Health care reform is moving back to the top of the local and national political agenda – and for good reason.

Despite having some of the most advanced health care technology in the world, 47 million Americans are still uninsured—almost 20% of the population. Many others struggle to get and maintain employer coverage in face of rising costs to businesses.

President Obama’s proposals may help some people access low-cost care, such as Washington’s Basic Health Plan, even in the face of significant cuts to the state-run program. But that won’t treat the underlying problem: Health care has effectively become a commodity, like gold or wheat.

Despite its basic importance to human life regardless of economic circumstance, it is bought and sold in the private market, where high bidders – that is, private insurance companies – dominate the health care system.

In the past, rising health insurance costs could be somewhat accommodated by increases in corporate profits. But the current recession has put an end to that. With health care costs as high as ever, new ideas are emerging that buck the current trend, by cutting out health insurance companies and implementing a patient-first approach that deals directly with patients and employers.

The Qliance clinic in Seattle is one such provider, offering high-quality and inexpensive primary care for a monthly membership fee. Another alternative is the one that works for most other countries: single-payer health care, as proposed by Rep. John Dingell in the National Health Insurance Act of 2009.

When health care treated as a commodity, society suffers. Specialized treatment and preventive care go only to those who can pay the bill, while taxpayers are stuck with the bill for the uninsured. A system that promotes fairness and a patient-first attitute is key to a responsible system of health coverage.