PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

Those of us who have watched the health care debate in Congress may be glad that it appears to be over.

But is it?

There have been name-calling and recriminations that don’t reflect well on the ability of those in Congress or the Presidential Administration to govern this country. That could mean that nothing will happen to improve health care policy.

The bad news started when the Obama Administration and Congress, then under control of the Democrats, imposed what came to be called ObamaCare, without one Republican vote.

There are those who forget that ignominious start as they have watched Republicans, now in charge of Congress and the Administration, commit the same mistakes made by the Democrats – a Republican plan to repeal and replace ObamaCare without one D vote.

If you want a democracy to work, this is not the way to achieve it.

Better if smart minds in Congress – yes, there are some on both sides of the aisle – would set aside differences, get into a room with a circular table and design a new health care system for this country.

One reason this would be difficult is that ObamaCare has become a new federal entitlement. People who receive care under a nearly unworkable system want to preserve that care. So any change prompts horror stories about people who would lose what they now have under this federal dispensation.

But, I say set that aside and design a new and better, middle-ground system.

For my part, I always have maintained that the best first step would be to require everyone to buy health insurance just as we require every driver to buy automobile insurance. Such a mandate might not fare well in Congress, but it would be a beneficial first step to real reform, giving everyone a stake in the outcome.

Many other tenets of reform could follow, but again for my part, I am more interested for now in the process, not the product. Get both sides in a room, use experts and come up with middle ground proposals.

Scott Atlas, a senior fellow at Stanford’s Hoover Institution and author of “Restoring Quality Health Care: A Six Point Plan for Comprehensive Reform at Lower Cost” ( Hoover Press, 2016), wrote a thoughtful piece in the Wall Street Journal a few days ago to set out three examples of policies that could be part of any new plan – if one actually can be developed by a Congress that tends now to be focusing on tax reform, not health care.

Here is a summary of Mr. Atlas’ suggestions:

• First, equip consumers to consider prices.

“Critics always claim this is unrealistic: Are you supposed to shop around from the back of the ambulance? But emergency care represents only 6% of health expenditures. For privately insured adults under 65, almost 60% of spending is on elective outpatient care. Likewise, nearly 60% of Medicaid money goes to outpatient care. For the top 1% of spenders—a group responsible for more than a quarter of all health expenditures—a full 45% is outpatient. Giving consumers an incentive to consider price when seeking such care would make a huge difference.

“ObamaCare moved in the opposite direction, shielding consumers from having to care about prices. Its broad coverage requirements and misguided subsidies encouraged bloated insurance policies, furthering the misguided idea that the purpose of coverage is to minimize out-of-pocket costs. When the insurer picks up nearly the entire tab, patients have little reason to consider costs, and doctors don’t need to compete on price.”

• Second, work strategically to increase the supply of medical services to stimulate competition.

“In large part, this means deregulation. Lawmakers should remove outmoded scope-of-practice limits on qualified nurse practitioners and physician assistants. That would enable them to staff private clinics that would provide cheaper primary care, including vaccinations, blood-pressure checks, and common prescriptions. In a 2011 review, 88% of visits to retail clinics involved simple care, which was provided 30% to 40% cheaper than at a physician’s office, while keeping patients highly satisfied.”

• Third, introduce the right incentives into the tax code.

“Today employees aren’t taxed on the value of their health benefits—and there is no limit to that exclusion. This creates harmful, counterproductive incentives. It encourages higher demand for care and minimizes concerns about cost.

“Similarly, ObamaCare’s premium subsidies and the tax credits proposed by Republicans artificially prop up high insurance premiums for bloated coverage that minimizes out-of-pocket payments. This prevents patients from caring about the bill, which reduces the incentives for doctors and hospitals to compete on price. If health-care deductions are maintained, the tax code should cap them and limit eligibility to HSA contributions and catastrophic premiums.”

Are these critical spokes in the health care wheel? Perhaps.

But, at least this indicates that there are steps worth considering before we end up with a single payer system, which is the next step liberals and the Democrats want for this country.

It may sound good, but it also would drain the federal treasury without injecting any of the kind of health care disciplines listed above.