Meanwhile, we sit anxious, and he sits with a cool equanimity…just waiting for the optimal moment to unveil his masterpiece. Or….he still may be sifting through the eggs (when it comes to health plans and proposals, there’s no shortage of geese). He still intends to have Congress actively involved in the process. This gives him the addition of political points with the legislature, but will ultimately be a subtraction from whatever he desires as an optimal arrangement (i.e. each Congress man or woman will want and not want things that they feel they can sell to THEIR voters…not all voters). Hopefully, the plus signs are greater than the minus signs (making it the antithesis of the carbon-trade bill that’s been floating around lately). Time will surely tell.

Regarding the second point your bring up (cost), I agree…someone always has to pay the bill, which is the focus of this editorial, like you said. But the bigger question becomes, what EXACTLY is driving up the cost of health care at different places, different times? Some believe there are “efficiencies” to be had in various facets of our chimeric system, but when it comes to actually estimating how much money is to be saved through their elimination…they tend to agree to disagree. Another factor to consider is the American appetite for health care. In comparison to some other places, our health care meals certainly come with more courses (for some people, definitely not all). So, we have to throw “demand” somewhere in our calculation…and then account for a litany of variables (which I won’t list out of sympathy for the readers)….to ultimately lead us to some understanding of what we’re working with and what should be done. Not easy stuff (which is another reason I’m not impatient with the Obama team…out of courtesy we could at least give him the first year of his first term to rectify all of America’s outstanding issues). But yes, when the reform tires hit the pavement, cost will be on all the road signs.

I (and other readers I’m sure) appreciate your excellent comments and chance for more dialogue and learning. And I’m looking forward to taking a peek at the New Yorker link you provided.

In other words, we have no idea what he’ll do, not because he is without a plan – far from it – but rather he is playing it close to the vest.

Even if Obama were another politician, which he is, the crux of the argument is, as the author mentions, is cost. It does not matter if the government or the private sector writes the checks, the cost is still way too high and we do not have anything to show for it. Who says so? The new Medicare data says so. According to this new article from the New Yorker:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

“Nearly thirty per cent of Medicare’s costs could be saved without negatively affecting health outcomes if spending in high- and medium-cost areas could be reduced to the level in low-cost areas,” Peter Orszag, the President’s budget director, has stated. The Mayo Clinic has world class service, with one of the lowest costs in the country. If we bring costs down to Mayo Clinic levels, budget problems are fixed for 50 years – and promises by politicians would be a thing of the past.