This nation's health care system can't continue on its current course. The cost and waste involved with this country's method of health care delivery are arguably the great threat to its future, even more than a foreign enemy. The fact that Congress' latest attempt at reform has progressed so fitfully, amid so much need, says much about the vacuum of leadership in Washington — particularly in the Republican Party.

Anyone who has had the surreal experience of dealing with a personal health care bill knows about the insanity of American health care economics. Anyone who has watched the insurance premiums they pay at work increase at double-digit annual rates knows that reform is an imperative.

It always is instructive, however, to hear other people's stories to be reminded about a system that spends far more, on a per-person basis, than any other advanced industrialized country and still leaves 46 million people without insurance coverage.

One such story was told on National Public Radio by a Kentucky student named Brittany Hunsaker. She talked about her 19th birthday being "bittersweet" because it was the day she officially aged out of Kentucky's insurance program for low-income youth.

Going to the doctor or dentist costs more than the weekly paycheck at her fast-food restaurant job. Back in her rural hometown, "you can get health care there if you're in a dire situation — say, if you're pregnant or recovering from drug addiction. I know a few girls who got pregnant just to afford a doctor's visit, or had another baby just to keep their health insurance."

That is the shining system — ranked 37th in the world by the World Health Organization, just ahead of Slovenia — that the opponents of reform would have us preserve.

Yes, Republicans in Congress claim they've offered alternatives. But the options they've proposed — tax breaks and lifting of limits on buying insurance across state lines — don't do enough to get at the core of American health care's problems.

That core is a disjointed pay-for-service system that too often delivers care when it's most costly and least effective but survives because it's a gold mine for health insurers and some providers.

Thanks to their limitless money and lobbying, these corporations will no longer have to worry about competing against a public option, or Medicare buy-in for people in their 50s who are now out of the Senate bill. So what's their answer to the ever-increasing medical costs that threaten to bankrupt the country and hundreds of thousands of families yearly?

The naysayers feel no need to offer real answers. They won't recognize there are non-government options like Switzerland, where coverage provided exclusively by heavily regulated private insurers offers universal care that rates far above ours, and costs far less.

Sadly, that doesn't interest Congress' reform foes — probably because it would require handing President Barack Obama a victory and challenging the interests that fund their campaigns. As long as they do, the American people will pay an ever-growing price.