Thanks to a little gift from your favorite congressman, there's confusion over Medicare and Medicare Advantage. Not happy with the simplicity of plain-old-vanilla Medicare (and the fact that insurance companies were left out of the financial loop), Congress came up with the bright idea of introducing "competition" into the public system.

They allowed private insurers the opportunity to provide health care services to Medicare patients.

For some patients the plans work OK. But unfortunately for the taxpayers, Advantage is 12.5 percent costlier than what straight Medicare pays, so the myth that the private sector is cheaper than the public has been terribly shattered.

They do have added costs, like marketing and actuarial, which is the process of deciding which patients to allow into the system and which to deny. Thus we pay extra for their sales commissions and the cherry-picking that draws healthy people from the senior pool and makes real Medicare look less efficient.

Traditional Medicare is probably the only part of our health care system that does work well. It didn't need competition, but if it did, paying private insurers 12.5 percent more is not the free market approach most of us would expect. It's just another government giveaway to private industry.

Medicare patients currently go to their doctors for care and the government pays the bill though a private administrator (which is WPS in Wisconsin). What could be simpler? You get sick; you get care; and the care-giver gets paid!

The biggest disadvantage with Advantage (pun intended) is that the government pays the private insurers a lump sum per patient, so whatever health services the plan can avoid providing goes to the bottom line in profits.

Thus there too often is an incentive to deny services even when the patient is in need, or to have "pre-authorization" requirements that are easily overlooked by the patient, who then gets stuck with the bill rather than the plan.

To be fair, some Advantage HMO plans have tried to offset these issues by adding additional services, like limited dental and vision. But still these features can have tricky referral and pre-authorization requirements that void them.

Medicare Advantage plans can also deny coverage when hospital admissions are not pre-approved, thus sticking the patient with a massive bill. That's great flexibility, but it's all theirs.

In regular Medicare, physicians are reimbursed on a fee-for-service basis, and they get paid no matter how many times you see them or tests they perform. But you are not denied care.

If anything it can actually increase costs to the government, especially if the tests add profits to the physician's bottom line.

But even while providing more testing, Medicare's outlay per patient is still 12.5 percent lower than the Advantage system, and are most certainly lower than the high-profit policies. But we taxpayers are generous.

Our problem is not competition between the various insurance entities; it is systemic.

A true single payer system, like the Medicare-for-all system proposed by Sen. Mark Miller and Rep. Chuck Benedict (SB51/AB94), would eliminate the gigantic waste of the insurance bureaucracy, which consumes roughly 31 percent of health-care dollars without ever providing direct health care services.

The Health Security Act would cut in half these administrative costs, add dental and vision, eliminate co-pays and deductibles, and still provide coverage for 100 percent of our population, all at a lower cost than our current privatized system.

State politicians can fix the problem if they are willing to shun the delaying tactics being used.

We've seen enough experiments. They must simply sideline the special interests and adopt the Miller-Benedict bill.

It would be a windfall for businesses and the public alike.

-- Lohman, a retired business owner from Colgate, is author of "Politicians -- Owned and Operated by Corporate America."