There are two key reasons why President Bush and Congress must think carefully about health care reform. Get it right today and millions of Americans will benefit both now and when the first echelons of 77 million retiring baby boomers begin flooding into Social Security and Medicare. Get health care reform wrong now and the entitlement crisis that is just around the fiscal corner will be far worse than now projected.

The best way to reform America’s $2.2 trillion health care system starts with one of several methods of applying the basic concept behind health savings accounts. For example, Sen. Tom Coburn’s just-introduced “Universal Health Care Choice and Access Act of 2007” uses tax credits to enable individuals and families to buy health insurance coverage in a competitive nationwide market. Moving health insurance decisions from employers to individuals and families will force insurers to compete for customers like automakers, grocery stores and the makers of thousands of other everyday products. Competition will drive down health costs, encourage better service and expand coverage to everybody who wants it. The key here is simple: Individuals and families know their needs far better than a corporate or government bureaucrat ever can. Any “reform” that doesn’t start with this principle is not a solution, it simply makes the bigger problem worse.

The bigger problem, of course, is the coming explosion of federal entitlement spending in Social Security, Medicare and Medicaid. Put simply, for decades Uncle Sam has promised health and retirement benefits without providing a way to pay for them. Soon, the federal government will either have to renege on promised benefits or raise taxes so steeply that the economy collapses. If that sounds alarmist, here’s what Comptroller General David Walker recently told “60 Minutes” on CBS: “When those boomers start retiring en masse, then that will be a tsunami of spending that could swamp our ship of state if we don’t get serious.” Note too that Walker has often sounded his warning in company with similarly worried experts from the liberal Brookings Institution and the conservative Heritage Foundation.

Thus, any proposed health care reform that puts more power in the hands of government and corporate health insurance industry bureaucrats — instead of individuals and families — is not serious about fixing the health care system now or preventing an economic crisis of historic proportions when legions of retiring boomers start calling Uncle Sam’s promises due.