A look at key issues in the health care debate:

THE ISSUE: Why do medical costs increase at a rate faster than inflation?

THE POLITICS: Health care spending over the past year increased by 3.2 percent even as overall consumer prices dropped 2.1 percent. That's not unusual in the United States, where health care spending rises at rates substantially higher than inflation. Analysts agree on any number of reasons for the increases, but tend to disagree on which cause is most responsible. Among the reasons:

_Americans get too much unnecessary care — too many tests, treatments and hospitalizations that do not improve their health. The reasons for this vary: Many doctors have a financial interest in new technology, doctors and hospitals fear malpractice lawsuits and patients are indiscriminate consumers because they are shielded from health care costs through insurance or government health plans.

_Easy access to expensive new medical technologies.

_Inefficient health insurance companies with high administrative costs that don't have anything to do with actual health care.

_Unhealthy living habits that strain the system, including smoking and obesity.

WHAT IT MEANS: Curbing the rising costs of health care is at the heart of the current debate on overhauling the nation's health care system. Rising costs have placed Medicare, the federal government insurance program for the elderly, on an unsustainable trajectory that would be responsible for exploding government deficits. At the same time, employers and their workers have met with rising health insurance costs that are straining business and family budgets.

President Barack Obama will tell the nation in a prime-time address precisely how he wants to expand health care, pitching a fresh argument — but, to liberal disappointment, no demand — for a government-run insurance option.

"The president's going to speak clearly and directly to the American people about what's in this bill for them," press secretary Robert Gibbs said Wednesday, hours before Obama appeared before a rare joint session of Congress and a live national television audience.

Opening a final push for his top domestic priority, Obama will push for a health care overhaul that provides new and crucial protections for people who already have insurance, affordable access to coverage to those without, and reduced spending for families, businesses and government.

"We do intend to get something done this year," Obama said on ABC's "Good Morning America."

Even as the president prepared to speak — and continued Wednesday to write and hone the approximately 35-minute address himself — the leader of the influential Senate Finance Committee raced to broker an overhaul proposal with both Democratic and Republican input.

And Republicans pressed their case that Obama's sweeping approach won't wash.

"The status quo is unacceptable. But if August showed us anything, it's that so are the alternatives that the administration and Democrats in Congress have proposed," said Senate Minority Leader Mitch McConnell of Kentucky in prepared remarks. "That means sensible, step-by-step reforms, not more trillion-dollar grand schemes."

Discussing Obama's thinking on what is sure to be one of the most closely watched portions of the address, a senior administration official said the president will make a case for why he still believes a public insurance plan is the best way to introduce greater competition into the system.

Dr. Rudra Sabaratnam, who ran City of Angels Medical Center, faces up to 10 years in federal prison after pleading guilty to paying a recruiter nearly $500,000 to find Skid Row homeless people with Medi-Cal or Medicare cards and transport them to the hospital.

In his plea agreement, which remains under seal, Sabaratnam also agreed to pay more than $4.1 million in restitution to Medicare and Medi-Cal.

Sabaratnam, 64, is scheduled to be sentenced June 8 on two counts of illegal patient referrals.

Messages left with City of Angels and Sabaratnam's attorney were not immediately returned Friday.

U.S. Attorney Thomas P. O'Brien said the doctor masterminded a sophisticated scheme to cheat the government out of millions of dollars from about August 2004 to October 2007.

The investigation was sparked in 2006 as Los Angeles police looked into reports that hospitals were dumping homeless patients on Skid Row streets.

Sam Juniper says his health benefits weren't supposed to change after he retired in 2000 from M&G Polymers.

But he received a $40 bill in 2002 after the company's new provider, Aetna Insurance, refused to cover the cost of some blood work.

He challenged that in Mason County court in 2003 and won every decision all the way to the 4th U.S. Circuit Court of Appeals in Richmond, Va. The appeals court ruled in his favor on Oct. 10.

Lawyer Mark Underwood handled Juniper's case for free and says small bills like this add up over time.

Juniper says he is still waiting for his $40 refund check, which he plans to frame and hang on his wall.

The FTC said it may rescind its guidance on tar and nicotine yields that is based on that test. The commission said if the guidance is withdrawn, advertisers should no longer use terms suggesting FTC endorsement or approval of any specific test method.

The test, known as the Cambridge Filter Method, is a machine-based test that smokes cigarettes according to a standard procedure and is sometimes referred to as "the FTC method." The FTC issued its guidance in 1966 at a time when most public health officials believed reducing the amount of tar produced by a cigarette could reduce a smoker's risk of lung cancer. The commission believed that giving consumers uniform information about tar and nicotine yields of cigarettes would help them make informed decisions about the cigarettes they smoked.

But the FTC said Tuesday scientists now believe the test does not provide meaningful information on relative amounts of tar and nicotine people are likely to get from smoking different brands of cigarettes.

The main reason is that smokers often alter their behavior to get the necessary nicotine dosage, the FTC said. The techniques include taking larger and deeper puffs, smoking more and blocking the ventilation holes that may contribute to lower levels of tar and nicotine.

Nicotine acts as a stimulant and is one of the main factors contributing to the addictive quality of smoking. Tar is the residue from burning tobacco and one of the most destructive byproducts of smoking, accumulating in a smoker's lungs.

The 5th U.S. Circuit Court of Appeals in New Orleans ruled Monday that the state's three-year statute of limitations barred Kenesha Barnes' claim against Koppers Inc. and Beazer East Inc.

After a three-week trial in 2006, a jury found the companies liable for negligently exposing Barnes' mother, Sherrie, to harmful chemicals from the Grenada plant, which treats railroad crossties and utility poles with creosote and other chemicals.

Sherrie Barnes, who lived next to the plant her entire life, died about a year after she was diagnosed with breast cancer in June 1997. More than five years elapsed between her diagnosis and the date in 2003 when Kenesha Barnes filed a wrongful death suit on her mother's behalf.

A three-judge panel from the 5th Circuit said the companies raised "troubling questions" about how the case was handled by U.S. District Judge W. Allen Pepper Jr., including his decisions on the admission of expert testimony.

Government lawyers told a three-judge panel Friday they should reverse a lower court ruling that allowed Kansas-based Creekstone Farms Premium Beef to conduct more comprehensive testing to satisfy overseas customers.

The Agriculture Department currently tests less than 1 percent of slaughtered cows for the disease. It argues that more widespread testing does not guarantee food safety and could result in a false positive that scares consumers.

Creekstone claims the Agriculture Department has no authority to prevent companies from using the test to reassure customers.