While Republicans in Congress have never said America's health care system is perfect, they've certainly argued that dramatic change and more government regulation would be going too far in the name of making insurance available to everybody while trying to lower costs of care. Maybe a little tweaking is needed, they say, but otherwise the free market and competition among insurance companies will bring costs into line.

So how's that going? Well, if California is any example, not too well. Anthem Blue Cross, that state's largest for-profit insurer, is planning to raise rates for some individuals by up to 39 percent. That'll be a killer, maybe literally, for people who are already on the economic edge.

The company defends its plans by noting that the economic crisis has prompted some healthy people to give up insurance in order to save money, which means Anthem is left with a smaller number of policy-holders and a greater percentage of people among them who are suffering from various illnesses. That means more expense for the company and thus higher rates for policy-holders.

This situation is likely to be felt in other states as well. Meanwhile, Medicare and Medicaid government programs are growing in size and expense. Emergency rooms are crowded with uninsured people getting care the only way they know how.

People are still losing their jobs, which puts those with employer-connected health insurance in dire circumstances indeed, particularly if they have pre-existing conditions. Then there is the increasing shortage of primary care doctors, a problem that's becoming worse as more medical students drift toward lucrative specialties.

With the loss of a U.S. Senate seat in Massachusetts, Republicans now have the parliamentary power to filibuster health care reform, which President Barack Obama set as one of the centerpieces of his agenda. Sadly, Republicans have stayed in lockstep in opposition.

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