Commentary: Here's why Obama should stay stubborn about health care overhaul

A reader of my blog asked a fair question:

"I am curious if you have similar leadership praise for [George W. Bush] for sticking with his vision for transforming the Middle East by liberating Iraq. He did so in the face of tremendous opposition from Democrats (and some Republicans). ... He proved the naysayers wrong and may have created a foothold for democracy in the Middle East."

My answer: Yes, I supported the surge and didn't waver when most thought it a horrible idea.

And I support Obama's push for comprehensive health care reform. A piecemeal approach is what got us into this mess.

Had Bush not held firm for a surge, our combat troops in Iraq would not be coming home in triumph later this year.

The stakes are similarly high with health care. Up to 45,000 people die annually for lack of insurance, and cost increases are poised to make insurance unaffordable for many who have coverage today.

Seven presidents have tried to enact reform. It will be bad for the country if the eighth fails, too.

Here's why Obama should remain stubborn:

The proposal includes a variety of pilot health programs. Those that work will be expanded; the others will be cut.

According to the Congressional Budget Office, the proposal could cut the deficit by $700 billion over 20 years and create at least several hundred thousand jobs. Long-term estimates are always uncertain. But the CBO could be underestimating costs by half a trillion dollars - and the deficit would still drop by $200 billion.

David Cutler, a Harvard economist, wrote in the Wall Street Journal that costs will drop by $600 billion in the first decade because the proposals incorporate the best cost-control measures. Savings could be larger if a public option - opposed by Republicans - was included, and if Democrats had not defanged the malpractice reform in the package.

The debate is bringing greater attention to other issues, as well. The New England Journal of Medicine found that up to 60 percent of cardiac patients in one study unnecessarily received catheterizations, risking their health and driving up costs. A doctor in the same publication challenged every medical specialty to identify five procedures "that are done a lot and cost a lot but provide no benefits to some or all of the patients who receive them."

Others are speaking up about patients who demand the most expensive care - and for insurance to pay for it - even when it is unlikely to work. Insurance companies increase premiums and deny coverage to the sickest among us in response. From a purely market-based perspective, they are giving customers what they want. Healing the sick is nice - if it occurs while producing a profit. They can't remain in business otherwise.

Obama's stubbornness is forcing a deeper look at how we are contributing to an unsustainable system that could bankrupt the country.

He deserves credit for that.