Our neighboring congressman to the north, Idaho Rep. Raul Labrador, made an unfortunate comment at a town hall meeting last week -- saying that nobody dies because they don’t have access to health care.

I’m sure he wishes he could restate the point he was trying to make. He managed to get on the national news as an example of Republicans being insensitive.

It’s hard to never say anything inappropriate in politics, especially when one has to think on one’s feet in high-pressure situations. Even the smooth, smart and disciplined orator Barack Obama has said some really dumb things.

Labrador’s comment and the ensuing reaction, and the national furor over health reform all across the country, demonstrates how emotional and difficult this issue has become. It’s nearly impossible to stake out a sensible position that attracts widespread support, that responsibly deals with the healthcare crisis, while not requiring massive tax increases or running up the national debt.

In the massive uprising against the healthcare plan just passed by the U.S. House, it’s easy to forget that Obamacare, in many ways, was a disaster. It was so unpopular that it contributed significantly to big Democratic losses in Congress and Republicans winning control over Congress and the presidency.

But Obamacare did bring a lot more people into the system of government benefits. And despite its many flaws, the Obamacare mandate that everyone buy health insurance, and everyone is covered in some fashion, created and strengthened the notion that healthcare access is an absolute right that everyone should enjoy, at a price they can afford, no matter their situation in life.

Once a government benefit has been extended, it’s nearly impossible to withdraw it. Thus, as other commentators have stated, we’ve crossed a critical tipping point in this country. Everyone must have access to full medical benefits. And society (that’s you and me) must pay for it.

The trouble is, the only truly effective way to ensure that everyone has full access to healthcare is through a single-payer system. Essentially, put everyone on Medicare. That’s what the Democrats really want. And that may be where we’re headed.

Republicans want a market-based system. But we’ll never have a true free enterprise system in healthcare as long as employers provide health insurance and as long as insurance pays for most healthcare needs. If insurance provided only catastrophic coverage, and we paid for most procedures out of our own pockets, then free-market incentives would be injected into the system. We’d shop around and pay attention to what various health services cost.

Healthcare has not been a free market system for many decades, and probably will never be. We’re not smart healthcare consumers.

Perhaps the U.S. Senate can cobble together some miracle system that gets everyone covered, despite pre-existing conditions, and does it without busting the budget or massively raising taxes. But I doubt it.

It may take a few years, but we’re probably headed to a single-payer system. And if everyone has coverage for everything, there will be little incentive to be wise healthcare consumers. To make up for this defect, the system will impose its own controls. Healthcare will have to be rationed. Panels of doctors (the infamous death panels) will determine what levels of care are appropriate in what situations – and what prices will be.

As in other countries with single-payer systems, we will see shortages and long waits for procedures.  Market incentives to improve service and innovate will not exist.

But everyone will have some government-determined level of healthcare access and service. Wealthy people, of course, will be able to pay for the best healthcare in the world.

The system of healthcare we had before Obamacare had all kinds of problems. Responsible people recognized we were in a healthcare crisis. While solving some problems, Obamacare created a lot of new ones. The House plan made some improvements, but many flaws remain. The Senate is going to struggle mightily to do any better.

I suspect the healthcare issue is going to cause political headaches for many years to come.