worth up to $5,000, based on provable need, to be used to buy insurance on the open market.

- Eliminate, by law, precondition exclusions.

- Legislate tort reform to bring down the cost of medical liability insurance.

- Make failure to pay premiums the only cause for health care insurance cancellation.

- Demand that the bureaucracy running Medicare and Medicaid reduce paperwork and administrative costs.

- Finally, Congress and the president should insist on a bill everyone can understand. We do not need a bill that Congressman Conyers described as over 1,000 pages long and requiring two lawyers to interpret.

It is time that the president and Congress, including Jim Himes, recognize that a bill no one understands will not reduce health care costs. Instead, an obscure, legalistic document will result in confusion, increase costs and procedures, and invite more and more lawsuits requiring the courts to make the final interpretations.

We deserve health care reform and can have it, but only if President Obama and our congressional representatives, Himes included, will address the problem with candor and true bipartisanship leading to a bill all can read and understand.

Carl Stahl is a Greenwich resident.