Kansas Gov. Kathleen Sebelius, D, says policymakers have to think about more than health insurance if they want to solve the current U.S. health care crisis.

“Almost half of every [health care] dollar is not paying for health care at all,” Sebelius said here during an interview.

About 30 cents on every dollar covers administrative costs, and 16 cents of every dollar is “the tax we pay for Americans who don’t have insurance,” Sebelius said.

Sebelius, a former president of the National Association of Insurance Commissioners, came here Saturday to be the keynote speaker at the NAIC’s summer meeting.

Sebelius was first elected governor of Kansas in 2002 and then reelected in 2006. She is appearing frequently these days on lists of possible candidates for the Democratic vice presidential nomination.

While Sebelius was an insurance commissioner, she was chair of the NAIC’s Health Insurance and Managed Care Committee.

During the interview, Sebelius said the U.S. health care system should put more emphasis on prevention; encourage Americans to take more responsibility for risk factors that they can control, such as exercising and eating right; and make better use of technology

Sebelius also talked about strategies for helping the uninsured and making sure that workers with employer-sponsored coverage keep their coverage.

The government should use public-private partnerships to help low-income uninsured people get coverage and use the private market to help other people, Sebelius said.

The government also should share responsibility for health care costs with employers, to help the United States maintain its global competitiveness, Sebelius said.

Executives of car manufacturers have stated “fairly compellingly” that health care costs have helped make them less competitive against car manufacturers in Japan and Korea, Sebelius said.

Also during the interview, Sebelius discussed the provision of the Employee Retirement Income Security Act that preempts state regulation of employee benefit plans.

The law doesn’t work well when it comes to helping consumers with complaints or with helping them get bills paid, Sebelius said.

President Bush has tried to preempt states’ ability to regulate small group and association plans, and now Sen. John McCain, R-Ariz., the Republican presidential nominee, is trying to expand ERISA preemption , Sebelius said.

The idea of expanding ERISA preemption is “alarming,” because preemption expansion could weaken states’ ability to protect consumers facing medical situations that, in many cases, literally involve matters of life and death, Sebelius said.

Having a continued, “timely, appropriate response is essential,” Sebelius said. “The plan advocated by Republicans would dismantle the market.”