"Why is it that we spend more than $6,000 per person per year for health care in this country and still have close to 47 million people with no coverage, while Canadians spend about half of what we spend, yet have longer life expectancies, lower infant mortality rates, and all their people have equal care available to them?" Dan Kanoza aimed his question at the presidential candidates, one of nearly 2,000 questions submitted by our readers for AARP's two presidential forums.

It's the right question for Congress, too. Especially today. Kanoza is 79, a retired industrial engineer who lives in Cincinnati. He says he's in good health, yet he, like 43 million other Medicare recipients, has seen health care costs skyrocket. The cost of the monthly premium paid by all Medicare enrollees has more than doubled in the past decade—from $43 to $96—and is expected to keep climbing. And because the factors driving the cost of Medicare premiums are the same factors driving up all health care costs, there's no end in sight.

Hospital and outpatient costs, doctors' bills and drug prices are rising faster than the inflation rate, beyond the cost-of-living adjustment for Social Security and far faster than wages and salaries.

What makes Kanoza's question especially timely is the ongoing health care debate on Capitol Hill. Congress started the year exploring ways to stabilize Medicare premium hikes, curb waste, trim the 12 percent overpayment to private Medicare Advantage plans, ensure that doctors don't abandon the program, and extend health insurance to uninsured Americans.

Lawmakers tried and failed to authorize government purchases of prescription drugs or individual purchases of drugs from Canada.

Today, Congress and the White House are battling over the children's health insurance plan. But the Medicare agenda is stuck.

Some progress on assuring affordable health care has occurred in the states. According to the National Governors Association, four states have implemented universal coverage, and 14 more are at varying stages of expanding coverage.

Health care has changed dramatically since 1965, when Lyndon Johnson signed Medicare legislation. (The program has grown from $2.7 billion that year to an estimated $372.3 billion this year.) So have Medicare's shaky finances. It faces bankruptcy in 2019.

Public health is far more complex today, with new research, new treatments and new technology that have conquered plagues and fearsome ailments. These developments have added to the cost of the medical bill (even while helping us live longer). But Dan Kanoza is right: The United States is not keeping pace. Other industrialized nations spend less and get better health care.

Congress has a chance to take an important step to ease the burden of soaring costs by reopening its discussion of Medicare financing. [See Bill Novelli's column on AARP.org.] Failure to do so would leave Americans losing twice. First, costs will continue to rise. Second, a polarized Congress, which has already watched Medicare premiums double, is making itself irrelevant in the critical discussion over the future of health care.