Americans are having a tough time finding common ground on health care reform.

Sure, most everyone agrees that changes are needed, but that's turning out to be an awfully narrow patch on which to build a bipartisan coalition.

We can't even agree on the size of the problem.

Most of the media and politicians cite the Census Bureau's estimate, which shows 47 million Americans are uninsured.

But some conservatives question the wisdom of using that figure for formulating health care policy, since it includes some large groups that aren't really targets for reform.

Illegal aliens, Americans who could get insurance but opt out and people who qualify for existing government programs but haven't signed up are all lumped into the Census Bureau estimate.

Of course, no one is completely without access to health care in the U.S., since hospital emergency rooms are required to treat anyone who shows up.

However, it's hard to imagine a more inefficient system for providing services to folks without insurance.

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