At a town hall meeting on health care in Portsmouth Tuesday that was thankfully civil, President Obama reacted to the myths - and some outright lies - that have been attached to his effort to reform a national health care system that fails to serve tens of millions of Americans.

Some of the mistaken beliefs are easy to correct. The charge, by foes of health care reform and zanies like former Alaska governor Sarah Palin, that panels would be created to decide which seniors will get health care and which will be allowed to die, for example, is patently false.

Equally false is the contention that the president's real goal is a takeover of health care by government bureaucrats. Insurance industry bureaucrats, whose employers' profits depend on denying care, make health care decisions now. Reform, the president said, would mean that doctors and patients, not bureaucrats call the shots. There will be no single-payer program with care provided by government doctors.

As articulate as he is, Obama nonetheless had a hard time convincing doubters. And doubts are understandable. The president chose not to emulate the Clintons by drafting a reform proposal. Instead, he left it to Congress to craft a health care bill. The result, at this stage, is five competing bills and confusion that's made selling health care reform hard and demonizing it easy.

Obama needs to make his case more convincing. He repeatedly emphasizes, as he did in Portsmouth, that he will not sign a health care bill that increases the deficit. Yet until Congress agrees to tax high-priced employer-provided health plans, raise taxes on the wealthy, or find some other way to offset the estimated $1 trillion, 10-year cost of reform, that vow will not offer much reassurance.

Many opposed to health care reform or on the fence fear that Congress will require that everyone purchase health insurance but offer a substandard plan that, unless they're uninsured, is worse than the one they have now. To answer that charge, the president should promise to veto any bill that does not open up the health care system available to all federal employees, from members of Congress to janitors, to all comers. That way, at a minimum, people would know what they would be getting should their employer use reform as an excuse to drop employee health insurance.

Many among the millions of seniors insured through Medicare or a private Medicare Advantage program fear change. The reform proposals, according to Dr. James Squires, president of the Endowment for Health, would have little effect on Medicare. Medicare Advantage, however, deserves changes and it will get them. With luck, the advantage program that pays private insurers about 12 percent more per year to manage the program for seniors than traditional Medicare will be scrapped. Its outcomes are no better than care under traditional Medicare and too much of the money taxpayers spend on the program is pocketed as profit.

The Congressional Budget Office estimates that if the cost for Medicare Advantage programs were brought down to Medicare spending levels, taxpayers would save $157 billion over the next decade. That's a big chunk of the cost of insuring everyone under health care reform. Why does Medicare Advantage cost so much? Consider the salaries of some of the CEOS of companies that offer the program. According to FierceHealthcare, a website that bills itself as a daily news service for health care executives, the highest paid executive, Aetna's Ron Williams, got total compensation of more than $24 million last year.

The CEOS of the three big players in the New Hampshire health insurance market, Wellpoint (Anthem) CIGNA and Harvard Pilgrim, were paid total compensation of, in round numbers, $12 million, $9 million and $1.7 million respectively.

Compare that to the less than $200,000 salary of the federal official who oversaw both the Medicare and Medicaid programs in 2008 to get a sense of where some of the subsidy money goes.

That's one of the things Obama should talk about if he wants to succeed in reforming health care.