Another ignorant question of mine

Kevin Drum notes the persistence of a disturbing trend:

JOBS UP, HEALTH INSURANCE DOWN....The number of people suffering from a chronic lack of health insurance jumped more than 10% in 2003: An additional 2.6 million people ages 18 to 64 were uninsured for more than a year [...]

Which brings up a nagging question. A couple, really. First, is the cost of insurance driving up the cost of health care, or is it the other way around?

And second, since we have no way to know how insurance companies set their rates, how would we know whether we're being overcharged for insurance?

Am I the only one who wonders about this stuff?