With all the political activity being devoted to health care reform based largely on the presumption that health care costs too much in this in country, have you noticed no one is asking why? We spend $2.5 million on healthcare in the=is country, more than twice what the Japanese spend per capita and the Japanese have longer life expectancies.

I asked my physician and her response (with owl edits), noting that like many aspects of modern society and economics, there are many facets is as follows:

1. Defensive medicine - the extra tests, cost of medical liability insurance, etc.

2. Patient expectations - since someone else is picking up the tab, patients request numerous tests, medicines, etc.

3. Medicare rules and procedures do not invite cost control. If a Medicaid patient wants an extra day in the hospital following a procedure, they get it and the hospital has to absorb the cost.

4. Refusal to pull the pug on the elderly when they are past any chance of meaningful life.

5. Obesity and the resultant cost for illnesses such as diabetes.

6. Poor lifestyle choices with respect to lack of exercise, overeating, smoking and drinking.

None of the matters are being addressed by Congress and health care reform will be non-existent until they are.