With the talk about making health care more affordable, one can only wonder why the government does not pay its fair share in North Dakota. Medicare pays about 60 cents for a procedure that costs Blue Cross Blue Shield $1. Since Medicare makes up about 70 percent of the medical payments in North Dakota, it seems the simple solution would be for our congressional delegation to use the clout they talk about and get proper reimbursement.

There has also been talk about "co-ops." What would be the difference between the proposed co-ops and Blue Cross Blue Shield of North Dakota? BCBS is a member-owned, nonprofit company. So why would the U.S. government want to compete with the citizens of North Dakota?

If the Washington was really interested in lowering health care costs while maintaining high quality, the solutions really aren't that difficult. This is what I would do:

n Reimburse the providers at a rate that allows health care providers to adequately cover costs.

n Send the illegal aliens home.

n The health care industry estimates that 20 percent of the procedures done today are to protect themselves from lawsuits. So why isn't a tort reform bill in Congress?

n Patient involvement needs to be a priority. Simply going to the doctor and having the insurance provider settle with the doctor does not encourage cost-effective medicine. I suggest that each patient must pay a set amount (indexed to their income) before insurance would cover anything. Whether the amount is $50 or $10,000 (depending on the patients' income), patients need to be invested in their health care.

n The government could take over "catastrophic" health care claims. About 2 percent (or less) use about 50 percent of the insurance claims money paid out. Setting a threshold for claims that would be paid by the government could significantly lower health insurance premium costs.

n Finally, the real problem with health care costs is, we, as a population are becoming "unhealthy." Obesity is a major contributing factor in many of the "diseases" that are costly to our health care system. Yet not one politician seems to want to speak up and ask those who chose a less than healthy lifestyle to pay more than someone who does live a healthy lifestyle.