The prospect of national health-care reform has focused the public relations machine of the medical-industrial complex to a wondrous degree. Mouthpieces for doctors, hospitals, insurers and drug companies have promised President Obama that they will cut growth in health-care costs by 1.5 percent a year, saving $2 trillion over a decade.

Trouble is, their promise is vague and unenforceable. It's not something that the president or Congress or cash-strapped employers can take to the bank.

Still, it shows that the moguls of medical money know that they're in for a fight. For now, they want to play nice, making a show of cooperation.

That could change if the president and his Democratic colleagues in Congress stick with their decision to provide a public plan to supplement private insurers. Those same private insurers fear that such a government scheme, which would not have to earn a profit, could drive them out of business, evolving into a single-payer plan, a Medicare for everyone.

There are many advantages to a single-payer system. They can be efficient. But they do not contain costs and are not the be-all and end-all of health-care reform. And besides, that's not what President Obama is proposing.

He wants to keep the current employer-based system for those Americans who want it, but offer a public plan for those who cannot get employer-based insurance or cannot afford it. The trick is how to organize and pay for such a system in a way that allows public and private plans to compete on an equal footing. That's no small challenge.

As an alternative, reformers should look to The Netherlands, home of the most market-oriented national health system in Europe. There, all Dutch must buy a basic plan from one of 41 private companies. The government sets premiums, which are paid half by employers and half by workers. Insurers compete on deductibles. This managed competition helps control costs. Subsidies, financed through a tax on salaries, help the poor and middle class.

Meanwhile, back in the U.S., no one questions that the status quo is grossly inefficient and leaves an unconscionable number of Americans uninsured or bankrupt. It's also killing American businesses with a burden that they cannot bear in the international marketplace.

We'll take it as a start that the providers are at least willing to concede their inefficiency, misaligned incentives and runaway costs. But it is a small start.