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Obesity is in the news again, as the LA Times reports that in the eight years leading up to 2006, the number of Americans categorized as obese shot up a whopping 37%, causing a $40-billion-a-year rise in health care costs.

Could it be true what health insurance companies have been saying all along? That the lack of affordable health insurance today is due to a rise in health care costs, not due to a blatant manipulation of profits by the companies themselves?

After all, the disturbing truth is that the most fatal, and most costly, of preventable diseases are all linked to obesity, including heart disease, stroke, and type 2 diabetes. With insurance companies expected to absorb these costs, their claim that affordable health insurance just isn't possible anymore takes on more meaning.

Then again, the boost in health insurance companies' profits over the last 10 years is pretty good evidence that it's not all our fault in every way.

Such evidence citing obesity as both costly and dangerous is why President Obama wants to focus on preventative care in order to make affordable health insurance finally affordable. Unfortunately, you can lead a horse to water, but you can't make him drink. And along the same lines, you can show someone how to take better care of themselves, but you can't make them do it.

Opponents to the "preventative care" notion argue that those who don't take good care of themselves should pay more for coverage than those who do. However, opening up this argument to claims of discrimination is a whole different can of worms.

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The prospect of a government-run individual health insurance plan seems to be making health insurance companies very uncomfortable, particularly when it may disrupt what appears to be a near monopoly on the market.

At Businessweek, a report released by the American Medical Association claims to have found that "out of 314 metropolitan areas across the nation, 94% can be defined as highly concentrated, with two companies or even a single provider dominating the market. In 15 states, one insurer has half or more of the entire market, and in seven states, a single insurer has 75% or more."

In other words, for those searching for a good individual health insurance plan, there aren't a whole lot of options, and that lack of options might explain why health insurance premiums have gone up 9% annually over the last 7 years, while health care spending has only gone up 6.7%.

This kind of data is popular with Democrats, and President Barack Obama, who use it as evidence to support the notion of a government-run health insurance plan. Such a plan would offer basic care at a fraction of the cost.

However, opponents argue that the plan would drive the individual health insurance market under, and leave Americans to deal with a federal health insurance giant like Medicare, complete with the many flaws and substandard coverage that Medicare is reported to provide.

No one has mentioned quality of coverage either, leaving consumers to wonder exactly what kind of care, and at what cost, would be available to them should the health care plan pass.

Of course, to the 47 million uninsured Americans out there right now, minimal coverage is still better than none.

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The role of big business in current health care debates has just gotten a bit murkier, as Wal-Mart Stores Inc. supports proposals that would legally require companies to provide group health insurance for employees.

According to Chron.com, the National Retail Federation and the Chamber of Commerce lead opposition to the congressional health care proposals that include a group health insurance mandate for employees.

Wal-Mart isn't a member of either group, and a spokesman for the company states that 94 percent of its 1.4 million U.S. workers have coverage through the company, and that they need to focus on "containing costs."

Of course, both the opposition, as well as The United Food and Commercial Worker's Union, wonder how Wal-Mart's support of group health insurance mandates will contain those costs.

It will be interesting to see in coming months how these arguments play out as health care legislation slowly makes it way through congress, towards the desk of the President.

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Small business health insurance buyers can hopefully breathe a sigh of relief, since it appears that they won't be affected by the struggle over employer based coverage currently debated by Congress.

CNN Money is right - the question of whether or not a government run health care system would "upend" the employer insurance that currently covers 160 million Americans is one of the touchiest issues involved in the current drive to overhaul health care. It would be too easy for many employers to simply drop coverage, and allow employees to enroll in a government plan, funded by taxpayer dollars.

The answer to that concern is the "pay or play" clause that has been suggested. "The Health Committee bill includes a "pay or play" provision that would require employers to provide adequate coverage for their workers or subsidize a system that will."

Small business health insurance plans would be particularly vulnerable to fines imposed for not offering enough coverage. Often caught between providing for employees and making ends meet, many small business owners are simply unable to pay for higher premiums, and owners have been nervously awaiting the outcome of current health care debates.

But, according to the article, businesses of 25 employees or less would be exempted from the "pay or play" rule, protecting them from high fines and/or high premiums that could drive their businesses under.

Now, if small business health insurance could be purchased at a more affordable price, and still offer enough coverage to protect employees, that would be even better. But until then, keeping small businesses out of the "pay or play" debate is the only way to keep such employers from folding under.

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Perhaps the most contentious piece of potential health care legislation facing Congress today - namely the public health insurance plan option - seems to be suffering from a lack of concrete supporters.

According to a recent article by The Wall Street Journal, the public health insurance plan "may be losing momentum in Congress," forcing supporters to fight for it.

The issue is whether or not such an option would drive the private health insurance plan off the market. Opponents argue that with so many perks coming at a better price, no one will want to purchase individual health insurance themselves.

Supporters argue that this would force the private market to offer better coverage at more affordable prices.

Potential solutions include "a network of regional health co-operatives, and a public plan with a "trigger" that would kick in if private insurers fail to cover certain groups."

In other words, only those who are denied coverage for pre-existing conditions could qualify for a "trigger" plan, since a private company isn't likely to take them on.

This, unfortunately, does little to mediate the issue of cost. For those who can't afford coverage there must be an option.

And, as 47 million Americans can attest, there are a lot of people who can't afford a decent health insurance plan right now.