The answer is unleashing markets—not government.

This is the basic plan I proposed in Massachusetts. It has worked: 360,000 previously uninsured citizens now have private health insurance. The total number of uninsured has been reduced by almost 75 percent. The Massachusetts plan costs the state more than expected, largely because the legislature has been unwilling to further reduce state payments to hospitals for free care. The costs should be brought in line by eliminating these payments, by requiring sustainable copremiums and by removing coverage mandates (for example, every policy is now required to include unlimited in vitro fertilization procedures).

2. Make health insurance affordable and portable. Eliminate the tax discrimination against consumers who purchase insurance on their own. This, plus getting everyone insured, will sharply lower insurance costs (in Massachusetts, the premium for a single male has declined by almost 50 percent). The result: Americans wouldn't have to worry that their insurance would be unaffordable or canceled if they changed or lost a job.

3. Give people an incentive to care how expensive and how good their health-care treatment will be. Learn from the French and Swiss experience with coinsurance, where the insured pays a given percent of the entire bill, up to some upper limit. Unlike a deductible, where there is no cost to the insured once a threshold has been reached, coinsurance means that the insured continues to care about cost.

4. Provide citizens with information about the cost and quality of providers and the effectiveness of alternative treatments. This transparency, when it's combined with a meaningful personal financial incentive, will help health care work more like a consumer market.

5.Reform Medicare and Medicaid, likewise applying market principles to lower cost and improve patient care.

6. Center reforms at the state level. Open the door to state plans designed to meet the various needs of their citizens. Before imposing a one-size-fits-all federal program, let the states serve as "the laboratories of democracy."

Republicans have introduced bills in Washington that promote these and other consumer-driven policies. In every one, the patient and doctor guide care, not the government—and that makes all the difference.

Romney is a former governor of Massachusetts.

© 2009