The health care debate has come down to whether or not the government should pay for everyone's health insurance.  While it seems to be a noble cause and idea, it neglects to recognize the fact that health insurance is different than health care.  Health insurance is an important aspect of the cost of the health care puzzle.  But the problem with health care is the rising cost of health care.  Merely providing health insurance by paying for it with taxpayer money does not do anything to solve the problem of the rising cost of health care.

Health insurance is an important aspect of the cost of health care because it is the vehicle within which health care prices are negotiated.  Without such negotiations, people would find themselves in a position of negotiating price of a life saving medical procedure only after they were certain that they needed it.  The health insurance apparatus enables the negotiation of the cost of medical procedures apart from the pressures of actually needing the procedure done.  In other words, if you need heart surgery to save your life, it is worth everything you have or will have to get the surgery done.  But if the prices have already been negotiated by the insurance companies, your cost will be much less to have the life saving surgery.  Without health insurance, it might be common to pay $50 for an aspirin because there would not be a check on the doctors' prices.

Having said that, I understand that there is a relationship between the cost of health care and the number of people with health insurance.  This is because the doctors and hospitals still provide services to people who don't have insurance (that's true, it is against the law to deny someone life saving medical treatment - even illegal aliens).  As a result of these services that are provided for free, the hospitals and doctors negotiate rates with insurance companies to offset the costs of treating those who can not pay.  So essentially the people with insurance are already paying for the care of the people without insurance anyway.  With this understanding, people say that if everybody had health insurance, the cost of health care would be less because it would be evenly distributed.  But these costs are already in the system during the negotiations between health care providers and insurance companies.

Paying for health insurance for all Americans will likely cause the cost of health care to continue to rise.  People will use the services more because they will consider them to be free.  Any time you give something away for free utilization goes up.  So we will need much more capacity to service everyone who has free health insurance which enables them to get free health care.  We will need twice as many doctors, hospitals, emergency rooms, etc. in order to care for everyone equally for free.  The availability of doctors and hospitals is one problem in much smaller countries who have universal health care.  The waiting list to see the doctors in those countries is oppressively long so quality of care decreases.

The current debate is over whether or not the government should pay more for health insurance for children.  The debate has soured into the idea that President Bush's veto denies health care to needy and sick children.  This is far from the truth.  The veto merely prevents the government (your and my tax dollars) from paying for their health insurance.  All of these children can get health care at clinics provided by state governments.  Many of these children already have health insurance on their own.  Most of the money that the Congress is going to use to pay for this 35 billion dollar program is going to come from the poor and middle class who have children on the current SCHIP program.  This is a bad idea because it does nothing to address the issue of the cost of health care.  The only point of this program is to pay for health insurance for these children regardless of lifestyle choices that might make them less healthy such as over eating.

Many people think that the solution to universal health care is Medicare for everyone.  That sounds great because Medicare is a very good program provided by the government.  I wish I could qualify for Medicare because I would have much better coverage than I do now at a lower cost.  However what people don't realize is that the government can not sustain the current Medicare program.  It costs too much.  Also, many doctors and hospitals are charging private insurance companies more to offset the cost of treating Medicare patients much like they do for patients who don't pay.  The Medicare reimbursement rates are much lower than private health insurance companies pay.  Also there are new Medicare Advantage programs where the government is paying insurance companies to get people to opt out of their Medicare coverage and into private coverage that is equivalent or better than Medicare benefits.

The cost of health care is a problem in this country.  Providing health insurance to everyone through tax dollars is no solution to the rising cost of health care.  There are simple solutions that would be difficult to pass.  But they would address the problems instead of merely providing government handouts that pass the buck to future generations.  Three solutions would be prescription drug cost reforms, medical malpractice lawsuit reform, and a non-profit model for health insurance companies.  These solutions would fall far short of the call for the government paying for everyone's health insurance.  But these solutions would actually do something to address the problem rather than postpone the problems for future generations.  These solutions would likely cut the cost of health care in half in this country.  My message to the congress on these 'government provided health insurance for all' debates would be 'It's the COST of health care, stupid'.