President Trump remarked a few months ago that health care is incredibly complicated. His first clue should have been that medical doctors have to go to school and serve as interns for a very long time before they’re allowed to practice by themselves.

Guaranteeing 20 million people who wouldn’t buy health insurance get it, in exchange for millions of families who desperately need affordable health insurance to pay for their care not being able to afford premiums is wrong-headed and stupid.

His second clue should have been that most people, upon arrival at a health care facility, have to endure running the gauntlet of check-in procedures, insurance cards, co-pays, and forms required for HIPAA and other federal laws. But billionaires who were born with silver spoons hanging from Sikorsky helicopters don’t worry about such things.

In the days of Marcus Welby, M.D.-style medicine, you would call the doctor, and the doctor would come, with a black medical bag. That’s only possible now if (a) you and the doctor are close, warm, personal friends, or (b) you’re rich. The rich can buy pretty much anything they want except good health. Even billionaires get sick, and if there’s one doctor on the planet who can help them, that man can still say “no.” Or he can say “yes, pay me” and the billionaire still dies.

Nobody can buy more life with money. It’s not what economists would call a fungible good. So, yes, it’s complicated.

But in America, we’ve taken complicated to Byzantine levels. We’ve got medical providers—the person who actually sees you; then there’s the medical facility or practice; there’s the administrative group that handles records and billing for the facility; there’s the insurance carrier; and there’s the ever-looming federal government.

The nanny state.

The process of obtaining “health care” is needlessly complicated by a government fixated on as many people as possible participating in a risk-sharing system known as health insurance. The ACA, “Obamacare,” grafted a massive government Medicaid program onto the existing health insurance market, and killed it.

Insurance company after company have withdrawn from state markets because they can’t afford to pay the claims. And people who used to get insurance from their employers at reasonable premiums now can’t afford the coverage. That’s because Obamacare mandated minimum coverages, required insurers to accept pre-existing conditions (like selling fire insurance on an already-torched house), and failed to get enough young, well people into the risk pool to cover the expenses.

This despite the fact that health insurance was required on penalty of hefty fines. But fines only deter to a degree. I read a story a while ago about how Rhode Island charged so much to register a tractor trailer to legally drive through the state that it was cheaper to pay the fines if you’re caught. I think you can guess the result of that. Similarly, people who can’t afford Obamacare premiums and 20 percent increases took their chances with the IRS.

Now President Trump did away with the IRS fines. And the U.S. Senate is about to pass some kind of health care reform, after the House of Representatives passed their version. While Senators and Congressmen argue over funding for Planned Parenthood and tax credits, and the number of people who will “lose health care,” a lot of folks who actually need health insurance aren’t insured because they can’t pay for it.

Don’t get me wrong, I am pro-life, and I care about giving a half billion dollars to abortionists. We shouldn’t do it. But on the other hand, our government has it totally wrong about health care. People without health insurance don’t lose health care. Health insurance should be a purely voluntary risk decision, which insurance companies are very well able to deal with.

It’s not the government’s responsibility to ensure everyone has equal health care. That’s because it’s impossible—remember, life is not a fungible good, and even billionaires get sick and die. The only way to ensure everyone gets equal health care is to ensure nobody gets it, so we all get zero. We are headed that way.

Government should have one goal. They should get out of the way. Provide what’s needed for those in genuine need, and ration it if necessary. For everyone else, let the market rule so premiums can decline. Keep drug companies from making obscene profit from patents for the public good, and that’s it.

We’re tired of the nanny state. A note to Washington lawmakers from Americans: It’s the premiums, stupid.