The new health care law is raising its head once more as the election campaign heats up.  The Congressional Budget Office (CBO) has dropped a bomb, it raised its initial estimate for what the law will cost from $800 billion to $1.7 trillion more than double  the original estimate.  Of course we will need to follow Congresswoman’s Pelosi’s famous maxim, “We have to pass the bill to see what is in it,” now we have to let the law work to see how much it will actually cost. 

I am amazed that the health insurance industry is not underwriting President Obama’s re-election campaign.  He is bringing them an estimated 40 million new customers with guaranteed premium payment.  Under the new law all must buy health insurance and, for those who cannot pay the premiums, the Federal Government will pay.   Sure the insurers will have to insure all comers, not matter their age or condition, but they will be able to set premiums according to the higher risk.  The bottom line is that the insurance companies get 40 million new customers with guaranteed payment. 

No matter what the new law actually costs, the main item Obama points to as paying for this will be the $500 billion he takes from Medicare, my health care program.  Essentially we old boys will be paying much of the tab to extend insurance to those who do not have it now.  While I should be concerned, I am sure that when he sees potential big losses of  senior votes, the president will reconsider stealing from Medicare to pay for the currently uninsured and drop the Medicare cuts.  

So what do we have?  A new health care law that does nothing to reduce the costs of health care.  It does extend insurance coverage but at what cost?   Sort of like we should give free college education to all the willing and able but at what cost?    We should have a clean, stable environment but at what cost?  

I believe the public option alternative, i.e. have a single payer health care system with that single payer being the Federal Government offers a much better way to control health care costs, the payer determines what it will pay as well as what services each client receives.  Expanding the health insurance industry will simply expand and sharply increase the rapid rise in health care costs.  Of course letting the Feds set what services you will receive does not sit well with many voters and letting the Feds set fees it will pay does not sit well with the doctors.

There is one idea that provides some control over costs while preserving one’s right to choose (pro-choice?).  Republican Congressman Paul Ryan has proposed turning Medicare into a voucher system.  This is the Medicare I already have.  Medicare pays a set fee for my care and I am free to shop for the best deal I can find for that fee.  The choices vary in terms of how much I must chip in to pay for services and what services I receive.  But there is a wide assortment of choices and so far I have tried three different plans.  Essentially the Feds control costs by setting the fee it will pay for my care, my voucher.   But it allows me the freedom to choose among several offers of services.