Who is better positioned to make health care decisions, you and your doctor, or the governor and his bureaucrats?

Based on the premise of his Illinois Covered, Gov. Rod Blagojevich is betting you believe it's him and the bureaucrats.

The plan is modeled on Healthy New York, a plan designed to fix New York's ailing health insurance market. Yet, Healthy New York has only succeeded in becoming a widely recognized culprit behind the most expensive and wasteful Medicaid program in the country.

Now Gov. Blagojevich wants to import that plan - only on a much larger scale.

The proposal calls for Illinois families of four earning $80,000 per year to be made Medicaid eligible. It forces insurance companies to offer state-subsidized policies, replete with expensive mandates and price caps, and it forces insurance companies to accept all comers - regardless of risk.

His projected cost is $2 billion and, as originally proposed, it would be funded by a $1 billion payroll tax and Gross Receipts Tax.

But sticker shock shouldn't be the only thing to give Illinoisans pause; the fact that the program addresses the wrong problems should also weigh heavily.

Those wrong reasons are that health care is too expensive, that providers are inefficient and businesses are refusing to provide more to workers.

While it's true that Americans do spend significantly more on health care than the rest of the world, it's been true since at least 1950. Long before health care was in "crisis" or there was large-scale government intervention, Americans spent more on health care.

Americans also spend more on cars, TVs and technology. But there are few calls to fundamentally restructure these markets.

According to authorities on the British health care system, Britain would have to spend a third more on health care per capita to reach U.S. levels of care. This should be celebrated, not condemned.

Skyrocketing health care inflation is another target of the governor's plan. Yet, average health care inflation in the United States has been 4.9 percent per year from 1960 to 2002, according to figures from the Organisation for Economic Cooperation and Development. That puts the United States in the middle of the pack of western democracies.

Health care–;inflation is higher in France (5.2 percent) and Japan (7 percent) while lower in Canada (4 percent) and Germany (3.5 percent). All have designed their systems differently, yet annual prices increases are similar.

From this we can conclude that rearranging the health care deck chairs won't have an impact on inflation in health care costs.

Other rationales for Illinois Covered include uncompensated care, the uninsured and preventive care.

Recent national studies demonstrate that uncompensated care amounts to a mere 3 percent of costs - and most of that is comprised of insured patients refusing to make co-payments.

Chronic illnesses, another target of Illinois Covered, can be treated more cost effectively with preventive measures and compliance but the financial impact is insignificant.

Finally, the problem of the uninsured has been exaggerated.

Recent revisions to the Census Bureau's 2005 figures show that there are 1.8 million fewer Americans without insurance than earlier reported.

There are a half a million fewer children without insurance than at the beginning of the Bush administration. By historical standards the numbers of uninsured are quite low, according to Grace-Marie Turner of the Galen Institute.

Harvard health economist Joseph Newhouse and others point to innovation and technology as major contributors to health care inflation.

Unlike the business world, where the desktop computer replaced the typewriter, new health technologies do not replace old ones but instead new technologies tend to expand the universe of treatments and patients. More patients are able to be treated for more things in more ways. This means more spending.

The only way to arrest technology is to ration it. Inevitably, Illinois Covered will do just that.

Under Illinois Covered, participants are offered choices in insurance companies, but prices and services will be set by the state. Insurance companies unwilling to stomach price caps will leave the Illinois market just as private insurers have left New York - leaving consumers with higher prices and fewer choices.

To make ends meet at the state level, just like Medicaid, services and doctor reimbursements will shrink in some form or manner.

Because companies must guarantee insurance to all comers, many won't enroll until they are sick. This increases pressure on insurance premiums and health costs which in turn will cause the healthy to drop coverage to avoid subsidizing the sick.

The subsequent rising costs will force businesses to drop coverage creating even more demand for Illinois Covered. After all, once premiums exceed 3 percent of payroll, pushing employees to Illinois Covered will make more economic sense for your boss.

Instead of starting us down the road to rationed care, Illinois should take steps toward more consumer-driven reforms. Solutions such as health savings accounts and the Medicare Prescription Drug Benefit are proving themselves every day.

These are just two examples of market-oriented approaches that satisfy patients and save money.

And isn't that what the whole exercise is about?

Greg Blankenship is president of the Illinois Policy Institute and author of the recent report, "The Medicaid Fix: Increasing Access and Quality Without Breaking the Bank."