On May 19, Dr. Lori Heim addressed the League of Women Voters on the issue of health care reform.

Heim is a retired Air Force colonel, the president-elect of the American Association of Family Practitioners, and a worldwide lecturer on this issue.

Heim pointed out that, unlike past reform efforts, this effort is driven by the economy. In these days of belt-tightening, all of us are feeling the pinch of higher medical insurance premiums, higher co-pays, and higher drug costs. This includes middle-class taxpayers, small employers, and large corporations, as well as local, state, and federal governments.

So what would health care reform look like? Heim suggested that the best way to reform health care delivery is with a "patient-centered medical home." That is, a primary care physician who manages a patient's overall health, with referral to specialists as needed. Critical to this is an effective system of electronic medical records. With this system, the primary care physician can integrate and coordinate the patient's care, keeping track of what care the patient needs, follow up to assure compliance, and all test results come immediately back to the primary doctor.

This system of health care has worked well with the military and Veterans' Administration, and can reduce costs while increasing the quality of care.

As for health insurance reform, Heim stated that a single-payer plan would provide great savings while eliminating the insurance nightmare faced by all practicing physicians and many patients. Uniformity of care, administration of insurance claims, and bargaining power with drug companies would greatly benefit the health care system, but Heim predicts that will not happen because the various insurance companies have a rich powerful lobby against it.

Heim suggested that instead a "public option" plan might be adopted. Under such a plan, those insured by private insurance companies could elect to continue that coverage, but those without coverage could participate in a State or Federal insurance plan. This optional plan would have the advantages of lower overhead costs and great bargaining power with health care providers and drug companies. It would provide coverage for many uninsured people, but again the big insurance companies feel they would not be able to compete, so they are lobbying and advertising against this plan.

Heim reported that there are about 46 million uninsured people in America, and every time a business closes down or lays off workers, they are added to that total. There are many people just one illness or one accident away from bankruptcy.

"Health care delivery must be reformed, or the costs, both physical and monetary, will overwhelm our economic system," says a spokesman.