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 to 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 press secretary in Washington, D.C. for a Democrat Congressman from Oregon, as an Oregon state government manager in Salem and Portland, as press secretary for Oregon’s last Republican governor (Vic Atiyeh), and as 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.

Given that we are in the middle of a presidential election, perhaps it should not be surprising that health care policy remains off track in the nation’s capital.

Most who are running tend to utter platitudes to appeal to a political base, not real-world proposals for better health care policy.

On one side, Democrats, including those running for president, want health care to be a full federal responsibility, even though most don’t want to deal with how to pay for the federal largesse.

On the other side, Republicans are no better. All they appear to have the will to say is “no” – nothing to contribute to a reasonable, middle-of-the-road outcome.

For this to be the case in America, which ought to have better ideas, is a crime. Both sides are to blame.

And, amid all of the failure to articulate a sound, compromise plan, we continue to see Democrat presidential candidates Bernie Sanders and Elizabeth Warren touting the benefits of a plan they cannot describe.

At least, Sanders, on occasion, admits that taxes on the middle class will have to increase to fund his new federal entitlement. Warren won’t, saying only that she has a plan, but will wait weeks before disgorging it.

Republicans simply utter typical right wing dogma.

From the cheap seats out West, I have developed my own plan, at least in part so I would be able to say something other than no to health care reform ideas. My notions are informed by more than 25 years of dealing with health care policy in Oregon on behalf of hospitals and insurers.

I have summarized my plan in previous posts, here are the four planks in my health care policy plan.

1. It won’t be popular in some quarters, especially with some Republicans, but, first, a critical component of reform is to require all citizens to have health insurance, either by buying it if they can afford it, or by having it provided by government if they cannot.

Without everyone in the to-be-insured pool, any system will collapse, much as occurred with ObamaCare. The very rationale for insurance is that the largest pool possible should be covered in order to spread the risk.

Think of this way. All of us who drive cars are required to have automobile insurance. If we don’t, we pay a price. The same policy should exist for health insurance.

2. Second, a catastrophic health insurance plan should be provided so that those who cannot afford regular insurance have an option for a lower-cost plan.

As the American Enterprise Institute has written: “Health insurance is also important for financial security. The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.

“Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit that can be used to enroll in a health-insurance plan. The credit would be set at a level comparable to the tax benefits available to individuals with employer-sponsored insurance plans. The subsidy would be enough to make a basic level of catastrophic coverage easily affordable for all Americans.”

3. Third, any new middle-of-the-road health coverage approach should accommodate people with pre-existing health conditions.

I have mixed emotions about this because, inevitably, the price of insurance will go up with the added risk of covering pre-existing conditions. Yet, there is a reasonable social consensus that people should not be penalized financially for health problems largely outside of their control.

And, I firmly believe in the concept that human being should take care of other human beings (if they are willing to accept help) rather than leave the differently-abled to the scrap heap.

4. Fourth, any new plan should allow broad access to health-savings accounts (HSA). ObamaCare pushed millions of Americans into high-deductible insurance without giving them the opportunity to save and pay for care before insurance kicks in. There should be a one-time federal tax credit to encourage all Americans to open an HSA and begin using it to pay for routine medical bills. And HSAs, combined with high-deductible insurance, could be incorporated directly into the Medicare and Medicaid programs.

My views also are informed by a recent experience with health care in England, where there is nationalized health care. While on a European cruise, I came down with a potentially significant health care problem that resulted in me staying in an English hospital for 14 hours of emergency are before I was discharged – in full health, I add.

The charge for my 14 hours was zero – yes, zero – which means that, while I was not paying for my care, someone else was…taxpayers in England. Through this experience, I could not help but that think that smart policymakers on both sides of “The Pond,” should be able to take the best of England and the best of America and produce a meld of both. It would mean a better system in both places.

But, sigh, developing a smart solution is not likely in the presidential election. Those on the left will advocate for a government-run system without knowing the price. Those on the right will advocate for doing nothing, again without knowing the price.

And, surely, there will be a price if we do nothing – a price in the form of higher taxes or a price in the form of lesser health care than we deserve.