The "end of life" section of the House 1,017-page health care bill, "America's Affordable Health Choices Act of 2009," makes for some chilling reading.

There's the Medicare edict for an "advance care planning consultation" for individuals every five years, or more often "if there is a significant change in the health condition." Implementation of Congress' wishes is left to the Secretary of Health and Human Services and other government agencies.

Yes, end of life discussions are necessary, even encouraged, if painful. Almost anyone who has been around long enough has had to face such an agonizing choice.

But the issue with the "advance care planning consultation" provision of House Bill 3200 is that government has no place - no place - injecting itself in any way shape or form into that discussion.

Placing the provision in the bill has turned out to be a huge error and overreach that could forestall any health care reform at all.

Now, as other cornerstones of the House bill falter, including, potentially, the central "public option," Congress and the White House should press the reset button and begin again.

In fact, there are some things that could be done immediately that would begin to heal the system without creating a new Medicare-style health care bureaucracy.

For instance:

-- Allow small employers to pool together to provide leverage in purchasing insurance.

-- Since it appears abolition of the employer tax deduction for health plans is off the table, at least extend the benefit to individuals who purchase insurance on their own.

-- Encourage, rather than discourage, health savings accounts and catastrophic plans that are more affordable and give individuals more control over their own health care.

-- Allow insurance companies to compete across state lines. The current law is akin to forbidding Microsoft from selling software outside of the state of Washington.

-- Finally, reform current tort law that forces huge malpractice insurance costs on average physicians and encourages overutilization of medical procedures via "defensive medicine."

Those five steps would be a good start.

Brad Bollinger is the Business Journal editor in chief. He can be reached at 707-521-4251, or online at