Kerry's plan is to extend health insurance coverage to 27 million people at a cost of $653 million to $1.5 trillion over 10 years, depending on which estimate you believe.

Bush, a big proponent of health savings accounts, has stated he wants to expand insurance coverage to as many as 17.5 million Americans, although an independent analysis suggests it would be about a third that number.

The estimated cost of the Bush plan over 10 years is about $129 billion, according to the American Enterprise Institute.

At the core of the debate is who should pay the higher costs. Some believe the federal government should step in and defray health-care costs.

On the other side are tho

se who argue that consumers can reduce the costs by picking and choosing what levels of coverage are appropriate for their individual needs. And when consumers "pay more out of pocket, they are more prudent in their choices," Pauly told the committee.

Maybe in theory, but Cardon said that choices are affected more by income levels, not the level of coverage that might be warranted. In other words, if people can afford more insurance coverage, they get it even if they might be in a low-risk demographic group.

Even then, Cardon said, consumer behavior when it comes to spending money on health insurance is "purely random and unpredictable."

The hearing was not related to any specific legislation, and no bills related to affordability of health insurance are slated for debate before Congress adjourns in about two weeks.

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E-mail: spang@desnews.com