President Barack Obama is planning some dramatic — and potentially very costly — changes to health care that simply may not be necessary to provide health insurance for millions of currently uninsured Americans.

Recently, a senior White House political adviser would not rule out a new tax on health benefits to pay for a new public health plan. Limiting the tax-free status of employer-provided health benefits to help pay for the public plan could result in employers dumping insurance, severing the traditional system of employer-sponsored health-care coverage. As a presidential candidate, Obama vigorously attacked Republican John McCain for making the same proposal.

Such a sharp disruption of the current system is not necessary to help provide health insurance for the estimated 45.7 million Americans who lack insurance, as the Heritage Foundation and syndicated columnist George Will have pointed out.

Roughly 7 million to 9 million of the uninsured are not American citizens but illegal immigrants, according to the Heritage Foundation and Will. And about 9.1 million of the uninsured have household incomes of at least $75,000 and could purchase insurance, according to Will. Is it fair to tax middle-income and low-income Americans to provide health insurance for families who clearly have the wherewithal to purchase insurance themselves but refuse to do so?

A plan floated by key Senate Democrats late last week calls for fining Americans who refuse to buy affordable health insurance, The Associated Press reported.

Up to 12 million of the uninsured are eligible for existing government programs — Medicare, Medicaid, SCHIP, veterans' benefits, etc. — but have not enrolled, according to Sally Pipes of the Pacific Research Institute. Helping the 20 million or so Americans who genuinely can't afford insurance could be relatively easy. They could be given tax credits or debit cards to help them purchase insurance in the open market. That at least would not pose a threat to current system of employer-provided health insurance.

Obama's new public insurance program — which would compete with private-sector insurance companies — would cost more than $600 billion. Critics also say that such a large-scale public plan, likely modeled after Medicare, would have the ability to set prices and would have an unfair advantage over private-sector insurance companies. Many of those private companies could be forced out of business.

Americans benefit most from a health-care marketplace with robust competition among private plans. Health-care reform should not involve new onerous taxes or undermine a system of employer-provided health insurance that works well for millions of Americans.