As I noted in a previous posting, our current health care delivery system logs in as a $7,000-per-person-per-year behemoth. And I mean per all 300 million of us. (Do the math: $2.1 trillion divided by 300 mil.)

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.