In the ongoing push to reform medical insurance in Utah, the governor, lawmakers and civic leaders must take a firm stand against the doctrine of "affordable" health care.

The concept of affordability is alluring at a rhetorical level. It seem innocuous enough -- everyone should be able to "afford" health care, right? But at bottom it's alarming. "Affordable" can conceal a trap. A salesman may convince a buyer that a 100-inch TV is affordable. But that may turn out to mean, "Now you can only afford to eat Ramen noodles, until the TV is paid off."

Even the "affordable" can have its price. And that price may be steep in health care.

What about Utahns who are utterly destitute, living on the streets, or many of our working poor? For them to "afford" medical care, it must be free, like fresh air or sunlight. But then their care isn't free -- and maybe not even affordable -- for the rest of society.

The concept of affordability also ducks the question of what kind of health care is provided. Should all Utahns get "affordable" health care for every cut and scrape? For plastic surgery to take away wrinkles? For a personal trainer to get in shape and live longer? For an ambulance parked in every driveway? Probably not.

Even the most far-left of liberals doesn't think that hospitals, nurses and doctors can supply unlimited services without cost. So the question of affordability is interlaced with the question of who's paying the freight.

In the quest for affordability, the role of business looms large. Should businesses be burdened with the costs of employee health insurance? Some say, yes, insurance is just another form of compensation, no different from a company subsidy for an automobile or, in some markets, housing. Others say no, it's more like paying for a person's TV set or gym membership.

Any search for answers should begin with history. Insurance through one's employer is actually an unintended consequence of World War II wage controls. Employers, forbidden from raising salaries, threw in health care as an incentive.

The war ended a long time ago, but insurance stayed with business. It may now be time to rethink that. Good arguments can be made for shifting the responsibility back to individuals, so long as they are able to combine in groups large enough to negotiate favorable rates with insurance companies.

Giving people control of their health insurance, without undue interference from government, seems like a good idea. More individual choice is always good in a free-market, where competition helps keep costs in check.

Whether those costs end up being "affordable" is another question. Different people can afford different services. So we're wary of letting lawmakers decide the meaning of the word.

Perhaps "affordable" means ability to pay. That's ominous. "From each according to his abilities, to each according to his needs" is the slogan popularized by Karl Marx, whose ideas have been found wanting.

Perhaps "affordable" merely means that government will make health care cheaper. OK, you can stop laughing now.

The bottom line is we can't avoid the harsh reality of market prices. As economists have long known, price indicates the underlying fact that medical resources are limited. But price also allows individuals to make judgments about what services will or won't be used.

That's what this debate is really about. Those who use the rhetoric of "affordability" would take society in a direction of more government interference and an erosion of free-market pricing.

We worry that Utah politicians and business leaders may succumb to the temptation to make health insurance "affordable" by shifting and masking true prices -- trying to disguise the reality that medical care requires well-trained professionals in modern offices with advanced technology.

"Affordability" may also shield us from the fact that prudent choices are sometimes unavoidable, even when they're painful. Everyone simply can't have everything.

Make no mistake: the rhetoric of "affordable health care" is designed to move the country toward socialized medicine. To borrow a recent comment from Rep. Chris Cannon on another government-run medical scheme, "If this approach prevails, Americans should get used to the words 'I'm from the government and I am here to check your temperature.'"