The biggest travesty in this "historic" health care debacle is that it never had to come to this. Simple fixes (an anathema on Capitol Hill) would have significantly reduced costs, without introducing uncertainty over quality of care. More of a focus on consumer directed health care and allowing for insurance to be sold across state lines and are just two effective strategies for reducing costs considerably. Remember, the stratospheric rise in health care costs can be tied directly to the passage off ERISA by a Democratic Congress in 1974, when they first pitched it as an employee benefit and removed the patient from involvement with payment considerations. But now (as Investor's Business Daily notes) the new government plan removes the patient even further from involvement in cost and payment considerations. The familiar "I pay taxes, therefore I'm entitled refrain" will only serve to push utilization rates, and therefore costs, higher. I realize I'm a day late and a dollar short on this observation, but it's something to be considered as praise is sung for the legislation's passage.