PORT ANGELES — National health care needs a reform, and there is a small window of opportunity in which to do it, State Insurance Commissioner Mike Kreidler told the Port Angeles Regional Chamber of Commerce on Monday.

Kreidler, who regulates insurance companies in Washington state, told a group of about 75 people that now is the opportune time to make changes.

“You don’t hear anyone advocating keeping the system exactly how it is,” he said.

He said although there is some congressional support for a single-payer system — in which the government pays for health care — such as is available in Canada, most people are not supportive of that option.

“I do not believe that we, in America, will ever get to the point that we go to a single-payer system,” he said.

Congress now is considering various options.

Four principles

Kreidler said he hopes reform will be based on four principles.

• “One, I believe that the system has got to be universal.”

• “Second, the system has to be affordable and cannot be linked to the employer, so if you retire early or your job goes away, you don’t lose it.”

• “Third, choice has to be guaranteed. If you like the doctor you have, you should be able to keep going to him. You won’t be shifted away from your choice as the reform takes place.”

• “Last, we have got to build on the private system we already have in place.”

The audience questioned whether it is viable for the government to have a public health coverage option in what Kreidler called a “private-public partnership.”

“You see a good example of this kind of plan here in Washington with the state plan that others have bought into,” Kreidler said.

Uniform standards

“I feel very strongly because I regulate insurance, that to operate efficiently, you must have uniform standards for both the public and the private plans.”

Kreidler estimated that any public plan would not get more than 15 percent to 20 percent of the market.

“What I think is more likely is that the private insurers would have to adapt costs to make them more attractive, and they would stay viable,” he said.

Kreidler also said that one of the plans Congress is considering includes universal coverage for catastrophic incidents — medical emergencies requiring more than $10,000 in medical costs.

“If that is covered, then you would see that the rest of the plans would start to become much more affordable for people,” he said.

He said he views the situation in terms of economics rather than morals.

“We are outspending our economic competitors in the global market by 2 to 1 sometimes in medical coverage, and we are seeing less of a result,” Kreidler said.

“We cannot be economically viable if we are dedicating a third of our gross domestic product to health and not seeing results.”

An audience member asked if there is a country that has the “ideal” system in place, in his opinion.

Kreidler said all of them had things that he would probably change, but the Germans and Swiss have public options based on private plans that would be a good starting place.

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Reporter Paige Dickerson can be reached at 360-417-3535 or at paige.dickerson@peninsuladaily news.com.