No increase in public insurance plans. No mandates to businesses or individuals.

Health-care reform, according to Greg Scandlen, should be driven by consumers, who show an obviously increased interest to control their own health costs.

Scandlen is director of Consumers for Health Care Choices, a project of The Heartland Institute, Chicago. He will speak at a program Wednesday night at St. Ambrose University's Rogalski Center, Davenport.

After existing for only six years in the marketplace, consumer-driven changes - such as health insurance savings accounts - are doing very well, said Scandlen, who is from Maryland. Clear trends show that consumers choose, for example, high-deductible insurance plans that come at a lower cost and then use the special savings accounts for expenses.

"People really are changing their behavior - buying generic medications, not using emergency rooms as much, taking part in more wellness and prevention programs, and all of that," he said.

Reforms should not include a public option for health insurance or requirements on either employers or individuals to purchase insurance, such as now under way in Massachusetts.

Scandlen does advocate change to the current system. He does not think more money needs to be spent on health care and that efficiencies must be found to help people at lower income levels.

"Paying cash money at the time of service is lots more efficient," Scandlen said, as opposed to paying an insurance company to, in turn, pay a doctor. That doubles the amount of administrative costs involved in a simple transaction, he said.

With changes, "I think there will be plenty of money to go around for health-care services, and less for insurance bureaucracies," he said.

Scandlen is a senior fellow at The Heartland Institute. The organization promotes "free market solutions to social and economic problems," according to its Web site. Information can be found online at www.heartland.org.