Costs are the defining issue in the health care debate, and Brookings Institution economist Gary Burtless offers some revealing new data showing the remarkably equal distribution of health spending among Americans in all income categories.

Health care spending per person, in quintiles:

• Poorest fifth: $4,477
  
• Second-poorest: $4,426
  
• Middle-fifth: $4,388
  
• Second-richest: $4,941
• Richest fifth: $4,451

Yes, the uninsured need coverage, and we must make changes so more affordable coverage will be more widely available and portable. But as politicians, interest groups, and the media continue to repeat that our health system is "hopelessly broken," "in crisis," and "must be completely replaced," it's important to understand what's happening now so we fix the right problem.

As columnist Robert J. Samuelson explained in his Washington Post column on Wednesday, "It is widely assumed that health care, like most aspects of American life, shamefully shortchanges the poor." Yet, Burtless' research shows, "On average, annual health spending per person -- from all private and government sources -- is equal for the poorest and the richest Americans."

He notes that spending is driven by federal and state programs for the poor, the disabled, the elderly, children, and other groups; by expensive job-based health insurance that depresses take-home pay; and income transfers from the young to the old through taxes and cross-subsidies of private insurance.

Samuelson notes that we've gone from spending $1 out of every $20 in our economy on health care in 1960 to $1 out of every $6 today. He questions whether we should institute policy changes that make health care a "right," requiring even more government spending that would crowd out other national needs, such as schools, roads, defense, and scientific research.