The president has correctly diagnosed the need for major health care reform in our country. The problem is that the prescription being offered by Congress is worse than the disease.

Heath care costs have been rising much faster than inflation for several years. These costs consume an ever-increasing portion of all family and business budgets, including the city government's budget. Indeed, city and state governments face an increasingly difficult time balancing the budget because of the rapid escalating cost of health care coverage.

The solution, however, isn't spending a trillion dollars and creating a new federal bureaucracy. Those who are currently satisfied with their doctor and health care may find that they have fewer options than they currently do. Rationing treatment has become the key feature in most government health care systems outside of the U.S. Ultimately, with a massive new government health insurance system, all Americans will end up with a medical system that delivers all of the compassion of the IRS and the efficiency of the building department. This is the wrong way to fix health care for our families.

Instead, major reforms that will increase competition and reduce the cost of health care, without bankrupting the taxpayers, should be instituted, including:

• Malpractice tort reform. It is estimated that nearly one-third of all medical procedures today are for "defensive medicine," to protect doctors from malpractice lawsuits. Similarly, malpractice insurance is increasingly the largest single cost most medical doctors today have to pay to continue to practice. A cap on non-economic "pain and suffering" damages at the greater of $250,000 or triple economic damages will go a long way toward reducing rising health care costs. States that have instituted malpractice tort reform have seen their health care costs rise at a slower rate than the national average. It's time for Congress to enact national medical malpractice reform.

• Interstate health insurance. Currently, 90 percent of Hawai'i residents get their health insurance from just two insurers: HMSA and Kaiser. If a Hawai'i resident wants to shop for health insurance from other major insurers like Cigna, Aetna, or United Health, you can't by law. That's nonsensical. We should allow any validly licensed health insurance company to offer health insurance in all states to increase competition and offer more choices to the public. More competition will yield greater coverage and lower medical costs.

• Individual tax deduction of health insurance. We need to fundamentally change the way we tax health insurance. Today, health insurance is largely obtained through your employer using a corporate tax deduction. There is always a market disconnect, however, when the purchaser of a product is different from the consumer, as in the health insurance market. Health insurance should instead be an individual choice with an individual tax deduction rather than a corporate tax deduction. The health insurance market should be made more similar to the home or auto insurance market where individual families, not employers, decide which insurance company to use. By allowing an individual deduction for health insurance we can make health insurance a more "normal" market and better contain out-of-control costs.

A greater portion of the U.S. economy goes to pay for health care than any other Westernized nation and too many Americans are not covered by our health care system. We need meaningful fixes that bring down the ever-escalating cost of health care without destroying the positive aspects of medicine in America. Establishing a government run "public option" and spending more money to reduce health care spending does not make sense. Creative ideas to encourage more competition and broaden the reach of health care, however, are just what the doctor ordered.

City Councilman Charles K. Djou represents District 4 (Waikiki, East Honolulu). He wrote this commentary for The Advertiser.