Medicare is going broke. There are people in this country with serious illnesses who cannot afford health insurance. There are unethical people defrauding the system and providing care that is substandard.

Our health care system has some serious flaws. This President, as others before him, has challenged Congress to fix the problem. Unfortunately the media and members of Congress have made this a contest of winning or losing. Headlines and political rhetoric lead you to believe that the outcome of health care reform will be a victory or a loss for the President or for a particular political party. The reality is that health care reform will be a victory or failure for the American people. For our elected officials to view it in any other manner is negligent and a violation of the trust we gave them when electing them to office.

Passing a flawed bill is not a victory. Nor is it victory to stubbornly oppose any form of reform to a system that needs improvement. We deserve better from those we have elected to represent us.

Any “solution” to the health care challenge must be realistic in terms of cost. We cannot create another government program that will ultimately be in the same financial crisis that Social Security and Medicare currently face. While the government has the ability to print money, it cannot fabricate value. At some point the deficits and artificial cash pumped into the system will collapse, much as the mortgage failures brought about the crisis for many financial institutions in the past year. If government does not start to exercise fiscal prudency, this country will face a financial crisis that no bail-out can save.

The current house reform bill will require insurance companies to accept all patients regardless of preexisting conditions and will prohibit them from placing caps on benefits. The insurance companies cannot charge higher premiums for these individuals than they do for others in the plan.

True health care reform must address health and the issues that impact health. Poor diet, smoking, obesity, drug use, lack of exercise and poor prenatal care are big components of the cost of health care in the United States. Improving quality and reducing cost are not done by making sure everyone has health insurance. They are accomplished by improving the overall health of our population. This issue is not being addressed.

Many Medicare and Medi-Cal/Medicaid patients are finding it difficult to get a primary care doctor or get an appointment with certain specialists. This is because physicians cannot afford to see too many of these patients without risking financial ruin.

Patients who are insured through a commercial health insurance subsidize the federal programs by paying more than their fair share. Physicians therefore give priority to insured patients and commercial insurance is condemned for having high premiums.

Despite this fact, the House bill does not contain an outline to fix this problem. A separate bill does away with the existing payment formula that has physicians facing a 21% cut in 2010, but a long term solution is not included in either bill. Political promises seem to buy votes, but they seldom produce results.

Under such circumstances, how many bright young people will choose medicine as a career? A surgical specialist is in school and training until they are between 32-35 years old. Most will have spent well over $200,000 in tuition and fees. They will have put off establishing a home for themselves and their families.

The Pelosi bill is a bad bill. It does not go far enough in some areas and goes too far in others. It does not address the root causes of our health care challenge nor does it strengthen our health care system. It changes our health care system, but there is little hope that it is the change we need.