One of the latest drama going on is talking about the problem with health insurance costs and how they are spiraling out of control. This is the whole Affordable Care Act / Obamacare repeal stuff that’s going on in Washington.

Honestly, I think that it’s deeply flawed because its goal is to enrich the insurance companies by forcing people to buy insurance — and then subsidize it with federal funds on top of it.

But this isn’t directly about the ACA, insurance, or any of the latest debates. This is about the cost of healthcare — you know, the stuff that the insurance pays out on.

Something has to be done with healthcare in general. It’s not hard to see why insurance is so expensive when we spend so much on healthcare. In 2015 a federal report pointed out that we spent almost $10k per person per year in this country.

Let that sink in.

So let’s assume everyone has insurance we all pay for and everyone is covered. And let’s also assume that the insurance companies had zero overhead and didn’t make a profit. Yes, I’m aware I’m over-simplifying intentionally to show the best-case estimate.

In the above scenario, everyone would be on the hook for $10K per year to cover the costs. That’s how insurance works after all. You pay into the pot and some people need more out of it and some people need less. The money doesn’t come out of thin air. It doesn’t even matter if the government is paying that because fundamentally we are still paying that in taxes.

At its core, this is not an insurance problem. It’s where we immediately see it and feel it so it’s easy to blame the big bad insurance companies… but that’s just the cover for a far more fundamental problem we’re facing.

How do we fix it? Well, first we need something like tort reform to cut down on the number of malpractice suits. We also have to accept that we shouldn’t order every test up front as a CYA against malpractice. We need to look at the cost-benefit of procedures and services that we’re getting — paying millions to extend someone’s life by a few weeks is not worthwhile. We need to ensure that we have reliable access to preventative care, including birth control. We also need to accept some additional personal responsibility on healthcare issues that are our own fault, things like morbid obesity come to mind.

We need to have a controlled rollback of the ACA coupled with changes to the overall healthcare system while we move to have a public option for insurance. Ideally only a public option for primary healthcare insurance.