Both Houses of Congress debated a federal budget plan last week that would include cuts in Medicaid, the health care program for the poor.

Reducing Medicaid spending might help to lower the federal budget deficit, but it won't help taxpayers, the economy or put the brakes on rising health care costs.

In fact, reducing Medicaid spending will only help Congress bring its books closer to balancing.

Taxpayers will have to fund health care for the poor one way or the other.

Medicaid is a joint program run by the federal government and the states. If Congress cuts its spending, states may try to fill the gap.

Even if they don't, taxpayers will still end up

with the bill. Poor people aren't going to become healthier because Congress has allocated less

money for their health care. They will still need the same level of care, possibly more if wellness and disease prevention programs are taken away from them.

The poor will rely on hospitals, which will either pull from local governments for the money or increase the costs to paying patients to make up for the difference.

The costs will always be there and will be paid through one method or another. Any savings in the federal budget will simply be taken from another source.

The only way to real savings in Medicaid, and Medicare for that matter, is to try to bring down the cost of health care for everyone.

Congress needs to look at restructuring the health care finance system.

Few people spend their own money on health care. They either spend an insurance company's money or the government's money. That provides little incentive for cost controls.

A better system would allow people to pay for their own health care through private health care spending accounts. People would be insured only for major diseases requiring long hospital stays and tens of thousands of dollars worth of treatment. They would pay for the rest of their health care themselves from a tax-free account. They would be able to keep the money left over in this account.

That would bring market forces back into the health care industry, eventually bringing costs down.

Congress should design and enact a plan to bring such accounts to everyone.