What drives health care costs? There's truth, and there are polls.

As President Obama begins his whirlwind health care tour, his job will be to convince the unsure, angry and even incensed that the health reform legislation passed by Congress is good for health care in this country. It should be an easy argument: Any legislation that extends health care coverage for 32 million uninsured Americans, expands Medicare prescription drug coverage, increases federal subsidies to help people buy insurance, and bans denials of coverage for pre-existing conditions should not only help people stay well but should also reduce health care costs, right? After all, investments in preventative care help avoid the pain and cost of later complications. And extended drug coverage helps people keep more money in their pockets. It seems logical.

Yet when it comes to discussions of health care - and especially health care costs - people tend to be anything but logical. Even when you set aside the arguments and vitriol that have been passing for debate as of late, Americans get funny when it comes to understanding and explaining why we're in this health care mess in the first place. A majority of the Americans who describe themselves as "extremely" or "very worried" about the rising costs of health care place the blame for those increasing costs solidly at the feet of the drug and insurance industries, according to a recent poll. A majority of the nearly half of Americans who described themselves as significantly worried believe that ever greedy companies seeking ever larger profits are the reason why ordinary Americans are pinched ever harder with rising health care costs, according to the Harris Interactive/HealthDay poll. The poll of 2,389 adults was conducted online between March 11 and March 15.

But many health economists say the engines behind rising health care costs are far more complex than simple greed. And they say many of those engines are being driven by health care consumers themselves: Demand and use of increasingly sophisticated health care technologies, coupled with the prices charged by physicians and hospitals, explains a much bigger percentage of the health care cost increases than corporate profits.

"These findings show how little most people understand the economics of health care. Increased profits of insurers and drug companies (if they have increased at all) cannot possibly account for the increases in premiums," said Humphrey Taylor, chairman of The Harris Poll, a service of Harris Interactive that conducted the poll. "Many health-care economists attribute the increased cost of care to increased demand and utilization, increased prices and the increased use of expensive tests and treatments. Most people, as shown here, do not think of these as the main drivers of increased health-care spending."

That's not to say drug and insurance companies are barely making it. Obama's Health and Human Services Secretary Kathleen Sebelius has asked health care insurance companies to publicly account for their proposed premium rate hikes. In particular, she has targeted Anthem Blue Cross, which has proposed increasing Californian's premiums by as much as 39 percent, despite bountiful profits. But people do need to have a better grasp of how and why health care costs are increasing before they can decide whether they support the health reform legislation Obama is trying to sell them. While on his whirlwind tour, Obama will have to educate as well as persuade, or face potential consequences at the polls come November.

Photo Credit: Muffet