Lacking health care insurance is not the same as lacking health care . By law, most emergency rooms must provide health care -- to both legals and illegals. Yes, they stand in line, but no health insurance does not equal no health care.

Government (aka taxpayers) already pays half of our health care dollar, with programs such as Medicare, Medicaid, SCHIP and other federal and state plans. The stated goals are accessibility and affordability. Congress passed Medicare in 1965. In the 20 years before the program's inception, the cost of a day in a hospital increased threefold. In the 20 years following Medicare, a day in a hospital increased eightfold -- substantially higher than inflation over that period. Because of cost controls on government plans, providers increased the cost on everybody else.

So here's the question.

Do we allow a complete government takeover of the section of health care it doesn't already run, for 10-15 million or so without health insurance on a persistent basis? Again, 255 million Americans already have it. Many millions more could get it if they wanted to. And 89 percent of Americans are satisfied with the care they now receive.

What to do? Unleash the free market. Allow greater competition among health care providers. Decrease costly regulations that increase the price tag. Enable consumers to purchase insurance plans across state lines. Allow non-government-licensed paraprofessionals and others -- currently prevented by law from offering any medical services -- to provide low-cost care.

What about poor care and negligence? We have laws against force and fraud, as well as a common-law duty of care. That's why God created lawyers. (Just give us "loser pays.")

What about those who cannot afford it? What about those with pre-existing illnesses whose insurance applications carriers turned down? What's wrong with charity -- people helping people? America remains the most generous nation on the face of the earth. We donate more of our time and money than countries like England, Germany and Japan. During the Great Depression, before the New Deal, charitable giving skyrocketed. After the New Deal, charitable giving continued, but not at nearly the same rate. People expected government to address the problem, and taxpayers felt they gave at the office.

We can provide such "universal" coverage at a "low cost" -- through rationing. That means long lines, lower quality and less innovation for services that Americans currently take for granted.

Economists call it T.A.N.S.T.A.A.F.L. There ain't no such thing as a free lunch.