When the Supreme Court hears arguments this week over the constitutionality of the 2010 health care reform law, it will focus national attention on health care. But this week’s arguments for and against the law should lead to a debate of related issues, such as costs.

The court case, driven by the legal challenges brought by 26 states, will focus on a few narrow legal issues, notably the individual mandate provision of the law that requires nearly all American adults to acquire health insurance.

Beyond the legal issues, the health care debate has become political, which means that meaningful discussion is nearly impossible.

Conservatives and many Republicans believe the government cannot operate as efficiently as business. The opponents of the current law want market forces to correct whatever problems there are in the American health care system. But they have not proposed any realistic alternatives, despite the fact that almost nobody thinks the status quo is good.

Liberals and most Democrats point to the personal tragedies of people without health insurance and how the new law has provided millions more Americans with access to regular health care. But this group supporting the law ignores rapidly rising costs of health care.

And cost is an issue that few people today, or more than two years ago when the law was being debated, have addressed.

For people with pre-existing conditions, the law helps by forbidding insurance companies from denying coverage because of a pre-existing condition. When it comes to easing the burden on individuals, or companies offering health insurance, from paying ever-rising prices, the new law offers no relief.

The health care reform law, passed largely by congressional Democrats and backed by President Barack Obama, is officially known as “The Patient Protection and Affordable Care Act.” It’s the second part of the law’s name where the biggest failures are found. The law did increase access to heath care, but it has done next to nothing to make health care affordable.

The United States spends about twice as much per person on health care as other countries. Neither the law’s supporters nor its opponents offer a solution to that situation.

The individual mandate, now at the center of the court case, is an effort to control costs by creating a large insurance pool. By spreading the costs of health insurance coverage over many millions of people, including many younger and generally healthier people, the burden on those needing more health care is reduced. It’s reduced because it is subsidized by those not needing health care.

Beyond the narrow legal issues being debated in court this week, a new debate on health care should focus attention on some basic questions.

• Why should anyone become bankrupt because they or someone in their family becomes sick?

• What can be done to prevent health care costs from rising faster than the rate of inflation as they have been doing for more than a decade?

• Why does the United States spend double the amount, per capita, on health care as other advanced countries?

• What are the implications to the future of the United States if health care spending continues to absorb an ever-increasing percentage of the national economy?

While it is important to settle the legal issues surrounding the health care law, politics and demagoguery get in the way of meaningful discussions about how to create something better than the current, broken system.

The United States will continue to face serious health care issues, regardless of the outcome of the Supreme Court challenge. Americans should re-engage in the issue, with a focus on solving not only access but also cost issues — and keeping politics and 30-second sound bites out of it.