In the past, I've used this forum as an opportunity to work out my own opinions on complicated matters and then shamelessly prostitute said opinions in exchange for comments.  Memetic narcissism and all that.  After two months off I finally have the health care issue to wake me from my semi-voluntary slumber.

What intrigues me about the health care debate is that, despite near universal agreement that the system is broken, no one seems to have any sort of concrete solutions.  At least not any that make any sense.  On one extreme is the notion of a single payer system - sort of like Medicare for everyone.  This option is appealing for its simplicity but brings with it an astronomical long term price tag.  With Medicare set to go bankrupt in the next decade or so, it seems unwise to add yet another unfundable entitlement to the mix.  On the other extreme are the Adam Smith fiscal conservatives who assume that the invisible hand can take care of this whole business.  Just get the government out of the health care business and prices will go down.  This sort of thing warms the libertarian soul, but ignores the fact that the business of healing and saving lives demands a different morality than, say, the business of selling cars.  All but the most callous among us recognize the need to provide our fellowcitizens with basic health care, regardless of ability to pay.  The invisible hand may indeed find room to care for the poor, but it's not unreasonable for the government to intervene just to be sure.

Since there's no solution at the extremes, we assume that there is a solution somewhere in the middle, and thus put up with a mixed marketplace of public and private entities authorizing and paying for health care.  As a consequence, just about any debate on health care reform entails a philosophical discussion of the proper role of government in the health care industry.  This is great fun for the philosophers but it doesn't do much in the way of practical solutions.  The private and public sector are equally capable of high administrative overhead, restrictive access to necessary services, and cost-based health care rationing.  Costs can and will spiral out of control, regardless of who's at the wheel, unless we understand *why* health care costs are out of control in the first place.  Hint:  it's not as simple as corporate greed.  Hint:  it's not as simple as government mettling.  There are dozens of reasons that health care costs are spiraling out of control that have nothing to do with the role of goverment or tainted profit motives.  Unless these issues are addressed individually there's no hope of fixing the problem.

... and I haven't even gotten to Thomas Edison and ice cream ...