Now, in the context of today’s limited and incomplete health care debate, some will react to the areas of change and reform I have suggested by saying that this is all small stuff — that what we really need is that sweeping, top-down upheaval in American health care that can only happen through a federal solution.

They want that one big stroke that would provide an instant panacea. And I understand that, even from some of my own members who are drowning under a tidal wave of health costs.

But guess what? A single solution doesn't exist. And a top down government solution engineered by politicians in Washington won’t work!

We need a multifaceted program of wellness and prevention, transparency, technology, and consumer responsibility to cover more people and provide better care at lower cost.

Will it work overnight? No. Could it actually cost more at the outset to emphasize IT, better training, and prevention? Yes.

In fact, this nation must take a serious look at how we are going to attract, train, and fairly compensate the doctors, providers, and health care workers of the future. If we get that equation wrong, if we continue to force would-be doctors to take on a lifetime of debt in order to work in a profession that squeezes their incomes and bombards them with lawsuits and paperwork, guess what? We aren’t going to have the doctors we need for an aging population.

And if we continue to act in a bone-headed way in terms of our immigration policy, we aren’t going to have the health care workers, who we desperately need at all skill levels, to care for the sick and elderly.

Ultimately we as a nation must decide whether we want a band-aid solution, or to work towards achieving these real solutions:

• Quality care, not just universal care…
• Affordable care, not the false promise of "free" care…
• Good health, because that’s the real goal, not just good health care…
• And American health care seen once again as an opportunity, and not as a problem.