Gov. Eliot Spitzer’s plan is to reduce by half the number of uninsured New Yorkers within four years, with the goal of eventually providing coverage to everyone in the state. He does not, however, plan to achieve his goal by making health insurance more affordable. Instead, he plans to throw more of your tax dollars at the problem.

The Legislature has already passed an expansion of Child Health Plus, a state program that seeks to provide health insurance to the state’s 400,000 uninsured children. Of course, he can’t do it on his own: to pay for it, he joined in a lawsuit against the federal government over rules that limit federal matching payments to state health programs that enroll low-income children. Governor Spitzer also plans to establish an “office of long-term care” and to require that private health-maintenance organizations and other health insurance companies contribute to his efforts to increase hospital revenues and insure more New Yorkers.

If he succeeds with his plans, we’ll be looking at more government regulation — not a good thing if you want to insure more people. Instead of shaking down the federal taxpayer, Governor Spitzer should look to his own statehouse to understand why so many New Yorkers are uninsured.

In 1993, New York introduced health-care policies that require insurers to accept every application and to charge everyone the same price regardless of health. Within one month, rates for a 30-year-old single male increased by 170 percent, to $3,240 from $1,200 annually. As a result, young people with few, if any, health concerns refused to pay for the one-size-fits-all insurance and chose to do without it: 43,666 individual policyholders dropped their health insurance within a year. The resulting insurance pool contained a disproportionate number of unhealthy people and rates were $4,453 by mid-2005.

These policies — along with requirements that all individual and small-group plans cover services that are useless to many people, like hormone replacement therapy and midwifery services, and up to 15 chiropractic visits per year — has made premiums all but unaffordable in New York.

To put this in perspective, a 2002 study by a health insurance distributor, eHealthInsurance, comparing the cost of 20,000 different health policies in 42 states with 7,000 different benefit packages, revealed that in California the average annual premium for an individual policy holder was $1,500. In New York, it was more than $3,500 for a similar benefit package.

Now that there are 2.6 million uninsured New Yorkers, government dependence has followed. New York spends more money on Medicaid per capita than any other state. It has a higher percentage of deaths from chronic disease than any other state, and, according to Governor Spitzer, the state’s nursing homes rank among the nation’s worst. Based on existing government intervention in the health care market, it is no coincidence that the Pacific Research Institute ranked New York dead last among the 50 states in terms of how much control residents — as opposed to the state — have over their health care resources.

Governor Spitzer says that “every decision, every initiative and every investment must be designed to suit the needs of the patients first.” That is strange rhetoric from someone whose reforms propose to rope more children into government-run health care rather than giving families control of the money they need to buy good quality health care.

If the governor is really concerned about the needs of New York’s patients, he should repeal the laws from 1993 that force New Yorkers to pay for coverage they neither want nor need. This approach would be vastly more effective than bellying up to a federal trough in order to spend our way around home-grown problems.

No one cares about their health care as much as the patients receiving it. The only way to have a truly patient-centered system is to allow patients to take their health care into their own hands and to make the decisions that affect their own well-being. Along the way, New Yorkers would not only save money and improve their access to health care, they would gain crucial sovereignty of their own health.