Health care reform is at the forefront of national policy, as Democrats work out how to pay for their 10-year, $1 trillion “public option” proposal that the Congressional Budget Office says won’t reduce costs nor provide universal coverage. Then again, what government program has ever reduced its costs?

I’m amused that many folks who staunchly argue that the government has no right to intervene between a woman and her doctor on the abortion issue (for the record, I’m pro-choice) also argue that the government has the right to intervene in our health care. The fact that President Obama and almost no Democratic member of Congress will commit to give up their privately-run, taxpayer-subsidized health care plan to sign up for this single-payer-by-stealth proposal is a huge red flag about their proposal.

Republican support for any compromise proposal will also fall short, because Republicans generally accept the same premise, albeit to a lesser extent, as the Democrats: that Taxpayer A should fund the lifestyle choices of Taxpayer B or non-federal-taxpayers. Both major political parties are shortsighted on the issue. What needs to happen is an elimination of government’s role and a direct linkage between the consumer, his or her lifestyle choices, and payment for health care.

There are various issues that drive up health care costs; eliminating government intervention would help solve them. For one, the American Medical Association works with state legislatures to restrict doctors’ licenses. This setup decreases competition and increases price. Malpractice insurance is out of control, as it’s not uncommon for doctors to have to pay $100,000 a year for such insurance. Tort reform would go a long way in restraining costs, as would drastically reducing the extra bureaucratic layers in the medical billing field.

In a truly free market health care system, doctors wouldn’t receive almost the same training whether they want to fix broken bones or do neurosurgery. The virtual one-size-fits-all training jacks up prices for all specialties, and harms access for poorer people the most. I support private charities to pay for poor people’s medical care, with tax write-off for individuals who do so. There are more than enough caring people in America to put their money where their mouths are and fund their compassionate views from their pockets.

Most doctors also have their fees set by insurance companies, Medicare, and Medicaid. Thus, they can’t advertise lower prices. Nor can they advertise a higher-price-but-better-services business model. Ironically, abortion is one procedure that most insurance companies won’t cover and thus falls under market forces. Prices have significantly decreased, thus making the procedure more accessible to more Americans.

One of the pink elephants in the room is that health care costs are so high in America in no small part because of high levels of obesity. The Center for Disease Control and Prevention last week showed that the medical costs of treating obesity-related diseases skyrocketed to $147 billion in 2008. Yet, group insurance plans are forbidden by law from charging fat people more, say, according to body mass index. This is a penalty on people who take care of their bodies, while fat people don’t bear the full costs of their lifestyle choices.

A truly free market would induce more folks to be more preventative about their health choices by directly tying it to the money that comes out of their pocket. Until government gets out of health care, consumers can’t use our dollars to shop around for the best deals, reap the rewards of any moves toward personal responsibility for our health, and that hurts us all.