The health care debate finally got off the launch pad last week. Competing congressional committees and even former legislators like Bob Dole and Tom Daschle started arguing to define ways to improve health care. Like many Americans, we certainly want to see it improved.

The fractiousness of last week's discussion, however, shows that Washington needs several weeks, at minimum, to develop a common plan. These parameters should guide that effort:

DELIVERING CARE

This is the most politically achievable goal. Both parties believe changing the way medical care is delivered could produce a more efficient system. That's good news. Modernizations like these would have real bearing on our lives:

Reform the way doctors and hospitals are paid. There are several ways to achieve this, which President Obama backs. We particularly like giving providers a set amount of Medicare money, letting them figure out how to best treat the patient and rewarding providers if they offer better care for less. This beats reimbursing providers for each visit, which rewards them for services but not necessarily better care.

Pinch high Medicare spending areas, like Dallas and South Texas. A Dartmouth study reveals significant disparities in health from region to region. Obama has latched on to this angle, too, and he should pursue it. Getting to the root cause of the discrepancies could save billions.

Focus on changes that improve care and streamline costs. A consensus has formed around such delivery issues as: Making records available online, rewarding preventive care, producing more primary care doctors, providing patients more information about costs. Each could improve care and control expenses.

EXPANDING INSURANCE COVERAGE

Most Americans probably would like more people to have health insurance. How they get it is the question. This is where congressional hearings must provide clarity:

Why do we need a government plan?

Obama and most Democrats want a public plan to compete alongside private plans. We're skeptical about creating a new federal option since the trust fund that pays Medicare's hospital expenses runs dry in a decade. How can we pay for another federal health care effort when Medicare's about to swamp us?

How would a government plan work?

Would it play by the same rules as private plans? Democratic Sen. Charles Schumer says it should. We hope he prevails. The nation can't afford having the government plan becoming the de facto option.

There's growing chatter that any public plan should work more like a cooperative than a Medicare-type operation. Democratic Sen. Kent Conrad would have it run the way a community operates an agricultural co-op. This has potential, if we go the government route.

Conservative Democrats rightly argue that a public plan should be an insurer of last resort. We cannot sustain a government plan with millions of 25- to 64-year-olds on it, which reliable estimates show could happen.

FINANCING REFORMS

This worries us the most. The Congressional Budget Office puts the cost of reforms at $1 trillion or more.

What's the best funding mechanism(s)?

Obama wants to limit charitable tax credits for wealthy taxpayers and use the savings to partly finance the plan, but even congressional Democrats oppose that.

We hope the president returns to what he talked about earlier: adapting John McCain's proposal to take away the tax break companies use to fund high-dollar employee health costs. There is a tax fairness argument here, and Congress could raise billions if it did away with the employer tax break for employee plans that cost more than $13,000.

The president also suggests limiting how much hospitals get paid, including ones that treat a large number of poor patients. In theory, we agree. But this one faces serious opposition; if it got enacted and then repealed under pressure, as is likely, the financing scheme will have a serious hole.

If Washington cannot provide an airtight financing system, the sensible thing would be to wait until the economy has recovered. As cruel as it would be to those who need health insurance now, it would be equally cruel to pass trillions upon trillions of new debt to future generations. America is already on target to create the highest debt-to-GDP ratio since 1950.

These three areas are the big ones. Get ready for a snarly, complicated debate.