Eileen has spent some time trying to negotiate the health care morass.

What she has discovered is the fundamental truth that partisans on both sides want to ignore.

Eileen is not an economist, at least not officially. But she is a wife and mother of three, so she is, by necessity, an economist of sorts. She runs a household in south St. Louis County.

She has a couple of years of college, and she worked in the payroll department of a local builder. That was years ago. A co-worker set her up with a blind date, and that date was with her future husband, Rick. He was an MBA student at St. Louis University.

They were married in May 1987. They had three kids. While the kids were little, Eileen stayed home. When the kids started school, Eileen worked part-time jobs.

Six years ago, she was diagnosed with lupus and two associated auto-immune diseases. Fortunately, she had good health insurance. It came, of course, from her husband's job. He is on the management side of a small company. He makes pretty good money, and the family is comfortably in the middle class.

Still, with three kids and college tuition to factor in, things are tight. Factor a health insurance problem into this equation.

Rates have been rising for years. Actually, they've been soaring. At the same time, the number of families in the "group" family policy at the company for which Rick works has been dwindling. Perhaps a solution would be for the families to investigate "individual" family coverage.

Eileen knew her medical condition would be a problem. Also, there were other, albeit less serious, issues with other members of the family. Rick broke his leg two years ago and had a rod inserted into his leg. Two of the kids were diagnosed long ago with ADHD and have been taking medication since grade school.

Eileen checked with the company that had been providing the group policy at work.

The company offered a policy at a cost of $66,000 to $86,000 a year, depending on the deductible. It wasn't as comprehensive as the family's current policy.

Eileen said she checked with the Missouri Health Insurance Pool. For the family, the premiums could run around $38,000 a year. Better, but still awfully expensive.

She wrote to the governor, and she called various state agencies. People were sympathetic. Some said things would be better in 2014, when the Affordable Health Care Act requires health insurance companies to cover pre-existing conditions.

"But what will those policies cost?" Elaine asked.

Nobody had an answer.

Therein lies the fundamental truth. Medical technology has advanced to the point that it is hugely expensive to provide everybody with the best of care.

The current health care debate nibbles at the edges of the great problem. Some of the debate is partisan enough to be silly. Is it conservatism to mandate health insurance on the state level but socialism to do so on the national level?

No matter how you come out on that, that argument is only about the methodology of accessing health care. It has little to do with the escalating costs.

Already, companies are trying to opt out of the game as much as possible. They're taking health insurance away from retirees. They're requiring employees to pay more.

How are companies going to pay escalating premiums? If the costs gets passed on to workers, how are they going to pay?

Perhaps we could have a two-tiered system. A public system for most of us, a private system for those who can afford it. That's a very American solution. It's the way we handle education.

But even in a two-tiered system, the costs will continue to go up. As medicine advances, so does longevity.

Recently, I met a 90-year-old man who told me he had just received a pacemaker. He seemed vibrant. He was up and around. I'd say the operation was money well-spent. In a column last year, I mentioned a 94-year-old man who received a pacemaker. He was an invalid before and after the operation. The operation extended his life a bit. Was that money well-spent?

Figuring out how to deal with escalating health care costs would be difficult even for serious-minded people who are not trying to score political points. We're leaving it to politicians.

By the way, things worked out for Eileen. Her husband's company is continuing the current health insurance policy for another year. Also, last week, she was awarded Social Security disability. If the reward is retroactive, she will be eligible for Medicare.