Almost everything in American politics circles back to health care costs. The government has committed to pay for health care for certain classes of people—the elderly, its own workforce, the poor—and health care costs are growing more rapidly than the economy as a whole. Meanwhile, on the private sector side the insurance market as we know it exists largely because of tax subsidies that, in turn, are becoming more expensive to provide. The fact that these are manifest themselves as separate issues called “Medicare,” “Medicaid,” “public sector compensation,” “insurance premiums,” etc. reflects the fact that we have an unusually patchworky health care system.