The laws and regulations that govern the healthcare industry, like state and federal tax codes, are a complex patchwork of legislation and decisions stacked one on another after decades of special interest lobbying, partisan political wrangling, and honest attempts to correct real problems. Both Democrats and Republicans in the United States Congress and state legislatures are responsible for the current situation.

Now, with an iron grip on government, President Barack Obama and the liberal-Democrat-controlled Congress see “comprehensive healthcare reform” as a once-in-a-generation opportunity. They want to use their political power to pass healthcare legislation that would vastly increase the role of the federal government and Democrats' political power for decades to come. The honest politicians among them truly believe that Democrats' policies and control of government are good for America. Corrupt politicians just want more power and money for themselves and their special interests.

Democrats accuse Republicans of having no serious healthcare reform proposals. Last week Rep. Alan Grayson, D-FL, on the floor of the House of Representatives, said that “The Republican health care plan is this: die quickly . . . That’s right. The Republicans want you to die quickly if you get sick.”

Republicans have put forth numerous serious proposals. None of them get any traction because Democrats control all the committees of the House and Senate that draft legislation; so there is no Republican healthcare bill under consideration. Democrats have rejected practically every amendment Republicans have offered to Democrats’ bills--allowing Democrats to continue to accuse Republicans of having no plan. Of course, Republicans didn’t make healthcare reform a priority when they controlled the White House and both houses of Congress, so they are not above criticism.

Nevertheless, Republicans in Congress and conservatives have put forward several ideas that together constitute a common-sense, free-market approach to healthcare reform. Five proposals in particular stand out.

Allow people to purchase healthcare insurance across state lines. Currently, employers and employees must choose from a limited number of healthcare insurance plans offered on a state-by-state basis that include coverage for benefits most Americans will never need that drive up policy prices. If people could choose coverage that satisfies their families specific needs from the approximately 1400 plans available nation wide, interstate competition would drive the cost of all healthcare insurance down.

Tort reform. Frivolous malpractice law suits and excessive damage awards by juries force doctors to order unnecessary and duplicative tests and drive up the cost of malpractice insurance. Comprehensive tort reform legislation would contribute greatly to reducing healthcare costs. Trial lawyers are major contributors to the Democratic Party and are the principal obstacle to tort reform.

Low-cost catastrophic coverage. There was a time in the United States when healthcare insurance was called “major medical.” It covered hospitalization and prolonged illness. Millions of young, healthy Americans choose not to purchase health insurance because they can’t afford it and don’t believe they need it. Offering them low-cost catastrophic coverage and incentives to purchase it, either through their employer or on the open market, would greatly decrease the number of uninsured in this category.

Pre-existing conditions. Forcing insurance companies to cover pre-existing conditions without waiting periods in a non-universal-healthcare environment has its challenges; but they’re not insurmountable. As with auto insurance, government can require healthcare insurance companies to share the risk for people in this category.

Subsidies for the truly needy. A principle of American democracy that the overwhelming majority of Democrats and Republicans agree on is that there must be a safety net for those people not capable taking care of themselves. Federal and state governments should provide subsidies and tax credits for those people to purchase private health insurance. There has always been a tug of war over where government should draw the line in defining the truly needy, but this also isn’t difficult.

In a recent Rasmussen Reports public-opinion poll, just 41 percent of Americans support healthcare reform proposed by President Obama and Congressional Democrats. Fifty-six percent are opposed because they aren’t buying Democrats claims that they can extend coverage to everyone and reduce costs without rationing care and reducing its quality.

This opposition, along with resistance from conservative and moderate Congressional Democrats, puts “Obamacare” in jeopardy. Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi have their legislative strategies, but even with Democrats in control of the House and Senate, there’s an even chance they won’t succeed. Paying for their plans requires a tax increase on the middle class, and many Democrats are concerned how voting for a tax increase will play in the 2010 election.

We don’t know how many Americans would support the common-sense approach. It doesn’t exist as a question on an opinion survey. Because it relies on free-market competition and tort reform to lower healthcare costs, however, it wouldn’t require trillions of dollars of taxpayer money; nor is it likely to lead to an imbalance of the supply of healthcare resources and the demand for them. I suspect that at least 56 percent of Americans would support it. It would lower costs and extend coverage to millions who are not now covered--the core goals of healthcare reform. “Universal” healthcare in the United States that does not ration care or increase costs is a fantasy.

Democrats may succeed at passing healthcare reform legislation now before Congress. If they do, healthcare in the United States will change dramatically in the years ahead, and not for the better. If they fail, it will be time to take a fresh, more common-sense approach.