If you signed a contract to buy an $89,000 Cadillac Escalade with no idea of how you were going to pay for it you'd be branded financially reckless not to mention stupid.

And if a car dealer or a bank saddled you with an $89,000 Cadillac Escalade that they knew upfront you lacked the means to buy the full force of government regulatory agencies would come crashing down on them for selling you a car without the demonstrated ability to make monthly payments.

Should there be a loophole that allows car dealers or banks to escape punishment for irresponsibly burdening a buyer with a car they clearly couldn't afford, rest assured some lawmaker would parade the "victim" before cameras and declare they're pursuing legislative remedies to make sure such a travesty doesn't happen again.

Then why - might you ask - would the California Assembly pass a bill to make single payer healthcare the only player in the Golden State that by their estimates will cost $400 billion a year or more than 2½ times the current state budget and have no inkling of how to pay for it?

I know. I know. How can one talk money when people are sick and need health care?

Besides the fact responsible adults have to worry about paying for things - acting like an adult isn't a prerequisite to run for elected office - there is the little issue of actually correcting what ails healthcare in this country.

With all due respect, the California Nursing Association - the driving force behind the proposal - is part of the system that is the problem.

The questions that need to be answered is how do we get control on costs as well as how do we make people more responsible for their behaviors that have a direct correlation to the need for expensive healthcare. Think of an alcoholic that needs a liver transplant, a texting 20-something that causes a crash where people are seriously injured, or lifestyles that can bring about illnesses that are expensive to treat or manage.

There is clearly a shortage of doctors and nurses. What about working on increasing the supply? But wait; that might take the upward pressure off wages and the CNA wouldn't want that.

How about establishing clinics run by the state in underserved communities where healthcare would be at little or no charge with the medical staff being provided by state edict?

If you want to become a doctor or a nurse at a University of California medical school or hospital the state could pick up the cost. In exchange a physician would have to work four years at such clinics and nurses two years. They would have the option of being housed in quarters provided by the state while receiving a salary of $40,000 for doctors and $20,000 for nurses. After that, they are debt-free and can go anywhere they want.

I can imagine the CNA brass would view that as over restrictive, an attack on their income (for at least two years), and a substantial overreach into the lives of nurses and doctors. It's the same things that are wrong with single payer as unrolled in Sacramento.

There needs to be reform and streamlining in healthcare. Given how complicated and how big of an impact it is on the economy it would be nice if the debate just didn't focus essentially on who is going to pay for it by how to offer insurance or the pursuit of a single payer approach and instead focus on how to get back to the days when health care was affordable and those that lacked the means were quietly covered as charity by medical professionals.

Granted we can't go back to 1900 or earlier. But then again that is part of the problem. We've shifted from a physically active country where issues such as obesity were at a minimum. At the same time we've pursued expensive medical or pharmaceutical solutions that have prolonged life by stringing along fatal diseases and conditions.

That's not to say we go back to 1910. What it does say is we need solutions that address the reality of what we demand of the healthcare system and how most of that contributes to it being expensive whether it is through reckless behavior when it comes to our health or suing at the drop of a hat.

Back in 1900 during child birth the mortality rate was 100 infant deaths per 1,000 live births in the United States. By 2000 the mortality rate had dropped to 6.89 infant deaths per 1,000 live births. At the same time the maternal death rate in 1900 went from 7.2 women per 1,000 live births down to 0.1 women per 1,000.

Birth defects have plummeted. More preemies are being saved than ever. Death rates from virtually every medical procedure have dropped off significantly. All of this costs money.

Yet many of us still moan and groan about healthcare costs and demand that they be brought back down to earth. The answer is really quite simple. Ration expensive healthcare procedures. We're doing that now through insurance or the lack thereof - at least that's how the argument goes. Put a government bureaucracy in charge and see whether a 23-year-old drug addict gets a heart transplant unless, of course, they are the son of a dot.com millionaire that can afford to take him to a state or another country that isn't under a single payer health insurance plan.

Before we rush into anything major with healthcare, it would be nice if someone sweated the details for a change.

This column is the opinion of Dennis Wyatt and does not necessarily represent the opinion of Morris Newspaper Corp. of CA.