“I appreciate your efforts, and look forward to working with you so that the Congress can complete health care reform by October.” So declared President Obama in a letter this week to Senators Max Baucus and Edward Kennedy. The big health care push is officially on.

But the devil is in the details. Health reform will fail unless we get serious cost control  and we won’t get that kind of control unless we fundamentally change the way the insurance industry, in particular, behaves. So let me offer Congress two pieces of advice:

1) Don’t trust the insurance industry.

2) Don’t trust the insurance industry.

The Democratic strategy for health reform is based on a political judgment: the belief that the public will be more willing to accept reform, less easily Harry-and-Louised, if those who already have health coverage from private insurers are allowed to keep it.

But how can we have fundamental reform of what Mr. Obama calls a “broken system” if the current players stay in place? The answer is supposed to lie in a combination of regulation and competition.

It’s a sign of the way the political winds are blowing that insurers aren’t opposing new regulations. Indeed, the president of America’s Health Insurance Plans, the industry lobby known as AHIP, has explicitly accepted the need for “much more aggressive regulation of insurance.”