Ask Steve Poizner about how he’ll tackle health care costs if he recaptures his old job as California’s insurance commissioner, and he has a ready example.

Last year, he said, in a single fraud case involving bogus “medicated” creams and unnecessary urine tests, a Beverly Hills couple was charged with defrauding 27 health insurers out of $40 million.”That’s just the tip of the iceberg,” said Poizner, a Silicon Valley businessman. “Then there’s all of the fraud that never gets reported.”

Poizner held the office from 2007 to 2011 as a Republican but now is running as an unaffiliated candidate, and has made fighting fraud a centerpiece of his health care agenda.

He argues that the health industry may be forfeiting billions of dollars because the state insurance department’s fraud division is understaffed: 57 investigator jobs, or 24 percent, are unfilled.

Ultimately, that inflates health care costs and puts patients in harm’s way, he said.

“These vacancy rates are critical to fill,” Poizner said. “The less health care fraud there is, the better the quality of the health care system.”

Poizner is sounding a very different note from his Democratic opponent, state Sen. Ricardo Lara, who says reducing health care costs requires a broad transformation of health care, not just chasing criminals.

Lara, who co-authored the controversial single-payer legislation that stalled last year, said he believes health care costs will drop if people have coverage instead of postponing care until it is most urgent and expensive. “If we can get everyone comprehensive primary care, that’s a good way to start,” Lara said.

The insurance commissioner oversees car, property and some health insurance plans. Rooting out illegal activity is part of the job.