President Obama renewed his call for health-care reform in his first State of the Union address but, as has been the case from the start of the current debate over how to get more medical care at less cost, he provided little in the way of leadership.

Rather, he suggested that, even at this late stage in the wrangling over reform, he is open to suggestions for how to achieve it.

Said Obama of what remains a vaguely-defined and ever evolving set of reform proposals:

As temperatures cool, I want everyone to take another look at the plan we’ve proposed. There’s a reason why many doctors, nurses and health care experts who know our system best consider this approach a vast improvement over the status quo.

But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.

Let me know. Let me know.

I’m eager to see it.

House Minority Leader John Boehner, R-Ohio, raised his hand at this point. Presumably, in light of the "party of ‘no’" stance he has taken over the past year, Boehner was merely going for a laugh — or perhaps waving to Senate Minority Leader Mitch McConnell, R-Kentucky.

But Obama’s invitation did not go unanswered.

The people who have a better approach — a better approach that Obama once acknowledged as such — have responded by declaring, correctly, that: "There is a better health plan, Mr. President"

Members of Physicians for a National Health Care Program, the national movement of 17,000 physicians, medical students and health professionals who support single-payer national health insurance, are asking the president to consider the "Medicare-for-All" approach that really could expand access and quality of care, lower costs and break the stranglehold of big insurance and pharmaceutical companies on our health-care system.

Dr. Margaret Flowers, a pediatrician and congressional fellow for PNHP, went to the White House today to deliver an open letter to the president calling on him to meet with her and other Medicare-for-All advocates.

Here’s the letter:

January 28, 2010

President Barack Obama1600 Pennsylvania AvenueWashington, D.C. 20500

Dear President Obama,

I was overjoyed to hear you say in your State of the Union address last night:

"But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know."

My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.

I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/ National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare-for-All health system.

I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:

"I happen to be a proponent of a single-payer universal health care program." [applause] "I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."

And that is why I was so surprised when the voices of those who support a national single-payer plan/Medicare for All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.

There was an opportunity this past year to create universal and financially sustainable health care reform rather than expensive health insurance reform. As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.

The good news is that it doesn’t have to be this way. You said that you wanted to "keep what works" and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.

Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.

I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare-for-All national health system. We can implement it within a year of designing such a system.

What are the benefits of doing this?

* It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.

* It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.

* It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market.

* It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.

* It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.

* It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.

* It will allow our people in our nation to be healthy and productive and able to support themselves and their families.

* It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.

Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare-for-All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.

With great anticipation and deep respect,

Margaret Flowers, M.D.Congressional Fellow, Physicians for a National Health Program

Dr. Flowers has answered the president’s call. And she has a cure for ails not just the health-care system but a presidency that suffers from an incoherent and ineffectual approach to the challenge of reforming the way in which voters thinks about a public good that should be available to all Americans as a matter of right.

The question now is whether Obama’s request for "a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses" was sincere — or just a rhetorical flourish.

What we do know is that the Barack Obama who America elected president recognized the wisdom of the single-payer approach.

"If I were designing a system from scratch, I would probably go ahead with a single-payer system," Obama told an August, 2008, town-hall meeting in New Mexico.

The Wall Street Journal article on the campaign-trail session was headlined: "Obama Touts Single-Payer System for Health Care."

In fact, Obama stopped a little short of touting single-payer on the 2008 campaign trail.

But he did as a candidate for an open U.S. Senate seat representing Illinois. "I happen to be a proponent of a single-payer universal health-care plan," Obama told a union audience in 2003.

Perhaps President Obama does not need to invite others to suggest a better approach. Maybe he should just ask candidate Obama — the man voters elected to the Senate and then to the presidency after he promised the sort of fundamental change that only be achieved with what he once celebrated as an "everybody-in, nobody-out… single-payer health care plan" as the only real cure for what ails America.