The House and Senate interim committee on insurance heard testimony Thursday about how states across the country are addressing health care costs. Experts from the National Conference of State Legislatures and the Kansas Health Institute gave their takes, as lawmakers listened and gave their own commentary.

Unfortunately, some of those early comments suggest that actually addressing these problems in Kansas won’t be easy. Blame was placed on the Affordable Care Act and malpractice insurance costs, both convenient ideological targets for lawmakers who would rather not confront insurance or drug companies.

The nub of the problem was actually succinctly put by KHI’s president, Robert St. Peter. According to The Topeka Capital-Journal’s Tim Carpenter, St. Peter “told legislators the rise in health spending reflected an aging population, business concentration in the insurance industry, the volume of services consumed by patients, the price of pharmaceutical medicines and prevalence of chronic diseases, such as obesity.”

Not a single one of those problems is easy to address or convenient to address.

Making the population younger on average would require substantially increasing the population, likely through immigration. That would be a challenging sell these days.

Increasing instance industry competition would require disrupting a business model that has been exceptionally profitable. Given that those same businesses are more than willing to lobby, lawmakers would tread carefully.

The volume of services consumed by patients? Lowering them meaningfully could well lead to calls of rationing and “death panels.” Who wants to tell patients they can’t have an extra test?

The price of medicines? Again, that means tinkering with businesses determined to wield political clout in defense of their profits.

Reducing the prevalence of chronic diseases seems easy only in comparison. But any progress there would take many years to unfurl, and those staggering under the burden of increased health care costs don’t have that long to wait.

Once you look beyond convenient ideological punching bags (the ACA, trial lawyers), the reason that health care costs so much in the United States is because we use a lot of it and are unwilling to make difficult choices that might end up reducing the profits of insurers and drug companies.

Calls to abolish private insurance and institute a “Medicare for All” plan have become common among liberal Democrats. That might have seemed extreme 10 or even five years ago, and we’re certainly not endorsing them. But looking at the challenges to actually making health care affordable, bold thinking and brave choices might be the only ticket out of this mess.