That’s why I get a good laugh everytime I read the results of a new survey. The one I came across today from the Kaiser Family Foundation and Harvard University is full of comments by everyday Janes and Joes who pine for “affordable health care.”

Now, while I sympathize with these people’s plights (I struggle too in the health care battles) and agree with the concept of affordable health care, anybody who thinks we can add 50 million to the rolls of the insured while reducing the cost of health care is seriously delusional.

The only way to do that–and this is the dirty secret and dirty word that no politician in D.C. will ever admit to or utter–is to ration health care. You know, get on a waiting list a year in advance for your next physical, or even flu shot. Then, if you’re lucky, your number may be called.

There’s another way, but it will lead to the same result as the pool of doctors shrinks up: Socialize everything and put doctors on a salary.

The biggest problem with health care as it exists in the U.S. is the payment system. Doctors perform a procedure and get paid for it from a list of payable procedures, so they try to maximize their income by performing as many procedures as possible–whether necessary or not. You’ve been through this with car mechanics no doubt: You take your car in for brakes, and suddenly five other problems are found.

So, the reality is that there really isn’t a health care system in the U.S. There is a sick care system. Very few people go to the doctor until a problem develops, so doctors have become car mechanics for the body. Which makes them very wealthy since the vast majority of Americans abuse their bodies through their diets and life-styles and are constantly in and out of doctors’ offices for maintenance of high blood pressure, diabetes, digestive problems and so on.

Now, if someone can find a middle ground between rationing and socializing, please step forward. The nearest middle ground I can think of, and it has its own set of flaws, is the Kaiser concept, in which everything you need (barring major surgery) is housed in one building and everyone is on a salary.

However, what are the odds that the D.C. brainiacs will do anything except expand Medicare and Medicaid until they squish the private insurance companies out of business? Since these two federal programs are the masters at pay-per-procedure, that leaves us stranded with the rationing option.

If Las Vegas offered odds on which direction so-called health-care reform will take over the long haul, I’d wager everything on the Medicare-Medicaid bureaucratic trump card. Can’t go wrong betting on business as usual in the nation’s capital.

The PDA folk claim that, by just extending Medicare to all Americans (thereby jettisoning, one would presume, all other current health care delivery systems), the country could–bugles blaring, drums rolling–create 2,613,495 million new, permanent, good-paying jobs; boost the economy by $317 billion in increased business and public revenues; add $100 billion in employee compensation; and infuse public budgets with $44 billion in new tax revenues.

First, as for these “new, permanent, good-paying jobs,” you don’t just pick up doctors, nurses or skilled technicians off the street, and just about every study out there shows that there is already a complete dearth of these professionals to suddenly cover the estimated 47 million Americans who lack health insurance. In Massachusetts, under its new so-called universal health care plan, most of the newly insured can’t find a doctor–and can’t afford the premiums (which the state has found itself paying or subsidizing).

But what is most disturbing about this proclamation of health heaven just over the horizon is the disingenuous financing figures–just $44 billion (or $63 billion–the distinction between these figures is not entirely clear) more than what is currently being spent on health care in America, and you get this single-payer nirvana.

Sounds like a bargain, huh? Problem is, the PDA people never say how the government will transfer the other $2.1 trillion (yes, with a T) being spent yearly on the current, mostly private system, a sum which includes insurance premiums, co-pays, deductibles, out-of-pocket expenses, and so on.

The group’s obvious point is, “How could anyone object to spending about $44 (or $63) billion when we’ve bailed out all those banking, stock market and mortgage sleazeballs for several hundred billion?”

It would be hard to so object if it were the only factor, but it would be harder still to find a way to transfer the current $2.1 trillion being spent on health care. Remember, a lot of that money is money that taxpayers are paying themselves–and which they don’t want to pay under any so-called “health care reform.” The public wants out-of-pocket expenses to disappear, and then to be able to walk into any doctor’s office on whim and get treated–without any inconvenience, waiting time or personal money spent.

The public, in short, wants a pipe dream, and sites like this, which make insuring the whole country seem like it costs less than one day in Iraq, only contribute to the daydreaming American public’s fantasies.

As the PDA site proclaims, this $63 billion–they waffle back and forth with $44 billion–is one-sixth the size of the bailout for CitiGroup and half the bailout size for AIG.

Unless my math (and PC calculator) are faulty, if you divide $2.1 trillion by 300 million people, that comes out at $7,000 per person each year. Hardly free–and certainly a lot more than $66 billion, or $220 per person per year. Hell, I’ll write a check for $220 now if I can get that seamless, faultless health care system everyone dreams of.

Unfortunately, this being the real world, it’ll cost each of us $6,780 more a year–and that’s just to get Medicare.

Wrong for all kinds of obvious reasons, most notable of which is that either you or your employer is going to have to pay for your coverage–unless you qualify under a government program because of age, disability or low income.

However, one savvy professor of health policy (and attorney) writing for the New England Journal of Medicine has figured out a quick and simple method that will provide health care for all without a huge national bureaucracy. In fact, this health care delivery vehicle already exists.

It’s called–hold the drum rolls please–Medicaid.

I can sense shivvers going up and down everyone’s spine just upon hearing the word, which bespeaks poverty and welfare. However, it could be aptly renamed and expanded at the same time. MediCure is available, as is MedAdvantage and all kinds of nifty titles.

Anyway, this is an idea that’s so sensible and easy to implement that no one in Washington, D.C., would ever consider it. After all, the whole point of health care reform is to create legions of bureaucrats (read: the politicians’ cronies and supporters) and put them into lifetime sinecures.

(One compelling, negative factor in Medicaid, as the author admits in his proposal, is its low payment schedule for doctors. In fact, many doctors refuse to accept Medicaid patients, forcing them to rely on emergency rooms, as the American Enterprise Institute points out.)

I strongly suggest reading “Medicaid and the Path to National Health Insurance” by Michael Sparer, Ph.D. and J.D. His plan cuts to the quick and solves a zillion problems in one stroke.

Problem is, practicality has nothing to do with politics. Money and power do.