The president’s summit on health care revealed major schisms between public policy and reality. Those who feel that they must keep repeating to Americans that their health care is “broken” overlook a more fundamental problem.

Most Americans, based on a lifetime of experience, don’t think the medicine practiced by their own physician is broken. So they don’t believe surveys conducted by the United Nations claiming health care is better in other countries. But more importantly, most Americans — 86 percent, in a recent CNN survey — indicate that they think government is broken. So whatever they think of their medical care, they are unlikely to think that a broken government can fix it.

Yet, at the summit, the president and majority leaders behaved as if medical care would be best improved by a hundred or so new government agencies, boards and commissions to micro-manage most health-care decisions — from requiring physicians to administer patient treatments dictated by government protocols to requiring medical equipment manufacturers to pay fees for daring to invent new technologies.

Additionally, prior to the summit the president had to propose the creation of a new “Health Insurance Rate Authority” to tell insurance companies what premiums they can charge after fifty states already tell them the same thing. (No thought was given to how eliminating some agencies would improve costs.)

Not since Ayn Rand wrote Atlas Shrugged has anyone thought up more wasteful and destructive government agencies to control every aspect of the economy and our daily lives. At least Atlas Shrugged was fiction. Or in 1957 it was.

Fiscal fantasy from the Senate, House of Representatives, and now from the White House, is evident with the claim that spending one or two trillion dollars (depending on how you don’t count it) will reduce the deficit. Of course the only way that this largest increase ever in the size and cost of government could reduce the deficit is by the largest tax increase in history. Americans don’t think that huge increases in the size of government are the best way to reduce deficits.

The most amusing departure from reality was the idea that the president can proceed (and risk the political consequences) without bipartisan support. That assertion is nothing new — nothing has been bipartisan in Congress in the past year, not the bills passed by the Senate and House, nor the president’s recent proposals. That bipartisan ship sailed long ago. But the reality is that the president has not been able to proceed with Democratic support, which is more precarious than ever in the House of Representatives. When you have a large majority in the House — which requires only a simple majority to pass any bill — you cannot blame the Republicans if you fail. But they hope to force everything through, ignoring the meaning of recent elections as well as the next one.

This failure to recognize realities has two major causes, both of which eliminate real and appropriate reform of health care. The first is ideological. Many in the majority cannot conceal their contempt for insurances companies, physicians as “profiteers,” drug companies (whose profits pay for new medications), for all business activity as such. Better no medical care than medical care fueled by a return on investment.

The second cause is feeding the spoils systems of politicians who push for growth in government as the primary objective, for which health care is only the excuse. More government is good, but more specific pay-offs to your own political clients is better.

The president’s summit was a perfect case of form without substance. But it did cast light on the root of our problems in health care.