Most Americans are aware that buried somewhere in the 2,000-page health care reform bill are provisions for cutting the already- strapped Medicare program by billions of dollars. Few are aware that the bill also cuts expenditures on county hospitals currently serving the poor.

In Chicago, for example, those without health insurance go to the county hospital where they are treated without regard to whether they have health insurance. If the bill is passed, however, many of these county hospitals will either have to close their doors or deny treatment to those without health insurance.

Although the bill passed by the Senate has been depicted as using coercive means to require those currently uninsured to buy insurance they cannot afford, or as imposing additional new taxes on the American working man and family, that bill is based on a fundamental lack of understanding of how the health care needs of the nation’s poor are currently served.

The desperately poor, many of them unemployed, are not equipped to deal with complicated insurance programs, deductibles, co-pays and all the other accoutrements of the typical health care policy. They are poor, they are unemployed, they are sick, they need a place to go to be treated without red tape and procedural obstacles.

County hospitals across the country that have provided that place are now threatened with a cut-off of funding and in many cases with extinction by the current health care reform bill passed by the Senate.

A number of proposals for making health care affordable for all Americans have been put forward by those who have sought to be heard during the legislative process. All these proposals have been rejected by a Congress determined to impose government control of health care.

Among these rejected proposals is to allow people to buy health insurance they can afford. Currently, government mandates require a single man to buy maternity coverage he will never use, or to pay inflated premiums to insure against going insane. It would be similar to a government mandate requiring every person to buy a Rolls Royce instead of a Ford. And then when people can’t afford to buy the Rolls Royce, they’re without any car at all.

Another rejected proposal is to allow health insurance companies to compete across state lines, thus increasing the competitive pressure to provide affordable insurance. Proposals for modest curbs on the multimillion-dollar malpractice suits that divert billions of dollars away from health care and into the pockets of high-rolling trial attorneys have also been rejected.

Even proposals for limited but cost-effective catastrophic government insurance have been rejected by those determined to have government take over health care across the board.

Robert Hardaway is professor of law at the University of Denver and the author of 17 books on law and public policy.